ER stress activates immunosuppressive network: implications for aging and Alzheimer's disease

J Mol Med (Berl). 2020 May;98(5):633-650. doi: 10.1007/s00109-020-01904-z. Epub 2020 Apr 11.


The endoplasmic reticulum (ER) contains stress sensors which recognize the accumulation of unfolded proteins within the lumen of ER, and subsequently these transducers stimulate the unfolded protein response (UPR). The ER sensors include the IRE1, PERK, and ATF6 transducers which activate the UPR in an attempt to restore the quality of protein folding and thus maintain cellular homeostasis. If there is excessive stress, UPR signaling generates alarmins, e.g., chemokines and cytokines, which activate not only tissue-resident immune cells but also recruit myeloid and lymphoid cells into the affected tissues. ER stress is a crucial inducer of inflammation in many pathological conditions. A chronic low-grade inflammation and cellular senescence have been associated with the aging process and many age-related diseases, such as Alzheimer's disease. Currently, it is known that immune cells can exhibit great plasticity, i.e., they are able to display both pro-inflammatory and anti-inflammatory phenotypes in a context-dependent manner. The microenvironment encountered in chronic inflammatory conditions triggers a compensatory immunosuppression which defends tissues from excessive inflammation. Recent studies have revealed that chronic ER stress augments the suppressive phenotypes of immune cells, e.g., in tumors and other inflammatory disorders. The activation of immunosuppressive network, including myeloid-derived suppressor cells (MDSC) and regulatory T cells (Treg), has been involved in the aging process and Alzheimer's disease. We will examine in detail whether the ER stress-related changes found in aging tissues and Alzheimer's disease are associated with the activation of immunosuppressive network, as has been observed in tumors and many chronic inflammatory diseases.

Keywords: Ageing; Immunometabolism; Immunosenescence; Immunosuppression; Inflammaging; Neurodegeneration.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aging / immunology*
  • Aging / metabolism*
  • Alzheimer Disease / etiology*
  • Alzheimer Disease / metabolism*
  • Animals
  • Biomarkers
  • Cellular Microenvironment / immunology
  • Disease Susceptibility
  • Endoplasmic Reticulum Stress*
  • Energy Metabolism
  • Humans
  • Immunomodulation*
  • Inflammation / etiology
  • Inflammation / metabolism
  • Neurodegenerative Diseases / etiology
  • Neurodegenerative Diseases / metabolism
  • Unfolded Protein Response


  • Biomarkers