A groundbreaking study reveals how APOE gene isoforms influence human microglia in Alzheimer’s pathology.APOE ε4 is a known genetic risk factor for Alzheimer’s, affecting gene expression and epigenomic states in microglia.Human microglia with different APOE isoforms were transplanted into an Alzheimer’s mouse model for analysis.APOE ε4 microglia showed elevated expression of pro-inflammatory genes, while ε3 focused on repair functions.APOE ε2 exhibited anti-inflammatory gene expression and supported neuroprotective pathways.APOE isoforms altered chromatin accessibility, influencing gene regulation in microglia under disease conditions.Understanding APOE’s role in microglial regulation opens avenues for precision medicine in neurodegenerative diseases.The study challenges previous views by positioning APOE as a key regulator of microglial gene networks.Research inspired by these findings may explore reversing APOE ε4-driven epigenetic changes for therapeutic benefits.Personalized treatments considering APOE genotype could optimize immunomodulatory therapies in Alzheimer’s.