X‐linked adrenoleukodystrophy (X‐ALD) is a severe inherited metabolic disease with cerebral inflammatory demyelination and abnormal accumulation of very long chain fatty acid (VLCFA) in tissues, especially the brain. At present, bone marrow transplantation (BMT) at an early stage of the disease is the only effective treatment for halting disease progression, but the underlying mechanism of the treatment has remained unclear. Here, we transplanted GFP‐expressing wild‐type (WT) or Abcd1‐deficient (KO) bone marrow cells into recipient KO mice, which enabled tracking of the donor GFP+ cells in the recipient mice. Both the WT and KO donor cells were equally distributed throughout the brain parenchyma, and displayed an Iba1‐positive, GFAP‐ and Olig2‐negative phenotype, indicating that most of the donor cells were engrafted as microglia‐like cells. They constituted approximately 40% of the Iba1‐positive cells. Unexpectedly, no decrease of VLCFA in the cerebrum was observed when WT bone marrow cells were transplanted into KO mice. Taken together, murine study suggests that bone marrow‐derived microglia‐like cells engrafted in the cerebrum of X‐ALD patients suppress disease progression without evidently reducing the amount of VLCFA in the cerebrum.
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