Background: Strong genetic and epidemiological evidence points to a crucial role of the immune system in the development of Alzheimer disease (AD). CD3+ T lymphocytes have been described in brains of postmortem AD patients and in transgenic models of AD-like cerebral amyloidosis and tau pathology. However, the occurrence of T cells in AD brains is still controversial; furthermore, the relationship between T cells and hallmarks of AD pathology (amyloid plaques and neurofibrillary tangles) remains to be established. Objectives: We have studied the occurrence of T cells in postmortem hippocampi and mid frontal gyrus (MFG) samples of AD patients (Braak stage V-VI) and nondemented control subjects and correlated it with amyloid and tau pathology burden. Methods: Confocal microscopy and bright-field immunohistochemistry were used to identify brain-associated T cells. Extravascular CD3+ T cells were quantified and compared to nondemented controls. In addition, numbers of extravascular CD3+ T cells were correlated with amyloid (6E10 staining) and tau pathology (AT8 staining) in the same sections. Results: Several CD3+, extravascular T cells were observed in the brains of AD patients, mostly of the CD8+ subtype. AD hippocampi harbored significantly increased numbers of extravascular CD3+ T cells compared to nondemented controls. CD3+ T cells significantly correlated with tau pathology but not with amyloid plaques in AD samples. Conclusions: Our data support the notion of T-cell occurrence in AD brains and suggest that, in advanced stages of AD, T-cell extravasation is driven by tau-related neurodegenerative changes rather than by cerebral amyloidosis. T cells could be crucial for driving the amyloid-independent phase of the AD pathology.

1.
Heneka MT, et al: Neuroinflammation in Alzheimer's disease. Lancet Neurol 2015;14:388-405.
2.
Town T, et al: T-cells in Alzheimer's disease. Neuromolecular Med 2005;7:255-264.
3.
Lynch MA: The impact of neuroimmune changes on development of amyloid pathology: relevance to Alzheimer's disease. Immunology 2014;141:292-301.
4.
Engelhardt B, et al: Vascular, glial, and lymphatic immune gateways of the central nervous system. Acta Neuropathol 2016;132:317-338.
5.
Wolf SA, et al: CD4-positive T lymphocytes provide a neuroimmunological link in the control of adult hippocampal neurogenesis. J Immunol 2009;182:3979-3984.
6.
Ziv Y, et al: Immune cells contribute to the maintenance of neurogenesis and spatial learning abilities in adulthood. Nat Neurosci 2006;9:268-275.
7.
Ousman SS, Kubes P: Immune surveillance in the central nervous system. Nat Neurosci 2012;15:1096-1101.
8.
Itagaki S, McGeer PL, Akiyama H: Presence of T-cytotoxic suppressor and leucocyte common antigen positive cells in Alzheimer's disease brain tissue. Neurosci Lett 1988;91:259-264.
9.
Rogers J, et al: Expression of immune system-associated antigens by cells of the human central nervous system: relationship to the pathology of Alzheimer's disease. Neurobiol Aging 1988;9:339-349.
10.
Togo T, et al: Occurrence of T cells in the brain of Alzheimer's disease and other neurological diseases. J Neuroimmunol 2002;124:83-92.
11.
Parachikova A, et al: Inflammatory changes parallel the early stages of Alzheimer disease. Neurobiol Aging 2007;28:1821-1833.
12.
Grandjean J, et al: Complex interplay between brain function and structure during cerebral amyloidosis in APP transgenic mouse strains revealed by multi-parametric MRI comparison. Neuroimage 2016;134:1-11.
13.
Braak H, et al: Stages of the pathologic process in Alzheimer disease: age categories from 1 to 100 years. J Neuropathol Exp Neurol 2011;70:960-969.
14.
Braak H, et al: Staging of Alzheimer disease-associated neurofibrillary pathology using paraffin sections and immunocytochemistry. Acta Neuropathol 2006;112:389-404.
15.
Monsonego A, et al: Increased T cell reactivity to amyloid beta protein in older humans and patients with Alzheimer disease. J Clin Invest 2003;112:415-422.
16.
Lueg G, et al: Clinical relevance of specific T-cell activation in the blood and cerebrospinal fluid of patients with mild Alzheimer's disease. Neurobiol Aging 2015;36:81-89.
17.
Monson NL, et al: Elevated CNS inflammation in patients with preclinical Alzheimer's disease. J Cereb Blood Flow Metab 2014;34:30-33.
18.
Smolders J, et al: Characteristics of differentiated CD8(+) and CD4(+) T cells present in the human brain. Acta Neuropathol 2013;126:525-535.
19.
Ferretti MT, et al: T-cell brain infiltration and immature antigen-presenting cells in transgenic models of Alzheimer's disease-like cerebral amyloidosis. Brain Behav Immun 2016;54:211-225.
20.
Laurent C, et al: Hippocampal T cell infiltration promotes neuroinflammation and cognitive decline in a mouse model of tauopathy. Brain 2017;140:184-200.
21.
Ferretti MT, et al: Intracellular Abeta-oligomers and early inflammation in a model of Alzheimer's disease. Neurobiol Aging 2012;33:1329-1342.
22.
Bellucci A, et al: Induction of inflammatory mediators and microglial activation in mice transgenic for mutant human P301S tau protein. Am J Pathol 2004;165:1643-1652.
23.
Holman DW, Klein RS, Ransohoff RM: The blood-brain barrier, chemokines and multiple sclerosis. Biochim Biophys Acta 2011;1812:220-230.
24.
Grammas P, Ovase R: Inflammatory factors are elevated in brain microvessels in Alzheimer's disease. Neurobiol Aging 2001;22:837-842.
25.
Merlini M, Wanner D, Nitsch RM: Tau pathology-dependent remodelling of cerebral arteries precedes Alzheimer's disease-related microvascular cerebral amyloid angiopathy. Acta Neuropathol 2016;131:737-752.
26.
Liu CC, et al: Apolipoprotein E and Alzheimer disease: risk, mechanisms and therapy. Nat Rev Neurol 2013;9:106-118.
27.
Shi Y, et al: ApoE4 markedly exacerbates tau-mediated neurodegeneration in a mouse model of tauopathy. Nature 2017;549:523-527.
28.
Zotova E, et al: Inflammatory components in human Alzheimer's disease and after active amyloid-beta42 immunization. Brain 2013;136:2677-2696.
29.
Jack CR Jr, et al: Tracking pathophysiological processes in Alzheimer's disease: an updated hypothetical model of dynamic biomarkers. Lancet Neurol 2013;12:207-216.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.