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@INPROCEEDINGS{ZaragozaBallester:283079,
author = {Zaragoza-Ballester, Pablo and Nuscher, Briggitte and
Alcolea, Daniel and Fernández-León, Álex and
Rodríguez-Baz, Íñigo and Bejanin, Alexandre and Vera,
Elena and Vaqué-Alcázar, Lídia and Sala, Isabel and
Gómez-Grande, Adolfo and Lleo, Alberto and Fortea, Juan and
Camacho, Valle and Haass, Christian and Morenas-Rodriguez,
Estrella},
title = {{A}ssociation between soluble {TREM}2, {APOE} genotype,
{A}lzheimer's copathology and disease evolution in dementia
with {L}ewy bodies},
journal = {Alzheimer's and dementia},
volume = {21},
number = {Suppl 1},
issn = {1552-5260},
reportid = {DZNE-2025-01486},
pages = {e102529},
year = {2025},
abstract = {APOEε4 is a genetic risk factor for both Alzheimer's
Disease (AD) and dementia with Lewy bodies (DLB).
TREM2-dependent microglial activation is considered
protective in AD and has been proposed to interact with APOE
in this context. Since DLB often exhibits Alzheimer's
copathology, we investigate the interplay between TREM2
response, APOEε4 carriage and Alzheimer's co-pathology, and
its influence on disease evolution in DLB.We measured
cerebrospinal fluid (CSF) cleaved soluble TREM2 (cTREM2), as
a marker of TREM2-dependent microglial response, core AD
biomarkers and determine APOEε4 carriage in 76 DLB patients
(prodromal DLB [prodDLB], n = 39; DLB-dementia, n = 37).
Forty one patients additionally underwent
[18F]Florbetapir-PET (FBP-PET). We quantified cTREM2 by an
in-house MSD-based immunoassay; core AD biomarkers (Aβ42,
t-tau, p-tau181), by ELISA; and FBP-PET uptake, by standard
uptake value ratio (SUVr). We stratified patients according
to the A/T classification. Clinical follow-up (>1 year) was
available for 69 patients.APOEε4 carriers had lower cTREM2
levels compared to non-carriers in prodDLB
(3.72±1.79vs.6.83±2.25ng/mL, p-value=0.0005, Figure 1).
Furthermore, APOEε4 carriage itself was associated with
lower cTREM2 levels in prodDLB (β(carriers)=-0.42,
p-value=0.025) independently of AD core biomarkers.
Conversely, APOEe4 carriage did not impact cTREM2 levels in
DLB-dementia. cTREM2 levels across A-/+ and T-/+ DLB groups
are represented in Figure 1. In prodDLB, higher cTREM2
levels were associated with higher Aβ42 (β=0.77,
p-value=0.0002) and p-tau181 levels (β=0.612,
p-value=0.002). In DLB-dementia, cTREM2 levels were
associated only with p-tau181 (β=0.58, p-value=0.0001).
Additionally, higher cTREM2 levels were associated with
lower FBP-PET SUVr in prodDLB (β=-1.71, p-value=0.04).
Notably, higher sTREM2 levels at baseline in prodDLB were
related to a smaller subsequent longitudinal decrease in
MMSE scores (β=1.11, p-value=0.01). No significant
relationship was observed between baseline cTREM2 at a
DLB-dementia stage and subsequent cognitive decline
(β=-0.3, p-value=0.5).APOEε4 carriage attenuates the
TREM2-dependent microglial response in prodromal DLB, as
reflected by lower CSF cTREM2 levels. Elevated cTREM2 levels
in the prodromal phase are associated with slower cognitive
decline, suggesting a protective role of microglial
activation during early disease stages. These findings
suggest an early modulation of TREM2-driven microglial
response by APOEε4 which influences DLB progression.},
month = {Jul},
date = {2025-07-27},
organization = {Alzheimer’s Association
International Conference, Toronto
(Canada), 27 Jul 2025 - 31 Jul 2025},
keywords = {Humans / Male / Female / Aged / Biomarkers: cerebrospinal
fluid / Apolipoprotein E4: genetics / Alzheimer Disease:
genetics / Alzheimer Disease: cerebrospinal fluid /
Alzheimer Disease: pathology / Lewy Body Disease: genetics /
Lewy Body Disease: cerebrospinal fluid / Lewy Body Disease:
diagnostic imaging / Lewy Body Disease: pathology / Membrane
Glycoproteins: cerebrospinal fluid / Receptors, Immunologic
/ Amyloid beta-Peptides: cerebrospinal fluid /
Positron-Emission Tomography / tau Proteins: cerebrospinal
fluid / Middle Aged / Aged, 80 and over / Biomarkers (NLM
Chemicals) / TREM2 protein, human (NLM Chemicals) /
Apolipoprotein E4 (NLM Chemicals) / Membrane Glycoproteins
(NLM Chemicals) / Receptors, Immunologic (NLM Chemicals) /
Amyloid beta-Peptides (NLM Chemicals) / tau Proteins (NLM
Chemicals)},
cin = {AG Haass},
ddc = {610},
cid = {I:(DE-2719)1110007},
pnm = {352 - Disease Mechanisms (POF4-352)},
pid = {G:(DE-HGF)POF4-352},
typ = {PUB:(DE-HGF)1 / PUB:(DE-HGF)16},
pubmed = {pmid:41436355},
pmc = {pmc:PMC12727221},
doi = {10.1002/alz70855_102529},
url = {https://pub.dzne.de/record/283079},
}