ABCA7 (ATP binding cassette subfamily A member 7) is a lipid transporter that catalyzes ATP-dependent phospholipid translocation across cellular membranes, with preferential transport of phosphatidylserine over phosphatidylcholine 1. The protein plays crucial roles in lipid homeostasis, cholesterol efflux, and macrophage-mediated phagocytosis of apoptotic cells 23. ABCA7 is highly expressed in microglial cells and functions in amyloid-β clearance and processing 45. Loss-of-function variants in ABCA7 significantly increase Alzheimer's disease risk through multiple mechanisms 67. ABCA7 deficiency disrupts mitochondrial lipid metabolism, particularly affecting phosphatidylglycerol and cardiolipin levels, leading to compromised mitochondrial respiration, increased oxidative stress, and impaired synaptic function 89. In neurons, ABCA7 deficiency alters phosphatidylcholine metabolism and causes mitochondrial dysfunction, which can be rescued by CDP-choline supplementation 9. Neuronal ABCA7 deficiency exacerbates amyloid pathology and neurodegeneration by disturbing mitochondrial homeostasis 10. These findings establish ABCA7 as a critical regulator of neuronal lipid metabolism and mitochondrial function, with therapeutic implications for Alzheimer's disease treatment.