Apolipoprotein E ε4 exacerbates microglia-mediated complement-dependent synapse loss caused by neuronal Tpk deficiency

Thiamine pyrophosphokinse-1 (TPK) is a key enzyme that converts thiamine to functional thiamine diphosphate (TDP). TPK insufficiency and hence TDP reduction in neurons induced by amyloid-{beta} deposition and diabetes, an independent risk factor of Alzheimers disease (AD), recapitulate multi-pathophysiological features in the brain of mice, similar to those in human AD. Apolipoprotein E {varepsilon}4 allele (APOE4) is the most well-known genetic risk factor for AD. Clinical trials by boosting TDP using benfotiamine, a derivative of thiamine that significantly elevates TDP level in human encrythrocytes, have shown the inferior clinical efficacies in APOE4 carriers compared to non-APOE4 carriers. Clarifying the relationship between APOE4 and TPK expression and multi-pathophysiological characteristics of AD induced by Tpk deficiency in neurons is imperative. Here, we find that humanized APOE4 didnt directly affect Tpk expression of mice, but markedly aggravates behavior abnormalities of Tpk-cKO mice. Pathologically, the Tpk-cKO mice with humanized APOE4 knock-in (AE-cKO mice) exhibit more synapse loss than the mice with only humanized APOE4 knock-in and the Tpk-cKO mice. Transcriptomics and pathologic analysis identified that APOE4 promoted the overactivation of microglia and the transition of microglia to a disease-associated and phagocytosis state via a complement-mediated pathway. Further, the C3aR antagonist significantly repressed microglia phagocytosis and synaptic elimination of the AE-cKO mice. Our results demonstrate that APOE4 exacerbates behavior dysfunction of Tpk-cKO mice through microglia-mediated complement-dependent synaptic elimination. These findings provide important insights into the role of APOE4 in the pathogenesis of AD.