Understanding the functions and relationships of the glymphatic system and meningeal lymphatics
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TLDR
The glymphatic system is discussed as a system that allows CNS perfusion by the cerebrospinal fluid (CSF) and interstitial fluid (ISF), and the recently characterized meningeal lymphatic vessels and their role in drainage of the brain ISF.Abstract:
Recent discoveries of the glymphatic system and of meningeal lymphatic vessels have generated a lot of excitement, along with some degree of skepticism. Here, we summarize the state of the field and point out the gaps of knowledge that should be filled through further research. We discuss the glymphatic system as a system that allows CNS perfusion by the cerebrospinal fluid (CSF) and interstitial fluid (ISF). We also describe the recently characterized meningeal lymphatic vessels and their role in drainage of the brain ISF, CSF, CNS-derived molecules, and immune cells from the CNS and meninges to the peripheral (CNS-draining) lymph nodes. We speculate on the relationship between the two systems and their malfunction that may underlie some neurological diseases. Although much remains to be investigated, these new discoveries have changed our understanding of mechanisms underlying CNS immune privilege and CNS drainage. Future studies should explore the communications between the glymphatic system and meningeal lymphatics in CNS disorders and develop new therapeutic modalities targeting these systems.read more
Citations
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The glymphatic pathway in neurological disorders
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CNS lymphatic drainage and neuroinflammation are regulated by meningeal lymphatic vasculature.
Antoine Louveau,Jasmin Herz,Maria Nordheim Alme,Andrea Francesca Salvador,Michael Q. Dong,Kenneth E. Viar,S. Grace Herod,James Knopp,Joshua C. Setliff,Alexander L. Lupi,Sandro Da Mesquita,Elizabeth L. Frost,Alban Gaultier,Tajie H. Harris,Rui Cao,Song Hu,John R. Lukens,Igor Smirnov,Christopher C. Overall,Guillermo Oliver,Jonathan Kipnis +20 more
TL;DR: It is demonstrated that meningeal lymphatics drain CSF-derived macromolecules and immune cells and play a key role in regulating neuroinflammation and may represent a new therapeutic target for multiple sclerosis.
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TL;DR: In searching for T-cell gateways into and out of the meninges, functional lymphatic vessels lining the dural sinuses are discovered, which may call for a reassessment of basic assumptions in neuroimmunology and sheds new light on the aetiology of neuroinflammatory and neurodegenerative diseases associated with immune system dysfunction.
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The Glymphatic System: A Beginner’s Guide
TL;DR: The glymphatic system is a recently discovered macroscopic waste clearance system that utilizes a unique system of perivascular tunnels, formed by astroglial cells, to promote efficient elimination of soluble proteins and metabolites from the central nervous system.