Abdul Hamid Hafizah, Hambali Aqilah, Okon Udemeobong, Che Mohd Nassir Che Mohd Nasril, Mehat Muhammad Zulfadli, Norazit Anwar, Mustapha Muzaimi
Department of Human Anatomy, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia.
Department of Physiology, Faculty of Basic Medical Science, University of Calabar, Etagbor, PMB 1115 Calabar, Nigeria.
IBRO Neurosci Rep. 2023 Dec 23;16:98-105. doi: 10.1016/j.ibneur.2023.12.004. eCollection 2024 Jun.
A typical anatomical congregate and functionally distinct multicellular cerebrovascular dynamic confer diverse blood-brain barrier (BBB) and microstructural permeabilities to conserve the health of brain parenchymal and its microenvironment. This equanimity presupposes the glymphatic system that governs the flow and clearance of metabolic waste and interstitial fluids (ISF) through venous circulation. Following the introduction of glymphatic system concept, various studies have been carried out on cerebrospinal fluid (CSF) and ISF dynamics. These studies reported that the onset of multiple diseases can be attributed to impairment in the glymphatic system, which is newly referred as central nervous system (CNS) interstitial fluidopathy. One such condition includes cerebral small vessel disease (CSVD) with poorly understood pathomechanisms. CSVD is an umbrella term to describe a chronic progressive disorder affecting the brain microvasculature (or microcirculation) involving small penetrating vessels that supply cerebral white and deep gray matter. This review article proposes CSVD as a form of "CNS interstitial fluidopathy". Linking CNS interstitial fluidopathy with CSVD will open a better insight pertaining to the perivascular space fluid dynamics in CSVD pathophysiology. This may lead to the development of treatment and therapeutic strategies to ameliorate the pathology and adverse effect of CSVD.
典型的解剖学聚集和功能上不同的多细胞脑血管动力学赋予血脑屏障（BBB）和微观结构不同的通透性，以维护脑实质及其微环境的健康。这种平衡以淋巴系统为前提，该系统通过静脉循环控制代谢废物和细胞间液（ISF）的流动和清除。自淋巴系统概念提出以来，人们对脑脊液（CSF）和ISF动力学进行了各种研究。这些研究报告称，多种疾病的发生可归因于淋巴系统受损，这一新被称为中枢神经系统（CNS）间质液病。其中一种情况包括脑小血管疾病（CSVD），其发病机制尚不清楚。CSVD是一个总称，用于描述一种影响脑微血管（或微循环）的慢性进行性疾病，涉及供应脑白质和深部灰质的小穿通血管。这篇综述文章提出将CSVD视为“CNS间质液病”的一种形式。将CNS间质液病与CSVD联系起来，将为深入了解CSVD病理生理学中的血管周围间隙流体动力学提供更好的视角。这可能会促使开发治疗和治疗策略，以改善CSVD的病理和不良影响。
