Assessing Aβ-independent effects of Module 42 on immune function in vitro

Alzheimers Dement. 2026 Feb;22(2):e71215. doi: 10.1002/alz.71215.

Abstract

Introduction: A deep multi-omic analysis of post mortem human brains has identified a new co-expression protein network - Module 42 (M42), strongly corelated with Alzheimer's disease (AD) pathology. M42 comprises 32 transmembrane and extracellular matrix (ECM)-associated proteins, including the amyloid precursor protein (APP) and apolipoprotein E (apoE), and its members have been implicated in amyloid beta (Aβ) pathology. We systematically evaluated the Aβ-independent effects of M42 on immune function in vitro.

Methods: Recombinant M42 proteins were expressed and purified. Their effects on phagocytosis, intracellular signaling, and cell viability were assessed in human induced pluripotent stem cell-derived macrophages.

Results: Treatment with Midkine (MDK) reduced phagocytosis, while treatment with the ectodomain of Transmembrane protein with EGF-like and two follistatin-like domains 2 (TMEFF2) had the opposite effect. Both proteins promoted intracellular Ca2+ signaling, and TMEFF2 also suppressed Syk kinase activity. No M42 proteins had an effect on viability.

Discussion: Our results suggest an additional role for M42 in AD via regulating immune functions.

Highlights: We tested M42 proteins for their effects on immune functions in vitro. Five proteins altered phagocytosis, and seven altered Ca2+ signaling. MDK and TMEFF2 ectodomain had an effect on both phagocytosis and Ca2+ signaling.

Keywords: Alzheimer's disease; M42 proteins; immune function; matrisome.

MeSH terms

  • Alzheimer Disease* / immunology
  • Alzheimer Disease* / metabolism
  • Amyloid beta-Peptides* / immunology
  • Amyloid beta-Peptides* / metabolism
  • Cell Survival / drug effects
  • Humans
  • Induced Pluripotent Stem Cells
  • Macrophages* / drug effects
  • Macrophages* / immunology
  • Macrophages* / metabolism
  • Membrane Proteins* / metabolism
  • Phagocytosis* / drug effects

Substances

  • Amyloid beta-Peptides
  • Membrane Proteins