Nycz Blanka, Mandera Marek
Department of Pediatric Neurosurgery, Medical University of Silesia in Katowice, Medyków 16 Street, 40-752 Katowice, Poland.
Auton Neurosci. 2021 May;232:102774. doi: 10.1016/j.autneu.2021.102774. Epub 2021 Feb 3.
The glymphatic system creates a network of perivascular channels. It is made of astroglia cells, whose perikaryon extensions strongly express aquaporin-4 water channels (AQP4). The pathways of the glymphatic system ensure the transport of nutrients, including glucose, lipids, amino acids, neurotransmitters, antigens, and immune cells, as well as exchange of information via afferent and efferent immune pathways. Within the glymphatic system, convective exchange of cerebrospinal fluid (CSF) and interstitial fluid (ISF) components takes place, through aquaporin-4 water channels that facilitate fluid exchange. The proper functioning of the glymphatic system allows elimination and reabsorption of solutes, metabolites, pursuit of water and ionic balance, transport of lipid signaling molecules, regulation of intracranial pressure, cerebrospinal fluid pressure, and interstitial fluid pressure. The functions of the glymphatic system are primarily affected by the influence of the sympathetic and parasympathetic innervation, sleep and wakefulness cycle, the aging process, genetic factors, and body posture. Now, the glymphatic system shows weak activity during wakefulness, while its activity increases dramatically during sleep and the state of anesthesia. Changes occurring with age begin a number of factors that impair the function of the glymphatic system pathways. Dysfunction of the glymphatic pathways causes the aggregation of incorrectly formed proteins that underlie the development of neurodegenerative diseases. Harmful protein aggregates cause prolonged inflammation. All pathologies occurring within the central nervous system (CNS), both neurodegenerative diseases and injuries, disrupt the drainage of glymphatic pathways, which are important efflux of interstitial substances and byproducts of CNS metabolism.
类淋巴系统形成了一个血管周围通道网络。它由星形胶质细胞组成,其胞体延伸部分强烈表达水通道蛋白-4水通道(AQP4)。类淋巴系统的通路确保营养物质的运输,包括葡萄糖、脂质、氨基酸、神经递质、抗原和免疫细胞,以及通过传入和传出免疫途径进行信息交换。在类淋巴系统内,脑脊液(CSF)和组织间液(ISF)成分通过促进液体交换的水通道蛋白-4水通道进行对流交换。类淋巴系统的正常功能允许溶质和代谢产物的清除与重吸收,维持水和离子平衡,运输脂质信号分子,调节颅内压、脑脊液压力和组织间液压力。类淋巴系统的功能主要受交感和副交感神经支配、睡眠和觉醒周期、衰老过程、遗传因素以及身体姿势的影响。目前,类淋巴系统在清醒时活动较弱,而在睡眠和麻醉状态下其活动会显著增加。随着年龄增长出现的变化引发了一些损害类淋巴系统通路功能的因素。类淋巴通路功能障碍会导致错误折叠蛋白质的聚集,而这是神经退行性疾病发展的基础。有害的蛋白质聚集体会引发持续的炎症。中枢神经系统(CNS)内发生的所有病理情况,包括神经退行性疾病和损伤,都会破坏类淋巴通路的引流,而类淋巴通路是中枢神经系统代谢的间质物质和副产品的重要流出途径。