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Single-cell multi-omic profiling allows the dissection of peripheral immune phenotypes in Alzheimer’s Disease progression

Item Type:Preprint
Title:Single-cell multi-omic profiling allows the dissection of peripheral immune phenotypes in Alzheimer’s Disease progression
Creators Name:Spintge, Jannis B., Mai, Karola, Carraro, Caterina, Uelft, Martina van, Elli, Francesco, Mauer, Karoline, Holsten, Lisa, Frolov, Aleksej, Elangikal, Janice, Hinkley, Emily, Schulte-Schrepping, Jonas, Shakiba, Mehrnoush H., Lang, Laura, Elmzzahi, Tarek, Hamada, Doaa, Müller, Sophie, Li, Yuanfang, Gemünd, Ioanna, Kröger, Charlotte, Leidner, Jacqueline, Zajac, Timo, Montgomery, Jessica V., Hartmann, Celia, Hussein, Bidour, Büttner, Maren, Knoll, Rainer, Hüsson, Dina, Scholz, Rebekka, Paschek, Tobias, Isakzai, Victoria, Reusch, Nico, Paulusch, Stefan, Drews, Anna, Kraut, Michael, Theis, Heidi, Rüthing, Marie, Strube, Ulrike, Preis, Lukas, Gref, Daria, Spruth, Eike J., Gemenetzi, Maria, Fliessbach, Klaus, Hansen, Niels, Rostamzadeh, Ayda, Glanz, Wenzel, Incesoy, Enise I., Janowitz, Daniel, Stöcklein, Sophia, Rauchmann, Boris-Stephan, Kilimann, Ingo, Goerss, Doreen, Sodenkamp, Sebastian, Kronmüller, Marie, Roeske, Sandra, Gamez, Anna, Schmid, Matthias, Bürger, Katharina, Hellmann-Regen, Julian, Laske, Christoph, Ramirez, Alfredo, Brosseron, Frederic, Wiltfang, Jens, Perneczky, Robert, Düzel, Emrah, Teipel, Stefan, Spottke, Annika, Petzold, Gabor C., Peters, Oliver, Priller, Josef, Schmidt, Susanne V., Wagner, Michael, Kleineidam, Luca, Jessen, Frank, Schneider, Anja, Bonaguro, Lorenzo, De Domenico, Elena, Aschenbrenner, Anna C., Becker, Matthias, Ulas, Thomas, Schultze, Joachim L. and Beyer, Marc D.
Abstract:The role of the peripheral immune system in Alzheimer’s Disease (AD) remains insufficiently resolved, limiting the understanding of systemic disease effects and mechanisms. Here, we employed three high-resolution single-cell techniques, including flow cytometry, single-cell RNA- and ATAC-sequencing, to investigate peripheral immunity in AD dementia and earlier stages of the AD trajectory in over 100 patients. We identified reduced humoral immune responses in AD, characterized by a diminished B cell compartment displaying an impaired activation phenotype. Classical monocytes expanded in mild cognitive impairment and early AD dementia, acquiring a NF-kB/AP-1-mediated low-grade inflammation phenotype. Our findings link peripheral dysregulation in innate and adaptive immunity at cell frequency, transcriptional and epigenetic levels to the AD trajectory and provide insights into distinct phenotypes that define AD progression in contrast to healthy aging across cohorts.
Keywords:Alzheimer’s Disease, Cognitive Decline Trajectory, Peripheral Immunity, Single-Cell Multiomics, Transcriptomics, Epigenomics, High-Dimensional Cytometry, Monocytes, B Cells, T Cells, Disease Progression Stratification
Source:medRxiv
Publisher:Cold Spring Harbor Laboratory Press
Article Number:2026.03.12.26348228
Date:13 March 2026
Official Publication:https://doi.org/10.64898/2026.03.12.26348228

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