Tracking tau and cellular responses in human iPSC-microglia: from uptake to seedable secretion, including in extracellular vesicles

Alzheimers Dement. 2026 Apr;22(4):e71337. doi: 10.1002/alz.71337.

Abstract

Introduction: Microglia have been implicated in the templated spread of tau aggregates in tauopathies through mouse studies. However, it is unclear whether these findings translate to human disease.

Methods: We challenged human induced pluripotent stem cell (iPSC)-derived microglia-like-cells (iMGL) with monomeric and fibrillar recombinant tau and tau purified from Alzheimer's patient brains, examining in detail the uptake, processing, release, and seeding of tau by microglia.

Results: iMGL take up tau via lipoprotein receptor-related protein 1 (LRP)1 and heparan sulfate proteoglycans, with leucine-rich repeat kinase 2 affecting LRP1 trafficking. Monomeric tau is digested effectively with minimal effects on iMGL, but recombinant or brain-derived tau fibrils induce chemokine/interferon response subtypes, alongside downregulation of homeostatic genes. Fibrillar tau is degradation-resistant, can escape into the cytoplasm, and becomes phosphorylated on two specific residues. iMGL release partially digested fibrillar tau, including in extracellular vesicles, visualized by cryo-electron microscopy, that seed aggregation in neurons.

Discussion: Our study reveals new insights into human microglial responses to tau, highlighting opportunities to limit pathogenic tau spread.

Keywords: LRP1; cryo‐electron microscopy; extracellular vesicle; induced pluripotent stem cells; lipoprotein receptor‐related protein 1; microglia; phospho‐proteome; tau.

MeSH terms

  • Alzheimer Disease / metabolism
  • Alzheimer Disease / pathology
  • Brain / metabolism
  • Extracellular Vesicles* / metabolism
  • Humans
  • Induced Pluripotent Stem Cells* / metabolism
  • Low Density Lipoprotein Receptor-Related Protein-1 / metabolism
  • Microglia* / metabolism
  • tau Proteins* / metabolism

Substances

  • tau Proteins
  • MAPT protein, human
  • Low Density Lipoprotein Receptor-Related Protein-1