(A) Tau aggregates in 5M P301S DRGn prelabeled with pFTAA are transferred to microglia after phagocytosis. Microglia were purified after 4 days of coculture, replated, and imaged live. Left: Fluorescence and phase. Right: Fluorescence only. Arrows, pFTAA-positive tau foci. (B) htau is only released into the CM when 5M P301S DRGn and microglia are cocultured. Human transgenic tau was detected specifically by ELISA after 4 days (P = 0.012, versus all monocultures and coculture of microglia with 5M C57 neurons, one-sample t test). Tau is released over a further 4 days by microglia reisolated from 5M P301S DRGn cocultures (post) (P = 0.185 versus original coculture CM, unpaired t test). No tau is detected in CM from monocultures of 5M P301S or C57 DRGn or C57 microglia or from 5M C57 DRGn-microglia cocultures. Lactate dehydrogenase (LDH) activity is not significantly different across all conditions, indicating that released tau is not due to lysed cells (P = 0.069, one-way ANOVA). N = 3 to 4 independent experiments, means ± SD. (C) Release of tau requires phagocytosis by microglia. The number of htau-positive 5M P301S DRGn (% HT7/βIII-tubulin) is reduced after coculture with C57 microglia (green triangles, P = 0.0048, repeated-measures ANOVA), commensurate with an increase in tau in the CM (red circles, P = 0.0225, one-sample t test). Blocking phagocytosis by masking PtdSer with AnnV prevents neuronal loss (green triangles, n.s. versus P301S DRG, P = 0.0309 versus C57 microglia, repeated-measures ANOVA). AnnV also prevents the release of tau into the CM (red circles, n.s. versus P301S DRG). N = 4 independent experiments, means ± SD.