Crosstalk between peripheral immunity and central nervous system in Alzheimer’s disease

•The new hypothesis of AD pathogenesis involves peripheral and central immunity.•BBB impairment affects the occurrence and development of AD.•Risk genes participate in BBB function maintenance and immune systems’ crosstalk. The significance of peripheral immunity in the pathogenesis and progression of Alzheimer’s diseases (AD) has been recognized. Brain-infiltrated peripheral immune components transporting across the blood–brain barrier (BBB) may reshape the central immune environment. However, mechanisms of how these components open the BBB for AD occurrence and development and correlations between peripheral and central immunity have not been fully explored. Herein, we formulate a hypothesis whereby peripheral immunity as a critical factor allows AD to progress. Peripheral central immune cell crosstalk is associated with early AD pathology and related risk factors. The damaged BBB permits peripheral immune cells to enter the central immune system to deprive its immune privilege promoting the progression toward developing AD. This review summarizes the influences of risk factors on peripheral immunity, alongside their functions, highlighting the concept of peripheral and central immunity as an integrated system in AD pathogenesis, which has received scant attention before.