[Lymphatic system in central nervous system]

Med Sci (Paris). 2019 Jan;35(1):55-61. doi: 10.1051/medsci/2018309. Epub 2019 Jan 23.
[Article in French]

Abstract

The considerable metabolic activity of the central nervous system (CNS) requires an efficient system of tissue drainage and detoxification. The CNS is however devoid of lymphatic vessels, a vasculature ensuring interstitial fluid drainage and immune survey in other organs. A unique system of drainage has recently been identified between the cerebrospinal fluid (CSF), brain interstitial fluids and meningeal lymphatic vessels. This system is coupling a cerebral "glymphatic" flow with a meningeal lymphatic vasculature. The "glymphatic" system includes perivascular spaces and astrocytes, and drains interstitial fluids, from and towards the CSF. Meningeal lymphatic vessels are functionally linked to the cerebral "glymphatic" efflux by clearing intracerebral macromolecules and antigens towards the peripheral lymphatic system. The "glymphatic"-"meningeal lymphatics" system is potentially offering new therapeutic targets to improve cerebral drainage and immune survey in human CNS diseases.

Publication types

  • Review

MeSH terms

  • Brain / anatomy & histology
  • Brain / immunology
  • Central Nervous System / anatomy & histology*
  • Central Nervous System / immunology
  • Central Nervous System Diseases / immunology
  • Cerebrospinal Fluid / immunology
  • Extracellular Fluid / immunology
  • Glymphatic System / anatomy & histology*
  • Glymphatic System / immunology
  • Humans
  • Lymphatic System / anatomy & histology*
  • Lymphatic System / immunology
  • Lymphatic Vessels / anatomy & histology
  • Lymphatic Vessels / immunology
  • Meninges / anatomy & histology