Researchers have developed a new protocol to transplant immune cells called microglia into the brain – and show the strategy can protect neurons and combat hallmarks of neurological disorders in mice. Their therapy stands out from traditional microglia replacement methods because it doesn’t rely on risky conditioning regimens, making it a safer and more practical approach for microglia replacement. Studies have established a firm link between some neurological disorders and defects in microglia, which are immune cells that maintain and clean up the central nervous system. Scientists theorize that correcting or replacing these dysfunctional microglia could help treat neurological conditions such as Alzheimer’s disease. However, traditional methods to replenish microglia rely on bone marrow transplantation, which is arduous and inefficient. Furthermore, these transplants require strict preconditioning regimens that use radiation or chemotherapy, which can damage the brain, and the microglia that result from the transplanted bone barrow aren’t faithful copies of the originals. To avoid the need for preconditioning, Dadian Chen and colleagues developed a new approach named tricyclic microglial depletion for transplantation (TCMDT). This strategy uses three cycles of an experimental compound that inhibits the CSF1R receptor, which microglia require to proliferate. The treatments deplete the native, dysfunctional microglia and provide an optimal window to transplant cultured, healthy microglia. Chen et al. found that TCMDT given before symptoms replaced defective microglia and slowed the degeneration of neurons in mouse models of Alzheimer’s disease and Sandhoff disease, an inherited neurodegenerative disorder. The team calls for further research into the mechanisms at play, and to test whether human induced pluripotent stem cells could be used as a more clinically relevant source for microglia.