Skip to main content Accessibility help
×
Hostname: page-component-848d4c4894-pftt2 Total loading time: 0 Render date: 2024-04-30T11:40:43.426Z Has data issue: false hasContentIssue false

Chapter 11 - The Role of Adaptive and Innate Immunity in Alzheimer’s Disease

Published online by Cambridge University Press:  02 September 2021

Golam Khandaker
Affiliation:
University of Cambridge
Neil Harrison
Affiliation:
Cardiff University Brain Research Imaging Centre (CUBRIC)
Edward Bullmore
Affiliation:
University of Cambridge
Robert Dantzer
Affiliation:
University of Texas, MD Anderson Cancer Center
Get access

Summary

In the past the role of neuroinflammation in Alzheimer’s disease (AD) was considered to be a simple response to the established neuropathological features (e.g., the extracellular deposits of amyloid beta: neuritic plaques) of the disease. However, emerging evidence now shows it is a major contributor to the progression and development of the disease. Indeed, both preclinical and clinical research supports an early and substantial involvement of neuroinflammation in AD pathogenesis that changes in character as the disease progresses. Here, the term ‘neuroinflammation’, is used in its broadest sense to encompass any inflammatory process, whether acute or chronic, involving the nervous system. Depending on the nature of the inflammatory process diverse cell types may be involved. The central nervous system (CNS) resident cells (microglia and astrocytes) are a major component of this inflammatory response. However, in some circumstances e.g., where the blood-brain-barrier (BBB) is damaged or in areas surrounding the vasculature of the brain, other peripherally derived cells (e.g., lymphocytes, macrophages and monocytes) may also be involved. In AD the key cellular players are thought to be the CNS resident cells with its key mediators being cytokines but also chemokines, nitric oxide, hydrogen peroxide, complement and anti-microbial peptides (AMPS). However, there is also a developing interest in the potential role of adaptive immunity in the development of AD. In addition, there is increasing recognition that the neuroinflammatory processes within the AD brain are markedly influenced by genetic factors and by inflammatory processes that occur outside the CNS.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Chan, WY, Kohsaka, S, Rezaie, P. The origin and cell lineage of microglia: new concepts. Brain Res Rev. 2007;53(2):344–54.Google Scholar
Ginhoux, F, Greter, M, Leboeuf, M, et al. Fate mapping analysis reveals that adult microglia derive from primitive macrophages. Science. 2010;330(6005):841–5.CrossRefGoogle ScholarPubMed
Bianchi, ME. DAMPs, PAMPs and alarmins: all we need to know about danger. J Leukoc Biol. 2007;81(1):15.Google Scholar
Kono, H, Rock, KL. How dying cells alert the immune system to danger. Nat Rev Immunol. 2008;8(4):279–89.Google Scholar
Medzhitov, R. Recognition of microorganisms and activation of the immune response. Nature. 2007;449(7164):819–26.Google Scholar
Stewart, CR, Stuart, LM, Wilkinson, K, et al. CD36 ligands promote sterile inflammation through assembly of a Toll-like receptor 4 and 6 heterodimer. Nat Immunol. 2010;11(2):155–61.Google Scholar
Colton, CA. Heterogeneity of microglial activation in the innate immune response in the brain. J Neuroimmune Pharmacol. 2009;4(4):399418.CrossRefGoogle ScholarPubMed
Boche, D, Perry, VH, Nicoll, JA. Review: activation patterns of microglia and their identification in the human brain. Neuropathol Appl Neurobiol. 2013;39(1):318.CrossRefGoogle ScholarPubMed
Ransohoff, RM. A polarizing question: do M1 and M2 microglia exist? Nat Neurosci. 2016;19(8):987–91.Google Scholar
Yamasaki, R, Lu, H, Butovsky, O, et al. Differential roles of microglia and monocytes in the inflamed central nervous system. J Exp Med. 2014;211(8):1533–49.Google Scholar
Perry, VH, Holmes, C. Microglial priming in neurodegenerative disease. Nat Rev Neurol. 2014;10(4):217–24.Google Scholar
Perry, VH, Nicoll, JA, Holmes, C. Microglia in neurodegenerative disease. Nat Rev Neurol. 2010;6(4):193201.Google Scholar
Tajiri, N, Kellogg, SL, Shimizu, T, Arendash, GW, Borlongan, CV. Traumatic brain injury precipitates cognitive impairment and extracellular Aβ aggregation in Alzheimer’s disease transgenic mice. PLoS One. 2013;8(11):e78851.Google Scholar
Koshinaga, M, Katayama, Y, Fukushima, M, et al. Rapid and widespread microglial activation induced by traumatic brain injury in rat brain slices. J Neurotrauma. 2000;17(3):185–92.Google Scholar
Gentleman, SM, Leclercq, PD, Moyes, L, et al. Long-term intracerebral inflammatory response after traumatic brain injury. Forensic Sci Int. 2004;146(2–3):97104.CrossRefGoogle ScholarPubMed
Griciuc, A, Serrano-Pozo, A, Parrado, AR, et al. Alzheimer’s disease risk gene CD33 inhibits microglial uptake of amyloid beta. Neuron. 2013;78(4):631–43.Google Scholar
Bradshaw, EM, Chibnik, LB, Keenan, BT, et al. CD33 Alzheimer’s disease locus: altered monocyte function and amyloid biology. Nat Neurosci. 2013;16(7):848–50.CrossRefGoogle ScholarPubMed
Okello, A, Edison, P, Archer, HA, et al. Microglial activation and amyloid deposition in mild cognitive impairment: a PET study. Neurology. 2009;72(1):5662.CrossRefGoogle ScholarPubMed
Yasuno, F, Kosaka, J, Ota, M, et al. Increased binding of peripheral benzodiazepine receptor in mild cognitive impairment-dementia converters measured by positron emission tomography with [(1)(1)C]DAA1106. Psychiatry Res. 2012;203(1):6774.Google Scholar
Diorio, D, Welner, SA, Butterworth, RF, Meaney, MJ, Suranyi-Cadotte, BE. Peripheral benzodiazepine binding sites in Alzheimer’s disease frontal and temporal cortex. Neurobiol Aging. 1991;12(3):255–8.Google Scholar
Cagnin, A, Brooks, DJ, Kennedy, AM, et al. In-vivo measurement of activated microglia in dementia. Lancet. 2001;358(9280):461–7.Google Scholar
Venneti, S, Lopresti, BJ, Wang, G, et al. PK11195 labels activated microglia in Alzheimer’s disease and in vivo in a mouse model using PET. Neurobiol Aging. 2009;30(8):1217–26.CrossRefGoogle Scholar
Edison, P, Archer, HA, Gerhard, A, et al. Microglia, amyloid, and cognition in Alzheimer’s disease: An [11C](R)PK11195-PET and [11C]PIB-PET study. Neurobiol Dis. 2008;32(3):412–9.Google Scholar
Wiley, CA, Lopresti, BJ, Venneti, S, et al. Carbon 11-labeled Pittsburgh Compound B and carbon 11-labeled (R)-PK11195 positron emission tomographic imaging in Alzheimer disease. Arch Neurol. 2009;66(1):60–7.CrossRefGoogle ScholarPubMed
Kreisl, WC, Lyoo, CH, McGwier, M, et al. In vivo radioligand binding to translocator protein correlates with severity of Alzheimer’s disease. Brain. 2013;136(Pt 7):2228–38.Google Scholar
Yokokura, M, Mori, N, Yagi, S, et al. In vivo changes in microglial activation and amyloid deposits in brain regions with hypometabolism in Alzheimer’s disease. Eur J Nucl Med Mol Imaging. 2011;38(2):343–51.Google Scholar
Sudduth, TL, Schmitt, FA, Nelson, PT, Wilcock, DM. Neuroinflammatory phenotype in early Alzheimer’s disease. Neurobiol Aging. 2013;34(4):1051–9.CrossRefGoogle ScholarPubMed
Minett, T, Classey, J, Matthews, FE, et al. Microglial immunophenotype in dementia with Alzheimer’s pathology. J Neuroinflammation. 2016;13(1):135.Google Scholar
Campbell, GL, Williams, MP. In vitro growth of glial cell-enriched and depleted populations from mouse cerebellum. Brain Res. 1978;156(2):227–39.Google Scholar
Sofroniew, MV, Vinters, HV. Astrocytes: biology and pathology. Acta Neuropathol. 2010;119(1):735.Google Scholar
Medeiros, R, LaFerla, FM. Astrocytes: conductors of the Alzheimer disease neuroinflammatory symphony. Exp Neurol. 2013;239:133–8.CrossRefGoogle ScholarPubMed
Koistinaho, M, Lin, S, Wu, X, et al. Apolipoprotein E promotes astrocyte colocalization and degradation of deposited amyloid-beta peptides. Nat Med. 2004;10(7):719–26.Google Scholar
Farina, C, Aloisi, F, Meinl, E. Astrocytes are active players in cerebral innate immunity. Trends Immunol. 2007;28(3):138–45.Google Scholar
Togo, T, Akiyama, H, Iseki, E, et al. Occurrence of T cells in the brain of Alzheimer’s disease and other neurological diseases. J Neuroimmunol. 2002;124(1–2):8392.Google Scholar
Yang, YM, Shang, DS, Zhao, WD, Fang, WG, Chen, YH. Microglial TNF-alpha-dependent elevation of MHC class I expression on brain endothelium induced by amyloid-beta promotes T cell transendothelial migration. Neurochem Res. 2013;38(11):2295–304.Google Scholar
Schenk, D, Barbour, R, Dunn, W, et al. Immunization with amyloid-beta attenuates Alzheimer-disease-like pathology in the PDAPP mouse. Nature. 1999;400(6740):173–7.Google Scholar
Nicoll, JA, Wilkinson, D, Holmes, C, et al. Neuropathology of human Alzheimer disease after immunization with amyloid-beta peptide: a case report. Nat Med. 2003;9(4):448–52.Google Scholar
Monsonego, A, Imitola, J, Petrovic, S, et al. Abeta-induced meningoencephalitis is IFN-gamma-dependent and is associated with T cell-dependent clearance of Abeta in a mouse model of Alzheimer’s disease. Proc Natl Acad Sci USA. 2006;103(13):5048–53.CrossRefGoogle Scholar
Pierson, E, Simmons, SB, Castelli, L, Goverman, JM. Mechanisms regulating regional localization of inflammation during CNS autoimmunity. Immunol Rev. 2012;248(1):205–15.Google Scholar
Streit, WJ, Sammons, NW, Kuhns, AJ, Sparks, DL. Dystrophic microglia in the aging human brain. Glia. 2004;45(2):208–12.Google Scholar
Ethell, DW, Shippy, D, Cao, C, et al. Abeta-specific T-cells reverse cognitive decline and synaptic loss in Alzheimer’s mice. Neurobiol Dis. 2006;23(2):351–61.Google Scholar
Cao, C, Arendash, GW, Dickson, A, et al. Abeta-specific Th2 cells provide cognitive and pathological benefits to Alzheimer’s mice without infiltrating the CNS. Neurobiol Dis. 2009;34(1):6370.Google Scholar
Dansokho, C, Ait Ahmed, D, Aid, S, et al. Regulatory T cells delay disease progression in Alzheimer-like pathology. Brain. 2016;139(Pt 4):1237–51.Google Scholar
Lee, WL, Slutsky, AS. Sepsis and endothelial permeability. N Engl J Med. 2010;363(7):689–91.Google Scholar
Nau, R, Sorgel, F, Eiffert, H. Penetration of drugs through the blood-cerebrospinal fluid/blood-brain barrier for treatment of central nervous system infections. Clin Microbiol Rev. 2010;23(4):858–83.CrossRefGoogle ScholarPubMed
Simard, AR, Soulet, D, Gowing, G, Julien, JP, Rivest, S. Bone marrow-derived microglia play a critical role in restricting senile plaque formation in Alzheimer’s disease. Neuron. 2006;49(4):489502.Google Scholar
El Khoury, J, Toft, M, Hickman, SE, et al. Ccr2 deficiency impairs microglial accumulation and accelerates progression of Alzheimer-like disease. Nat Med. 2007;13(4):432–8.Google Scholar
Mildner, A, Schlevogt, B, Kierdorf, K, et al. Distinct and non-redundant roles of microglia and myeloid subsets in mouse models of Alzheimer’s disease. J Neurosci. 2011;31(31):11159–71.Google Scholar
Hawkes, CA, McLaurin, J. Selective targeting of perivascular macrophages for clearance of beta-amyloid in cerebral amyloid angiopathy. Proc Natl Acad Sci USA. 2009;106(4):1261–6.Google Scholar
Swardfager, W, Lanctot, K, Rothenburg, L, et al. A meta-analysis of cytokines in Alzheimer’s disease. Biol Psychiatry. 2010;68(10):930–41.CrossRefGoogle ScholarPubMed
Engelhart, MJ, Geerlings, MI, Meijer, J, et al. Inflammatory proteins in plasma and the risk of dementia: the rotterdam study. Arch Neurol. 2004;61(5):668–72.Google Scholar
Tilvis, RS, Kahonen-Vare, MH, Jolkkonen, J, et al. Predictors of cognitive decline and mortality of aged people over a 10-year period. J Gerontol A Biol Sci Med Sci. 2004;59(3):268–74.Google Scholar
Kuo, HK, Yen, CJ, Chang, CH, et al. Relation of C-reactive protein to stroke, cognitive disorders, and depression in the general population: systematic review and meta-analysis. Lancet Neurol. 2005;4(6):371–80.Google Scholar
Laurin, D, David Curb, J, Masaki, KH, White, LR, Launer, LJ. Midlife C-reactive protein and risk of cognitive decline: a 31-year follow-up. Neurobiol Aging. 2009;30(11):1724–7.Google Scholar
Hu, WT, Holtzman, DM, Fagan, AM, et al. Plasma multianalyte profiling in mild cognitive impairment and Alzheimer disease. Neurology. 2012;79(9):897905.Google Scholar
Buchhave, P, Zetterberg, H, Blennow, K, et al. Soluble TNF receptors are associated with Abeta metabolism and conversion to dementia in subjects with mild cognitive impairment. Neurobiol Aging. 2010;31(11):1877–84.Google Scholar
Thambisetty, M, Lovestone, S. Blood-based biomarkers of Alzheimer’s disease: challenging but feasible. Biomark Med. 2010;4(1):6579.Google Scholar
Holmes, C, Cunningham, C, Zotova, E, et al. Systemic inflammation and disease progression in Alzheimer disease. Neurology. 2009;73(10):768–74.Google Scholar
Holmes, C, Cunningham, C, Zotova, E, Culliford, D, Perry, VH. Proinflammatory cytokines, sickness behavior, and Alzheimer disease. Neurology. 2011;77(3):212–8.Google Scholar
Tarkowski, E, Andreasen, N, Tarkowski, A, Blennow, K. Intrathecal inflammation precedes development of Alzheimer’s disease. J Neurol Neurosurg Psychiatry. 2003;74(9):1200–5.CrossRefGoogle ScholarPubMed
Galimberti, D, Fenoglio, C, Scarpini, E. Inflammation in neurodegenerative disorders: friend or foe? Curr Aging Sci. 2008;1(1):3041.Google Scholar
Patel, NS, Paris, D, Mathura, V, et al. Inflammatory cytokine levels correlate with amyloid load in transgenic mouse models of Alzheimer’s disease. J Neuroinflammation. 2005;2(1):9.Google Scholar
Meda, L, Cassatella, MA, Szendrei, GI, et al. Activation of microglial cells by beta-amyloid protein and interferon-gamma. Nature. 1995;374(6523):647–50.CrossRefGoogle ScholarPubMed
Tan, J, Town, T, Paris, D, et al. Microglial activation resulting from CD40-CD40L interaction after beta-amyloid stimulation. Science. 1999;286(5448):2352–5.Google Scholar
Tan, J, Town, T, Crawford, F, et al. Role of CD40 ligand in amyloidosis in transgenic Alzheimer’s mice. Nat Neurosci. 2002;5(12):1288–93.Google Scholar
Jin, JJ, Kim, HD, Maxwell, JA, Li, L, Fukuchi, K. Toll-like receptor 4-dependent upregulation of cytokines in a transgenic mouse model of Alzheimer’s disease. J Neuroinflammation. 2008;5:23.Google Scholar
Streit, WJ. Microglial senescence: does the brain’s immune system have an expiration date? Trends Neurosci. 2006;29(9):506–10.Google Scholar
Ghosh, S, Wu, MD, Shaftel, SS, et al. Sustained interleukin-1beta overexpression exacerbates tau pathology despite reduced amyloid burden in an Alzheimer’s mouse model. J Neurosci. 2013;33(11):5053–64.Google Scholar
Chakrabarty, P, Ceballos-Diaz, C, Beccard, A, et al. IFN-gamma promotes complement expression and attenuates amyloid plaque deposition in amyloid beta precursor protein transgenic mice. J Immunol. 2010;184(9):5333–43.Google Scholar
Chakrabarty, P, Jansen-West, K, Beccard, A, et al. Massive gliosis induced by interleukin-6 suppresses Abeta deposition in vivo: evidence against inflammation as a driving force for amyloid deposition. FASEB J. 2010;24(2):548–59.CrossRefGoogle ScholarPubMed
Chakrabarty, P, Herring, A, Ceballos-Diaz, C, Das, P, Golde, TE. Hippocampal expression of murine TNFalpha results in attenuation of amyloid deposition in vivo. Mol Neurodegener. 2011;6:16.Google Scholar
Chakrabarty, P, Tianbai, L, Herring, A, et al. Hippocampal expression of murine IL-4 results in exacerbation of amyloid deposition. Mol Neurodegener. 2012;7:36.Google Scholar
Nathan, C, Calingasan, N, Nezezon, J, et al. Protection from Alzheimer’s-like disease in the mouse by genetic ablation of inducible nitric oxide synthase. J Exp Med. 2005;202(9):1163–9.Google Scholar
Jekabsone, A, Mander, PK, Tickler, A, Sharpe, M, Brown, GC. Fibrillar beta-amyloid peptide Abeta1-40 activates microglial proliferation via stimulating TNF-alpha release and H2O2 derived from NADPH oxidase: a cell culture study. J Neuroinflammation. 2006;3:24.Google Scholar
Choi, SH, Aid, S, Kim, HW, Jackson, SH, Bosetti, F. Inhibition of NADPH oxidase promotes alternative and anti-inflammatory microglial activation during neuroinflammation. J Neurochem. 2012;120(2):292301.Google Scholar
Savarin-Vuaillat, C, Ransohoff, RM. Chemokines and chemokine receptors in neurological disease: raise, retain, or reduce? Neurotherapeutics. 2007;4(4):590601.Google Scholar
Xia, MQ, Qin, SX, Wu, LJ, Mackay, CR, Hyman, BT. Immunohistochemical study of the beta-chemokine receptors CCR3 and CCR5 and their ligands in normal and Alzheimer’s disease brains. Am J Pathol. 1998;153(1):31–7.CrossRefGoogle ScholarPubMed
Ishizuka, K, Kimura, T, Igata-yi, R, et al. Identification of monocyte chemoattractant protein-1 in senile plaques and reactive microglia of Alzheimer’s disease. Psychiatry Clin Neurosci. 1997;51(3):135–8.CrossRefGoogle ScholarPubMed
Smits, HA, Rijsmus, A, van Loon, JH, et al. Amyloid-beta-induced chemokine production in primary human macrophages and astrocytes. J Neuroimmunol. 2002;127(1–2):160–8.Google Scholar
Lue, LF, Walker, DG, Rogers, J. Modeling microglial activation in Alzheimer’s disease with human postmortem microglial cultures. Neurobiol Aging. 2001;22(6):945–56.Google Scholar
Veerhuis, R, Nielsen, HM, Tenner, AJ. Complement in the brain. Mol Immunol. 2011;48(14):1592–603.Google Scholar
Strohmeyer, R, Ramirez, M, Cole, GJ, Mueller, K, Rogers, J. Association of factor H of the alternative pathway of complement with agrin and complement receptor 3 in the Alzheimer’s disease brain. J Neuroimmunol. 2002;131(1–2):135–46.CrossRefGoogle ScholarPubMed
Lambert, JC, Heath, S, Even, G, et al. Genome-wide association study identifies variants at CLU and CR1 associated with Alzheimer’s disease. Nat Genet. 2009;41(10):1094–9.Google Scholar
Harold, D, Abraham, R, Hollingworth, P, et al. Genome-wide association study identifies variants at CLU and PICALM associated with Alzheimer’s disease. Nat Genet. 2009;41(10):1088–93.Google Scholar
Lupetti, A, Nibbering, PH, Welling, MM, Pauwels, EK. Radiopharmaceuticals: new antimicrobial agents. Trends Biotechnol. 2003;21(2):70–3.Google Scholar
Cudic, M, Otvos, L, Jr. Intracellular targets of antibacterial peptides. Curr Drug Targets. 2002;3(2):101–6.CrossRefGoogle ScholarPubMed
Radek, K, Gallo, R. Antimicrobial peptides: natural effectors of the innate immune system. Semin Immunopathol. 2007;29(1):2743.Google Scholar
Kourie, JI, Shorthouse, AA. Properties of cytotoxic peptide-formed ion channels. Am J Physiol Cell Physiol. 2000;278(6):C1063–87.Google Scholar
Soscia, SJ, Kirby, JE, Washicosky, KJ, et al. The Alzheimer’s disease-associated amyloid beta-protein is an antimicrobial peptide. PLoS One. 2010;5(3):e9505.Google Scholar
Welling, MM, Nabuurs, RJ, van der Weerd, L. Potential role of antimicrobial peptides in the early onset of Alzheimer’s disease. Alzheimer’s & Dementia : The Journal of the Alzheimer’s Association. 2015;11(1):51–7.Google Scholar
Krstic, D, Madhusudan, A, Doehner, J, et al. Systemic immune challenges trigger and drive Alzheimer-like neuropathology in mice. J Neuroinflammation. 2012;9:151.Google Scholar
Campion, D, Dumanchin, C, Hannequin, D, et al. Early-onset autosomal dominant Alzheimer disease: prevalence, genetic heterogeneity, and mutation spectrum. Am J Hum Genet. 1999;65(3):664–70.Google Scholar
Rovelet-Lecrux, A, Hannequin, D, Raux, G, et al. APP locus duplication causes autosomal dominant early-onset Alzheimer disease with cerebral amyloid angiopathy. Nat Genet. 2006;38(1):24–6.Google Scholar
Hardy, J. Alzheimer’s disease: the amyloid cascade hypothesis: an update and reappraisal. J Alzheimers Dis. 2006;9(3 Suppl):151–3.Google Scholar
Nuutinen, T, Suuronen, T, Kauppinen, A, Salminen, A. Clusterin: a forgotten player in Alzheimer’s disease. Brain Res Rev. 2009;61(2):89104.Google Scholar
Hollingworth, P, Harold, D, Sims, R, et al. Common variants at ABCA7, MS4A6A/MS4A4E, EPHA1, CD33 and CD2AP are associated with Alzheimer’s disease. Nat Genet. 2011;43(5):429–35.CrossRefGoogle ScholarPubMed
Naj, AC, Jun, G, Beecham, GW, et al. Common variants at MS4A4/MS4A6E, CD2AP, CD33 and EPHA1 are associated with late-onset Alzheimer’s disease. Nat Genet. 2011;43(5):436–41.CrossRefGoogle ScholarPubMed
Lambert, JC, Ibrahim-Verbaas, CA, Harold, D, et al. Meta-analysis of 74,046 individuals identifies 11 new susceptibility loci for Alzheimer’s disease. Nat Genet. 2013;45(12):1452–8.Google Scholar
Sims, R, van der Lee, SJ, Naj, AC, et al. Rare coding variants in PLCG2, ABI3, and TREM2 implicate microglial-mediated innate immunity in Alzheimer’s disease. Nat Genet. 2017;49(9):1373–84.Google Scholar
Kunkle, BW, Grenier-Boley, B, Sims, R, et al. Genetic meta-analysis of diagnosed Alzheimer’s disease identifies new risk loci and implicates Abeta, tau, immunity and lipid processing. Nat Genet. 2019;51(3):414–30.Google Scholar
Yokoyama, JS, Desikan, RS. Association of Alzheimer Disease Susceptibility Variants and Gene Expression in the Human Brain-Reply. JAMA Neurol. 2016;73(10):1255.Google Scholar
Huang, KL, Marcora, E, Pimenova, AA, et al. A common haplotype lowers PU.1 expression in myeloid cells and delays onset of Alzheimer’s disease. Nat Neurosci. 2017;20(8):1052–61.Google Scholar
Guerreiro, R, Wojtas, A, Bras, J, et al. TREM2 variants in Alzheimer’s disease. N Engl J Med. 2013;368(2):117–27.Google Scholar
Jonsson, T, Stefansson, H, Steinberg, S, et al. Variant of TREM2 associated with the risk of Alzheimer’s disease. N Engl J Med. 2013;368(2):107–16.Google Scholar
Neumann, H, Takahashi, K. Essential role of the microglial triggering receptor expressed on myeloid cells-2 (TREM2) for central nervous tissue immune homeostasis. J Neuroimmunol. 2007;184(1–2):92–9.Google Scholar
Heslegrave, A, Heywood, W, Paterson, R, et al. Increased cerebrospinal fluid soluble TREM2 concentration in Alzheimer’s disease. Mol Neurodegener. 2016;11:3.Google Scholar
Suarez-Calvet, M, Kleinberger, G, Araque Caballero, MA, et al. sTREM2 cerebrospinal fluid levels are a potential biomarker for microglia activity in early-stage Alzheimer’s disease and associate with neuronal injury markers. EMBO Mol Med. 2016;8(5):466–76.Google Scholar
Hart, BL. Biological basis of the behavior of sick animals. Neurosci Biobehav Rev. 1988;12(2):123–37.Google Scholar
Dantzer, R, Konsman, JP, Bluthe, RM, Kelley, KW. Neural and humoral pathways of communication from the immune system to the brain: parallel or convergent? Auton Neurosci. 2000;85(1–3):60–5.Google Scholar
Ek, M, Kurosawa, M, Lundeberg, T, Ericsson, A. Activation of vagal afferents after intravenous injection of interleukin-1beta: role of endogenous prostaglandins. J Neurosci. 1998;18(22):9471–9.Google Scholar
Blatteis, CM, Bealer, SL, Hunter, WS, et al. Suppression of fever after lesions of the anteroventral third ventricle in guinea pigs. Brain Res Bull. 1983;11(5):519–26.Google Scholar
Matsumura, K, Kobayashi, S. Signaling the brain in inflammation: the role of endothelial cells. Front Biosci. 2004;9:2819–26.Google Scholar
Perry, VH. Contribution of systemic inflammation to chronic neurodegeneration. Acta Neuropathol. 2010;120(3):277–86.Google Scholar
Rivest, S. Regulation of innate immune responses in the brain. Nat Rev Immunol. 2009;9(6):429–39.Google Scholar
Godbout, JP, Johnson, RW. Age and neuroinflammation: a lifetime of psychoneuroimmune consequences. Immunol Allergy Clin North Am. 2009;29(2):321–37.Google Scholar
Cunningham, C, Wilcockson, DC, Campion, S, Lunnon, K, Perry, VH. Central and systemic endotoxin challenges exacerbate the local inflammatory response and increase neuronal death during chronic neurodegeneration. J Neurosci. 2005;25(40):9275–84.Google Scholar
Cunningham, C, Campion, S, Lunnon, K, et al. Systemic inflammation induces acute behavioral and cognitive changes and accelerates neurodegenerative disease. Biol Psychiatry. 2009;65(4):304–12.Google Scholar
Field, R, Campion, S, Warren, C, Murray, C, Cunningham, C. Systemic challenge with the TLR3 agonist poly I:C induces amplified IFNalpha/beta and IL-1beta responses in the diseased brain and exacerbates chronic neurodegeneration. Brain Behav Immun. 2010;24(6):9961007.Google Scholar
Rahkonen, T, Luukkainen-Markkula, R, Paanila, S, Sivenius, J, Sulkava, R. Delirium episode as a sign of undetected dementia among community dwelling elderly subjects: a 2 year follow up study. J Neurol Neurosurg Psychiatry. 2000;69(4):519–21.Google Scholar
Dunn, N, Mullee, M, Perry, VH, Holmes, C. Association between dementia and infectious disease: evidence from a case-control study. Alzheimer Dis Assoc Disord. 2005;19(2):91–4.Google Scholar
Calvani, R, Picca, A, Lo Monaco, MR, et al. Of Microbes and Minds: A Narrative Review on the Second Brain Aging. Front Med (Lausanne). 2018;5:53.Google Scholar
Vogt, NM, Kerby, RL, Dill-McFarland, KA, et al. Gut microbiome alterations in Alzheimer’s disease. Sci Rep. 2017;7(1):13537.Google Scholar
Cattaneo, A, Cattane, N, Galluzzi, S, et al. Association of brain amyloidosis with pro-inflammatory gut bacterial taxa and peripheral inflammation markers in cognitively impaired elderly. Neurobiol Aging. 2017;49:60–8.Google Scholar
Riviere, GR, Riviere, KH, Smith, KS. Molecular and immunological evidence of oral Treponema in the human brain and their association with Alzheimer’s disease. Oral Microbiol Immunol. 2002;17(2):113–8.Google Scholar
Ide, M, Harris, M, Stevens, A, et al. Periodontitis and Cognitive Decline in Alzheimer’s Disease. PLoS One. 2016;11(3):e0151081.Google Scholar
Casserly, I, Topol, E. Convergence of atherosclerosis and Alzheimer’s disease: inflammation, cholesterol, and misfolded proteins. Lancet. 2004;363(9415):1139–46.Google Scholar
Donath, MY, Shoelson, SE. Type 2 diabetes as an inflammatory disease. Nat Rev Immunol. 2011;11(2):98107.Google Scholar
Launer, LJ, Andersen, K, Dewey, ME, et al. Rates and risk factors for dementia and Alzheimer’s disease: results from EURODEM pooled analyses. EURODEM Incidence Research Group and Work Groups. European Studies of Dementia. Neurology. 1999;52(1):7884.Google Scholar
Clark, IA, Atwood, CS. Is TNF a link between aging-related reproductive endocrine dyscrasia and Alzheimer’s disease? J Alzheimers Dis. 2011;27(4):691–9.Google Scholar
Butchart, J, Birch, B, Bassily, R, Wolfe, L, Holmes, C. Male sex hormones and systemic inflammation in Alzheimer disease. Alzheimer Dis Assoc Disord. 2013;27(2):153–6.Google Scholar
Ngandu, T, Lehtisalo, J, Solomon, A, et al. A 2-year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. Lancet. 2015;385(9984):2255–63.CrossRefGoogle Scholar
Rogers, J, Kirby, LC, Hempelman, SR, et al. Clinical trial of indomethacin in Alzheimer’s disease. Neurology. 1993;43(8):1609–11.Google Scholar
de Jong, D, Jansen, R, Hoefnagels, W, et al. No effect of one-year treatment with indomethacin on Alzheimer’s disease progression: a randomized controlled trial. PLoS One. 2008;3(1):e1475.Google Scholar
Aisen, PS, Schafer, KA, Grundman, M, et al. Effects of rofecoxib or naproxen vs placebo on Alzheimer disease progression: a randomized controlled trial. JAMA. 2003;289(21):2819–26.Google Scholar
Reines, SA, Block, GA, Morris, JC, et al. Rofecoxib: no effect on Alzheimer’s disease in a 1-year, randomized, blinded, controlled study. Neurology. 2004;62(1):6671.CrossRefGoogle Scholar
Aisen, PS, Davis, KL, Berg, JD, et al. A randomized controlled trial of prednisone in Alzheimer’s disease. Alzheimer’s Disease Cooperative Study. Neurology. 2000;54(3):588–93.Google Scholar
Van Gool, WA, Weinstein, HC, Scheltens, P, Walstra, GJ. Effect of hydroxychloroquine on progression of dementia in early Alzheimer’s disease: an 18-month randomised, double-blind, placebo-controlled study. Lancet. 2001;358(9280):455–60.Google Scholar
Simons, M, Schwarzler, F, Lutjohann, D, et al. Treatment with simvastatin in normocholesterolemic patients with Alzheimer’s disease: A 26-week randomized, placebo-controlled, double-blind trial. Ann Neurol. 2002;52(3):346–50.Google Scholar
Sparks, DL, Sabbagh, MN, Connor, DJ, et al. Atorvastatin for the treatment of mild to moderate Alzheimer disease: preliminary results. Arch Neurol. 2005;62(5):753–7.Google Scholar
Feldman, HH, Doody, RS, Kivipelto, M, et al. Randomized controlled trial of atorvastatin in mild to moderate Alzheimer disease: LEADe. Neurology. 2010;74(12):956–64.Google Scholar
Bentham, P, Gray, R, Sellwood, E, et al. Aspirin in Alzheimer’s disease (AD2000): a randomised open-label trial. Lancet Neurol. 2008;7(1):41–9.Google Scholar
Harrington, C, Sawchak, S, Chiang, C, et al. Rosiglitazone does not improve cognition or global function when used as adjunctive therapy to AChE inhibitors in mild-to-moderate Alzheimer’s disease: two phase 3 studies. Curr Alzheimer Res. 2011;8(5):592606.Google Scholar
Butchart, J, Brook, L, Hopkins, V, et al. Etanercept in Alzheimer disease: A randomized, placebo-controlled, double-blind, phase 2 trial. Neurology. 2015;84(21):2161–8.Google Scholar
McGeer, PL, McGeer, EG. NSAIDs and Alzheimer disease: epidemiological, animal model and clinical studies. Neurobiol Aging. 2007;28(5):639–47.Google Scholar
Stewart, WF, Kawas, C, Corrada, M, Metter, EJ. Risk of Alzheimer’s disease and duration of NSAID use. Neurology. 1997;48(3):626–32.Google Scholar
McGeer, PL, Schulzer, M, McGeer, EG. Arthritis and anti-inflammatory agents as possible protective factors for Alzheimer’s disease: a review of 17 epidemiologic studies. Neurology. 1996;47(2):425–32.Google Scholar
Vlad, SC, Miller, DR, Kowall, NW, Felson, DT. Protective effects of NSAIDs on the development of Alzheimer disease. Neurology. 2008;70(19):1672–7.Google Scholar
Thal, LJ, Ferris, SH, Kirby, L, et al. A randomized, double-blind, study of rofecoxib in patients with mild cognitive impairment. Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology. 2005;30(6):1204–15.Google Scholar
Group, AR, Lyketsos, CG, Breitner, JC, et al. Naproxen and celecoxib do not prevent AD in early results from a randomized controlled trial. Neurology. 2007;68(21):1800–8.Google Scholar
Breitner, JC, Baker, LD, Montine, TJ, et al. Extended results of the Alzheimer’s disease anti-inflammatory prevention trial. Alzheimer’s & Dementia : The Journal of the Alzheimer’s Association. 2011;7(4):402–11.Google Scholar
Alzheimer’s Disease Anti-inflammatory Prevention Trial Research G. Results of a follow-up study to the randomized Alzheimer’s Disease Anti-inflammatory Prevention Trial (ADAPT). Alzheimer’s & Dementia : The Journal of the Alzheimer’s Association. 2013;9(6):714–23.Google Scholar
Meyer, PF, Tremblay-Mercier, J, Leoutsakos, J, et al. INTREPAD: a randomized trial of naproxen to slow progress of presymptomatic Alzheimer disease. Neurology. 2019;92(18):e2070–e80.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×