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Natl. Acad. Sci. U.S.A."],"published-print":{"date-parts":[[2026,3,10]]},"abstract":"<jats:p>The prevailing view frames microglia and macrophages as guardians against amyloid beta (A\u03b2) accumulation in Alzheimer\u2019s disease (AD). Here, we overturn this paradigm by demonstrating that human phagocytic cells, including differentiated THP-1 macrophages and hESC-derived microglia, are not merely passive responders but active producers of extracellular, seeding-competent A\u03b242 fibrils, the amyloid species most strongly linked to parenchymal plaque formation and neurodegeneration. These cell-generated aggregates differ structurally and functionally from synthetic fibrils, displaying enhanced seeding and tau cross-seeding activity in biosensor models. Notably, A\u03b242 fibril formation in this system requires active cellular processes and is exacerbated by loss of Triggering Receptor Expressed on Myeloid Cells 2 (TREM2), a major AD risk gene. Transcriptomic profiling reveals an early inflammatory response resembling microglial states observed in human AD models. Together, these findings support emerging evidence from in vivo studies that macrophages and microglia can influence amyloid seeding and introduce a human-relevant in vitro platform to explore how A\u03b2 aggregation intersects with innate immune function and genetic risk. Our results reinforce the concept that microglia may play a dual role in AD, acting both as responders and inadvertent facilitators of amyloid assembly, with implications for early therapeutic intervention.<\/jats:p>","DOI":"10.1073\/pnas.2516774123","type":"journal-article","created":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T20:10:06Z","timestamp":1772482206000},"update-policy":"https:\/\/doi.org\/10.1073\/pnas.cm10313","source":"Crossref","is-referenced-by-count":0,"title":["Phagocytes as plaque catalysts: Human macrophages generate seeding-competent A\u03b242 fibrils with cross-seeding activity"],"prefix":"10.1073","volume":"123","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0960-6274","authenticated-orcid":false,"given":"Katerina","family":"Konstantoulea","sequence":"first","affiliation":[{"name":"VIB Center for Neuroscience, VIB","place":["Leuven, Belgium"]},{"name":"Switch Laboratory, Department of Cellular and Molecular Medicine, University of Leuven (KU 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