Elham Elzat, Wumaier Reziya, Wang Chengji, Luo Xiangying, Chen Tao, Zhong Nanshan
Reconstruction and Micro-Surgery Center, Xuzhou Renci Hospital, Xuzhou Medical University, Xuzhou 221000, Jiangsu, China.
Key Laboratory of Medical Molecular Virology, Institute of Biomedical Sciences and Institute of Medical Microbiology, Shanghai Medical College, Fudan University, 200032 Shanghai, China.
Med Hypotheses. 2020 Oct;143:109898. doi: 10.1016/j.mehy.2020.109898. Epub 2020 May 30.
Respiratory infections can result in intracranial infections and unknown neurological symptoms. The central nervous system lacks classical meningeal lymphatic (circulation) drainage, and the exact underlying mechanisms of how immune cells from the peripheral lymphatic system enter the central nervous system (CNS) remain unknown. To determine whether the perinasal lymphatic system or lymphatic vessels are involved in cerebral immune defence and play a role in causing CNS infections (especially respiratory tract-related infections), we performed an anatomic study to investigate the drainage differences between the perinasal and intracerebral lymphatic systems by using injection of Evans blue and anatomic surgery, together with immunohistochemistry and immunofluorescence assays. Surprisingly, we found that (1) the pituitary (adenohypophysis) is involved and is rich in lymphatic vessels and (2) perinasal tissue could communicate with central pituitary lymphatic vessels in a specific and unidirectional manner. Taken together, our study may be the first to anatomically demonstrate the existence of novel lymphatic vessel structures in the pituitary, as well as their communication with the perinasal (lymphatic) tissue. Our findings suggest the existence of an ultimate loop for "classical" meningeal lymphatic drainage and are relevant to cerebral infection and immune defence.
呼吸道感染可导致颅内感染及不明原因的神经症状。中枢神经系统缺乏典型的脑膜淋巴（循环）引流，外周淋巴系统的免疫细胞如何进入中枢神经系统（CNS）的确切潜在机制尚不清楚。为了确定鼻周淋巴系统或淋巴管是否参与脑免疫防御并在导致中枢神经系统感染（尤其是呼吸道相关感染）中起作用，我们进行了一项解剖学研究，通过注射伊文思蓝和解剖手术，结合免疫组织化学和免疫荧光分析，来研究鼻周和脑内淋巴系统之间的引流差异。令人惊讶的是，我们发现：（1）垂体（腺垂体）参与其中且富含淋巴管；（2）鼻周组织能够以一种特定的单向方式与垂体中央淋巴管相通。综上所述，我们的研究可能首次从解剖学上证明了垂体中存在新的淋巴管结构，以及它们与鼻周（淋巴）组织的连通性。我们的发现提示了“经典”脑膜淋巴引流存在一个最终环路，并且与脑感染和免疫防御相关。
