Hershenhouse Korri S, Shauly Orr, Gould Daniel J, Patel Ketan M
Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Department of Plastic and Reconstructive Surgery, Keck Hospital of USC, Los Angeles, CA, USA.
Neurosci Insights. 2019 Dec 31;14:1179069519889027. doi: 10.1177/1179069519889027. eCollection 2019.
The recent discovery of lymphatic vessels in the meningeal layers calls into question the known mechanisms of fluid and macromolecule homeostasis and immunoregulation within the central nervous system. These meningeal lymphatic vessels and their potential role in the pathophysiology of neurological disease have become a rapidly expanding area of research, with the hopes that they may provide a novel therapeutic target in the treatment of many devastating conditions. This article reviews the current state of knowledge surrounding the anatomical structure of the vessels, their functions in fluid and solute transport and immune surveillance, as well as their studied developmental biology, relationship with the novel hypothesized "glymphatic" system, and implications in neurodegenerative disease in animal models. Furthermore, this review summarizes findings from the human studies conducted thus far regarding the presence, anatomy, and drainage patterns of meningeal lymphatic vessels and discusses, from a clinical perspective, advancements in both imaging technologies and interventional methodologies used to access ultrafine peripheral lymphatic vessels.
脑膜层中淋巴管的近期发现，对中枢神经系统内已知的液体和大分子稳态及免疫调节机制提出了质疑。这些脑膜淋巴管及其在神经疾病病理生理学中的潜在作用，已成为一个迅速扩展的研究领域，人们希望它们可能为许多毁灭性疾病的治疗提供一个新的治疗靶点。本文综述了关于这些淋巴管的解剖结构、它们在液体和溶质运输以及免疫监视中的功能、已研究的发育生物学、与新假设的“类淋巴”系统的关系，以及在动物模型中对神经退行性疾病影响的当前知识状态。此外，本综述总结了迄今为止关于脑膜淋巴管的存在、解剖结构和引流模式的人体研究结果，并从临床角度讨论了用于检测超细微周淋巴管的成像技术和介入方法的进展。
