Microglial phagocytosis is an energetically demanding process that plays a critical role in the removal of toxic protein aggregates in Alzheimer’s disease (AD). Recent evidence indicates that a switch in energy production from mitochondrial respiration to glycolysis disrupts this important protective microglial function and may provide therapeutic targets for AD. Here, we demonstrate that the translocator protein (TSPO) and a member of its mitochondrial complex, hexokinase-2 (HK), play critical roles in microglial respiratory-glycolytic metabolism and phagocytosis. Pharmacological and genetic loss-of-function experiments showed that TSPO is critical for microglial respiratory metabolism and energy supply for phagocytosis, and its expression is enriched in phagocytic microglia of AD mice. Meanwhile, HK controlled glycolytic metabolism and phagocytosis via mitochondrial binding or displacement. In cultured microglia, TSPO deletion impaired mitochondrial respiration and increased mitochondrial recruitment of HK, inducing a switch to glycolysis and reducing phagocytosis. To determine the functional significance of mitochondrial HK recruitment, we developed an optogenetic tool for reversible control of HK localization. Displacement of mitochondrial HK inhibited glycolysis and improved phagocytosis in TSPO-knockout microglia. Mitochondrial HK recruitment also coordinated the inflammatory switch to glycolysis that occurs in response to lipopolysaccharide in normal microglia. Interestingly, cytosolic HK increased phagocytosis independent of its metabolic activity, indicating an immune signaling function. Alzheimer’s beta amyloid drastically stimulated mitochondrial HK recruitment in cultured microglia, which may contribute to microglial dysfunction in AD. Thus, targeting mitochondrial HK may offer an immunotherapeutic approach to promote phagocytic microglial function in AD.

Microglial phagocytosis is an energetically demanding process that plays a critical role in the removal of toxic aggregates of beta amyloid (Aβ) in Alzheimer’s disease (AD). Recent evidence indicates that metabolic programming may breakdown in microglia in AD, thereby disrupting this important protective function. The mechanisms coordinating mitochondrial metabolism to fuel phagocytosis in microglia remain poorly understood, however. Here we demonstrate that mitochondrial displacement of the glucose metabolizing enzyme, hexokinase-II (HK) regulates microglial metabolism and phagocytosis, and that deletion of the translocator protein (TSPO) inhibits this. TSPO is a PET-visible inflammatory biomarker and therapeutic target in AD, previously shown to regulate microglial metabolism via an unknown mechanism. Using RNAseq and proteomic analyses, we found TSPO function in the brain to be linked with the regulation of mitochondrial bioenergetics, lipid metabolism and phagocytosis. In cultured microglia, TSPO deletion was associated with elevated mitochondrial recruitment of HK, which was associated with a switch to non-oxidative glucose metabolism, reduced mitochondrial energy production, lipid storage and impaired phagocytosis. Consistent with in vitro findings, TSPO expression was also associated with phagocytic microglia in both AD brain and AD mice. Conversely, TSPO deletion in AD mice reduced phagocytic microglia and exacerbated amyloid accumulation. Based on these findings we propose that microglial TSPO functions as an immunometabolic brake via regulation of mitochondrial HK recruitment, preventing hyperglycolysis and promoting phagocytosis in AD. Further, we demonstrate that targeting mitochondrial HK may offer a novel immunotherapeutic approach to promote microglial phagocytosis in AD.