Department of Immunology, Genetics and Pathology, Rudbeck Laboratory, Uppsala University, Uppsala, Sweden and Department of Medicine-Huddinge, Karolinska Institutet, Huddinge, Sweden.
Theodor Kocher Institute, University of Bern, Bern, Switzerland.
Nat Neurosci. 2024 Nov;27(11):2056-2072. doi: 10.1038/s41593-024-01701-8. Epub 2024 Sep 27.
The dura, arachnoid and pia mater, as the constituent layers of the meninges, along with cerebrospinal fluid in the subarachnoid space and ventricles, are essential protectors of the brain and spinal cord. Complemented by immune cells, blood vessels, lymphatic vessels and nerves, these connective tissue layers have held many secrets that have only recently begun to be revealed. Each meningeal layer is now known to have molecularly distinct types of fibroblasts. Cerebrospinal fluid clearance through peripheral lymphatics and lymph nodes is well documented, but its routes and flow dynamics are debated. Advances made in meningeal immune functions are also debated. This Review considers the cellular and molecular structure and function of the dura, arachnoid and pia mater in the context of conventional views, recent progress, and what is uncertain or unknown. The hallmarks of meningeal pathophysiology are identified toward developing a more complete understanding of the meninges in health and disease.
硬脑膜、蛛网膜和软脑膜作为脑膜的组成部分,以及蛛网膜下腔和脑室中的脑脊液,是脑和脊髓的重要保护者。免疫细胞、血管、淋巴管和神经的补充,这些结缔组织层有许多秘密,最近才开始被揭示。现在已知每个脑膜层都有分子上不同类型的成纤维细胞。脑脊液通过外周淋巴管和淋巴结清除的情况有充分的记录,但它的途径和流动动力学仍存在争议。脑膜免疫功能的进展也存在争议。这篇综述考虑了硬脑膜、蛛网膜和软脑膜在传统观点、最新进展以及不确定或未知的情况下的细胞和分子结构和功能。确定脑膜病理生理学的特征是为了更全面地了解健康和疾病中的脑膜。
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