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Higher CSF sTREM2 and microglia activation are associated with slower rates of beta-amyloid accumulation
Ewers M, Biechele G, Suárez-Calvet M, Sacher C, Blume T, Morenas-Rodriguez E, Deming Y, Piccio L et al.. EMBO molecular medicine, 2020-08-10
Topic: Brain proteins, microglia and lab models
Microglia activation is the brain's major immune response to amyloid plaques in Alzheimer's disease (AD). Both cerebrospinal fluid (CSF) levels of soluble TREM2 (sTREM2), a biomarker of microglia activation, and microglia PET are increased in AD; however, whether an increase in these biomarkers is associated with reduced amyloid-beta (Aβ) accumulation remains unclear. To address this question, we pursued a two-pronged translational approach.
Key findings
- Both cerebrospinal fluid (CSF) levels of soluble TREM2 (sTREM2), a biomarker of microglia activation, and microglia PET are increased in AD; however, whether an increase in these biomarkers is associated with reduced amyloid-beta (Aβ) accumulation remains unclear.
- To address this question, we pursued a two-pronged translational approach.
- Firstly, in non-demented and demented individuals, we tested CSF sTREM2 at baseline to predict (i) amyloid PET changes over ∼2 years and (ii) tau PET cross-sectionally assessed in a subset of patients.
- We found higher CSF sTREM2 associated with attenuated amyloid PET increase and lower tau PET.
Why it matters
In people with and without dementia, those who had higher levels of sTREM2 in their spinal fluid (a marker of immune-cell activity in the brain) built up amyloid more slowly on PET scans over about 2 years. In a subset scanned once, they also had lower tau. This links brain immune activity to slower amyloid build-up, but it is an observational association; it does not show that boosting sTREM2 or microglia treats or prevents Alzheimer's.
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Study details
- Study designlongitudinal study
- Evidence strengthModerate
How this study scored 60/100
Published in a peer-reviewed journal, and it is a longitudinal study following the same people over time. Scored zero for sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (EMBO molecular medicine) |
| Journal's citation record | 2 / 4 | EMBO Molecular Medicine: journal h-index 186 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A longitudinal study following the same people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2020 — within 10 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 131 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 16.4 citations a year over 8 year(s) since 2020 |
| Impact for its field and year | 4 / 6 | Cited 8.4× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 23 other studies in this library |
| Still being cited | 3 / 4 | Cited 65 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Nicolai Franzmeier: h-index 49 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Washington University in St. Louis: institution h-index 1,962 (OpenAlex) |
| Multi-centre collaboration | 3 / 3 | OpenAlex lists 14 institution(s) in 4 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 32790063) |
| Free to read | 2 / 2 | Free to read |
| Total | 60 / 100 | — |
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Read the original
- DOI: 10.15252/emmm.202012308
- PubMed: 32790063
- Original source →
- Free full text: EMBO Molecular Medicine →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Ewers, M., Biechele, G., Suárez-Calvet, M., Sacher, C., Blume, T., Morenas-Rodriguez, E., et al. (2020). Higher CSF sTREM2 and microglia activation are associated with slower rates of beta-amyloid accumulation. EMBO molecular medicine. https://doi.org/10.15252/emmm.202012308
Vancouver
Ewers M, Biechele G, Suárez-Calvet M, Sacher C, Blume T, Morenas-Rodriguez E, et al. Higher CSF sTREM2 and microglia activation are associated with slower rates of beta-amyloid accumulation. EMBO molecular medicine. 2020. doi:10.15252/emmm.202012308. PMID: 32790063.
BibTeX
@article{ewers2020-32790063,
author = {Ewers, M. and Biechele, G. and Suárez-Calvet, M. and Sacher, C. and Blume, T. and Morenas-Rodriguez, E. and Deming, Y. and Piccio, L. and others},
title = {{Higher CSF sTREM2 and microglia activation are associated with slower rates of beta-amyloid accumulation}},
journal = {EMBO molecular medicine},
year = {2020},
doi = {10.15252/emmm.202012308},
pmid = {32790063},
url = {https://doi.org/10.15252/emmm.202012308}
}
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