Estrella Morenas-Rodriguez, MD, PhD, German Center for Neurodegenerative Diseases, Munich, Germany, highlights new findings implicating soluble TREM2 (sTREM2) in the cerebrospinal fluid (CSF) as a promising biomarker in autosomal dominant Alzheimer’s disease (AD). Using data from the Dominantly Inherited Alzheimer Network (DIAN) observational study, longitudinal changes in sTREM2 levels were assessed and associations with amyloid β (Aβ) deposition, tau-related pathology, neuroimaging markers, and cognitive decline were investigated. Findings from ~250 patients showed that higher annual rates of sTREM2 increase were associated with a decreased rate of amyloid deposition (Aβ42 in CSF) in presymptomatic carriers and a decreased annual rate of increase in PiB-PET in symptomatic carriers. Additionally, presymptomatic carriers with above average rates of increase in sTREM2 showed decreased cortical shrinkage in the precuneus, diminished cognitive decline, and reduced rate of increase in phosphorylated-tau in the CSF. These data suggest that changes in TREM2 occur very early in autosomal dominant AD and that increasing TREM2 function prior to symptom onset may have beneficial effects on cognition and pathological changes. This interview took place at the Alzheimer’s Association International Conference (AAIC) 2022 in San Diego, CA.
