TLR5 decoy receptor as a novel anti-amyloid therapeutic for Alzheimer's disease.

There is considerable interest in harnessing innate immunity to treat Alzheimer's disease (AD). Here, we explore whether a decoy receptor strategy using the ectodomain of select TLRs has therapeutic potential in AD. AAV-mediated expression of human TLR5 ectodomain (sTLR5) alone or fused to human IgG4 Fc (sTLR5Fc) results in robust attenuation of amyloid beta (A beta) accumulation in a mouse model of Alzheimer-type A beta pathology. sTLR5Fc binds to oligomeric and fibrillar A beta with high affinity, forms complexes with A beta, and blocks A beta toxicity. Oligomeric and fibrillar A beta modulates flagellin-mediated activation of human TLR5 but does not, by itself, activate TLR5 signaling. Genetic analysis shows that rare protein coding variants in human TLR5 may be associated with a reduced risk of AD. Further, transcriptome analysis shows altered TLR gene expression in human AD. Collectively, our data suggest that TLR5 decoy receptor-based biologics represent a novel and safe A beta-selective class of biotherapy in AD.