The Complex Role of PLCG2 Variants in Alzheimer’s Disease Pathogenesis


Over the past few years, significant progress has been made in identifying genes associated with altered AD risk. These genes are increasingly recognized for their involvement in the microglia-mediated immune response within the AD brain. The research community’s renewed interest in immune mechanisms as potential therapeutic targets in AD centers on genes encoding proteins involved in immune receptor signal transduction pathways. One such pivotal gene is Phospholipase C-gamma-2 (PLCG2), which plays a crucial role in immune signaling, primarily within microglia in the brain.

PLCG2 functions through tyrosine phosphorylation, primarily initiated by Bruton’s tyrosine kinase (BTK), following ligand binding to cell surface immune receptors, such as triggering receptor expressed on myeloid cells 2 (TREM2). Another route of activation involves association with activated forms of Rac GTPases. This activation leads to a conformational change in PLCG2, enabling it to transduce signals crucial for the immune response. PLCG2 is associated with various downstream signaling pathways, including calcium-regulated transcription factor activation, nuclear factor kappa B (NF-κB), and nuclear factor of activated T cells (NFAT), as well as multiple cascades regulating the cellular immune response.

Genome-wide association studies (GWAS) have revealed that an exonic variant of PLCG2, PLCG2P522R, is associated with reduced AD risk. Carriers of this variant exhibit a slower cognitive decline rate, reduced cerebrospinal fluid tau concentrations, and improved microglial viability and phagocytic activity. Surprisingly, these mice also display elevated cytokine secretion. Moreover, studies have demonstrated that PLCG2 is essential for downstream signaling from TREM2, enhancing microglial viability, phagocytosis, and cholesterol metabolism. The PLCG2P522R variant appears to promote cholesterol metabolism more effectively than the wild-type enzyme. Additionally, PLCG2 is involved in transducing signals from various immune receptors, further underscoring its importance in the immune response.

However, not all variants of PLCG2 have a protective effect. Mutant forms of PLCG2 in diverse immune cell populations have been associated with peripheral immune disorders, including leukemias and lymphomas. Genomic deletions or somatic mutations within the regulatory domain of PLCG2 can constitutively activate it, leading to BTK inhibitor resistance in leukemia patients. Genetic data analysis has revealed that the missense PLCG2M28L variant is associated with elevated AD risk. BTK inhibition in microglia inhibits PLCG2 activation and phagocytosis, emphasizing the critical role of PLCG2 in Aβ clearance and AD pathogenesis. Thus, understanding how PLCG2 variants affect the immune system and the brain has far-reaching implications for aging, AD, and neurodegenerative disorders.

In a groundbreaking study recently published in the Journal Immunity, led by Professor Gary E. Landreth from the Indiana University School of Medicine, researchers have shed new light on the role of PLCG2 variants in Alzheimer’s Disease (AD) pathogenesis. This study has far-reaching implications for our understanding of the disease and potential therapeutic avenues. The research delves into the intricate molecular mechanisms governing the impact of these genetic variants on microglial function, amyloid plaque pathology, synaptic function, and overall AD risk.

The recent study led by Professor Gary E. Landreth provides a comprehensive analysis of the functional consequences of PLCG2 variants, shedding light on their role in AD pathogenesis. The research used a combination of genetic, molecular, and cellular approaches to elucidate the impact of these variants. The findings have been paradigm-shifting and can be summarized as follows:

Genetic analysis of a large-scale GWAS identified the PLCG2 missense mutation (rs61749044) associated with elevated AD risk, encoding the PLCG2M28L variant. In contrast, the PLCG2P522R variant was confirmed to be protective. Structural analysis revealed that the M28 mutation occurs in the N-terminal PH domain, required for membrane localization. Importantly, mice expressing PLCG2M28L exhibited reduced protein expression in the brain, which could be a loss-of-function effect.

High-resolution imaging techniques were used to assess amyloid deposition in the brains of mice expressing PLCG2M28L or PLCG2P522R variants. PLCG2M28L mice displayed exacerbated plaque deposition, while PLCG2P522R mice showed reduced amyloid pathology. Microglial phagocytosis of Aβ aggregates was assessed in primary murine microglia cultures, revealing that PLCG2M28L variant-expressing microglia exhibited reduced Aβ uptake compared to wild-type or PLCG2P522R-expressing microglia.

Further experiments explored the impact of PLCG2 variants on microglial function. PLCG2P522R-expressing microglia exhibited enhanced phagocytosis, reduced production of pro-inflammatory cytokines, and increased production of anti-inflammatory cytokines compared to wild-type and PLCG2M28L-expressing microglia. These findings suggest that the protective effect of PLCG2P522R may stem from its ability to modulate microglial activation and cytokine production.

This groundbreaking research into the complex role of PLCG2 variants in Alzheimer’s Disease pathogenesis provides a deeper understanding of the immune mechanisms at play in the disease. It highlights the delicate balance between microglial activation, Aβ clearance, and inflammation in AD. The findings suggest that PLCG2 variants can influence the course of the disease, with the PLCG2M28L variant associated with increased AD risk and exacerbation of amyloid pathology, while the PLCG2P522R variant appears protective by enhancing Aβ clearance and modulating microglial function.

These insights into the genetic and molecular mechanisms involved in AD open up exciting new possibilities for therapeutic interventions. Modulating PLCG2 activity or developing drugs that mimic the protective effects of the PLCG2P522R variant could be potential strategies for slowing or even preventing AD progression. Additionally, targeting microglial function and immune responses in the brain represents a promising avenue for future AD treatments.

The study led by Professor Gary E. Landreth has provided a comprehensive and transformative analysis of PLCG2 variants in Alzheimer’s Disease pathogenesis. It emphasizes the critical role of immune mechanisms, specifically microglial function, in AD development and progression. The research has identified PLCG2 variants as key players in modulating amyloid plaque pathology, microglial function, and AD risk. These findings hold significant promise for the development of novel therapeutic strategies aimed at harnessing the protective effects of specific PLCG2 variants to combat Alzheimer’s Disease.

The Complex Role of PLCG2 Variants in Alzheimer's Disease Pathogenesis - Medicine Innovates
PLCG2 variants affect plaque pathology and microglial uptake of Aβ aggregates
Image Credit: Journal Immunity 2023

About the author

Gary E. Landreth, PhD

Martin Professor of Alzheimer’s Research
Indiana University School of Medicine

Dr. Landreth’s work over the past 20 years has focused the principal genetic risk factors for Alzheimer’s disease. The laboratory has focused on the biology of ApoE, its role in amyloid homeostasis and the regulation of its expression by nuclear receptors. The laboratory has also investigated inflammatory mechanisms in Alzheimer’s disease and the biology of microglia.  Recent work has examined the mechanisms through which TREM2 influences disease pathogenesis. The laboratory maintains a focus on drug development for CNS disorders, including Alzheimer’s disease.


Tsai AP, Dong C, Lin PB, Oblak AL, Viana Di Prisco G, Wang N, Hajicek N, Carr AJ, Lendy EK, Hahn O, Atkins M, Foltz AG, Patel J, Xu G, Moutinho M, Sondek J, Zhang Q, Mesecar AD, Liu Y, Atwood BK, Wyss-Coray T, Nho K, Bissel SJ, Lamb BT, Landreth GE. Genetic variants of phospholipase C-γ2 alter the phenotype and function of microglia and confer differential risk for Alzheimer’s disease. Immunity. 2023:S1074-7613(23)00364-3. doi: 10.1016/j.immuni.2023.08.008.

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