Microglial metabolic reprogramming in Alzheimer's disease: Pathways, mechanisms, and therapeutic implications.

In recent years, the immune metabolism of central nervous system cells has gained increasing attention from researchers. Microglia (MG) are innate immune cells of the central nervous system. They can metabolize a wide range of energy substrates. The pathways and products generated through these processes play a critical role in the onset and progression of Alzheimer's disease (AD). This paper provides a comprehensive review of metabolic reprogramming in MG during AD. It focuses on the three primary energy substrates: glucose, fatty acids, and amino acids. It delves deeply into the molecular signaling pathways that regulate this reprogramming, including TREM2, PI3K-AKT-mTOR, HIF-1α, AMPK, PPARs, and LXRs. Additionally, the paper explores the potential of metabolomics as a tool for early diagnosis of AD, identifying biomarkers that could enhance detection in its early stages. Therapeutic strategies targeting the regulation of microglial phagocytic function, mitochondrial activity, and glycolysis are also examined, highlighting their potential to alleviate disease progression. This review article aims to uncover the dynamic network of microglial metabolic reprogramming. It also explores its causal relationship with the pathological cascade of AD. The findings provide theoretical support for developing innovative drugs that combine metabolic regulation and neuroprotective functions.