Sex-divergent responses to microglial depletion suggest distinct regulatory dependencies in the aged brain

Microglia are essential for brain homeostasis, yet their roles in the aged brain remain poorly defined. Using microRNA (miRNA) profiling, cellular-resolution spatial transcriptomics, and bulk proteomics in 21-month-old mice, we characterize sex-dimorphic responses to microglial depletion via CSF1R inhibition (PLX5622 treatment). Microglia-enriched miRNAs, notably miR-146a-5p and miR-223-3p, were downregulated across different brain regions in both sexes. Transcriptional responses were sex dimorphic: females showed predominantly cell-type-specific downregulation, while males showed bidirectional changes including upregulation of Lzts3, Shank3, and Fgfbp1 alongside downregulation of Ang. Proteomic changes were larger in magnitude and independent from mRNA changes: males exhibited 295 differentially expressed proteins (DEPs) versus 34 in females (8.7-fold difference). Male DEPs had opposing directional shifts in synaptic vesicle proteins (upregulated) and mitochondrial ATP synthesis machinery (downregulated). These data describe sex-dimorphic molecular consequences of microglial loss in the aged brain and identify candidate post-transcriptional mechanisms warranting further investigation.