The glymphatic system: A novel component of fundamental neurobiology

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Throughout the body, lymphatic fluid movement supports critical functions including clearance of excess fluid and metabolic waste. The glymphatic system is the analog of the lymphatic system in the CNS. As such, the glymphatic system plays a key role in regulating directional interstitial fluid movement, waste clearance, and, potentially, brain immunity. The glymphatic system enables bulk movement of CSF from the subarachnoid space along periarterial spaces, where it mixes with interstitial fluid within the parenchyma before ultimately exiting from the parenchyma via perivenous spaces. This review focuses on important questions about the structure of this system, why the brain needs a fluid transport system, and unexplored aspects of brain fluid transport. We provide evidence that astrocytes and blood vessels determine the shape of the perivascular space, ultimately controlling the movement of perivascular fluid. Glymphatic fluid movement has the potential to alter local as well as global transport of signaling molecules and metabolites. We also highlight the evidence for cross talk among the glymphatic system, cardiovascular system, gastrointestinal tract, and lymphatic system. Much remains to be studied, but we propose that the glymphatic/lymphatic system acts as a cornerstone in signaling between the brain and body.

OriginalsprogEngelsk
TidsskriftJournal of Neuroscience
Vol/bind41
Udgave nummer37
Sider (fra-til)7698-7711
Antal sider14
ISSN0270-6474
DOI
StatusUdgivet - 2021

Bibliografisk note

Funding Information:
This research was supported by Department of Health and Human Services/National Institutes of Health/ National Institute of Neurological Disorders and Stroke Grants R01-NS-100366 (to M.N.) and RF1-AG-057575 (to M.N.); US Department of Defense, US Army, US Army Research, Development and Engineering Command, Army Research Office Grant MURI W911NF1910280 (to M.N.); Fondation Leducq Transatlantic Networks of Excellence Program; Novo Nordisk Foundation; Lundbeck Foundation; and the EU Horizon 2020 Research and Innovation Program Grant 666881 (to M.N.). We thank Dan Xue for graphic illustrations. The authors declare no competing financial interests. Correspondence should be addressed to Lauren Hablitz at Lauren_Hablitz@urmc.rochester.edu. https://doi.org/10.1523/JNEUROSCI.0619-21.2021 Copyright © 2021 the authors

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© 2021 the authors

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