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. 2024 May 22:16:1407980.
doi: 10.3389/fnagi.2024.1407980. eCollection 2024.

Association of soluble TREM2 with Alzheimer's disease and mild cognitive impairment: a systematic review and meta-analysis

Ruiqi Wang #  1 , Yijun Zhan #  1 , Wenyan Zhu  1 , Qianwen Yang  1 , Jian Pei  1
Affiliations

Association of soluble TREM2 with Alzheimer's disease and mild cognitive impairment: a systematic review and meta-analysis

Ruiqi Wang et al. Front Aging Neurosci. .

Abstract

Objective: Soluble triggering receptor expressed on myeloid cells 2 (sTREM2) is a potential neuroinflammatory biomarker linked to the pathogenesis of Alzheimer's disease (AD) and mild cognitive impairment (MCI). Previous studies have produced inconsistent results regarding sTREM2 levels in various clinical stages of AD. This study aims to establish the correlation between sTREM2 levels and AD progression through a meta-analysis of sTREM2 levels in cerebrospinal fluid (CSF) and blood.

Methods: Comprehensive searches were conducted in PubMed, Embase, Web of Science, and the Cochrane Library to identify observational studies reporting CSF and blood sTREM2 levels in AD patients, MCI patients, and healthy controls. A random effects meta-analysis was used to calculate the standardized mean difference (SMD) and 95% confidence intervals (CIs).

Results: Thirty-six observational studies involving 3,016 AD patients, 3,533 MCI patients, and 4,510 healthy controls were included. CSF sTREM2 levels were significantly higher in both the AD [SMD = 0.28, 95% CI (0.15, 0.41)] and MCI groups [SMD = 0.30, 95% CI (0.13, 0.47)] compared to the healthy control group. However, no significant differences in expression were detected between the AD and MCI groups [SMD = 0.09, 95% CI (-0.09, 0.26)]. Furthermore, increased plasma sTREM2 levels were associated with a higher risk of AD [SMD = 0.42, 95% CI (0.01, 0.83)].

Conclusion: CSF sTREM2 levels are positively associated with an increased risk of AD and MCI. Plasma sTREM2 levels were notably higher in the AD group than in the control group and may serve as a promising biomarker for diagnosing AD. However, sTREM2 levels are not effective for distinguishing between different disease stages of AD. Further investigations are needed to explore the longitudinal changes in sTREM2 levels, particularly plasma sTREM2 levels, during AD progression.

Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024514593.

Keywords: Alzheimer’s disease; meta-analysis; mild cognitive impairment; neuroinflammation; soluble TREM2.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of the study selection process and results.
Figure 2
Figure 2
Forest plot of CSF sTREM2 levels in patients with AD compared to controls. Weights are from random-effects model.
Figure 3
Figure 3
Forest plot of CSF sTREM2 levels in patients with MCI compared to controls. Weights are from random-effects model.
Figure 4
Figure 4
Forest plot of CSF sTREM2 levels in patients with AD compared to MCI patients. Weights are from random-effects model.
Figure 5
Figure 5
Forest plot of plasma sTREM2 expression levels in patients with AD and MCI. Weights and between-subgroup heterogeneity text are from random-effects model.
Figure 6
Figure 6
Subgroup analysis of CSF and plasma sTREM2 levels stratified by study characteristics.
See this image and copyright information in PMC

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