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Innate immune activation and microglial transition during neurodegeneration. (A) During neurodegeneration, distressed neurons release DAMPs such as mtDNA, ROS, HMGB1, aberrant proteins, and pTau–bound RNA. These signals activate resident microglia and astrocytes, which then recruit peripheral immune cells. As shown in more detail in B, activated microglia upregulate PRRs, including TLRs, RAGE, and cGAS, enabling detection of neuron-derived DAMPs. Engagement of PRRs induces proinflammatory gene expression programs and activates inflammasome pathways that promote release of chemokines and cytokines into the CNS parenchyma. As microglia transition from homeostatic to reactive states in a TREM2-dependent manner, damage-associated microglia increase MHC-II expression to support antigen presentation and coordination of adaptive immune responses that attempt to limit neurodegeneration.

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