Population and single-cell analyses reveal immune cell-specific expression profiles associated with Alzheimer's disease risk

Alzheimers Dement. 2026 Mar;22(3):e71282. doi: 10.1002/alz.71282.

Abstract

Introduction: Dysregulation of the peripheral immune system may increase Alzheimer's disease (AD) risk, but the underlying cell type-specific mechanisms remain unclear.

Methods: We conducted Mendelian randomization and colocalization analyses of 4489 genes using single-cell expression quantitative trait locus data from unstimulated and stimulated peripheral immune cells, integrated with an AD genome-wide association study (N = 455,258). Spatial transcriptomics of brain tissue samples was used to identify brain-infiltrating immune cells.

Results: Thirteen genes were associated with AD risk. Expression of BIN1, CTSW, CTSH, HLA-DRB1, TSTD1, PLEKHA1, and SCIMP increased AD risk, while EPHA1-AS1, FCER1G, FIBP, KAT8, STX4, and HLA-DQA1 reduced it. These associations were peripheral immune cell type and state specific. PLEKHA1 and TSTD1 were upregulated and FIBP downregulated in natural killer and T cells in AD brain tissue.

Discussion: These findings link immune cell-specific gene expression to AD risk across activation states and within brain-infiltrating immune cells, highlighting potential targets for immune-based AD prevention and treatment.

Keywords: Alzheimer's disease; Mendelian randomization; brain infiltrating; colocalization; immune system; peripheral blood immune cells; single cell; spatial transcriptomics.

MeSH terms

  • Alzheimer Disease* / genetics
  • Alzheimer Disease* / immunology
  • Brain / immunology
  • Brain / metabolism
  • Genetic Predisposition to Disease
  • Genome-Wide Association Study
  • Humans
  • Mendelian Randomization Analysis
  • Quantitative Trait Loci
  • Single-Cell Analysis
  • Transcriptome