Shen Huimin, Zhu Bingrui, Qian Yajun, Jin Jiancheng, Zhou Jiankuai, Peng Guotao, Mo Jun
Department of Neurosurgery, The Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, Zhejiang.
Department of Neurosurgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University.
J Craniofac Surg. 2024 Dec 4. doi: 10.1097/SCS.0000000000010872.
Meningeal lymphatic vessels (mLVs), located around the dural sinuses, are considered significant participants in cerebrospinal fluid (CSF) circulation. Meningeal lymphatic vessels not only drain fluids and metabolic waste from the brain into deep cervical lymph nodes (dCLNs) but also transport immune cells from the brain to dCLNs, thus regulating the interaction between the central and peripheral immune systems. These vessels play a crucial role in maintaining normal physiological functions of the central nervous system (CNS). Meningeal lymphatic vessels are involved in the pathophysiological processes of various CNS diseases, including neurodegenerative diseases, cerebrovascular diseases, and brain tumors. In aging and various CNS diseases, damage and dysfunction of mLVs have been observed, leading to the abnormal accumulation of toxic substances and exacerbating neural damage. By transporting antigen-presenting cells that have taken up antigens within the brain to dCLNs, mLVs modulate the activation of peripheral immune cells and their migration and infiltration into brain lesions. Certain drug interventions or physical therapies can modulate the drainage function of mLVs, effectively improving the prognosis of CNS diseases. This review provides a detailed introduction to the anatomic structure, physiological roles, and research advances of mLVs in CNS diseases. In addition, we propose new strategies for targeting mLVs in the treatment of CNS diseases.
脑膜淋巴管（mLVs）位于硬脑膜窦周围，被认为是脑脊液（CSF）循环的重要参与者。脑膜淋巴管不仅将大脑中的液体和代谢废物引流至颈深淋巴结（dCLNs），还将免疫细胞从大脑运输至dCLNs，从而调节中枢和外周免疫系统之间的相互作用。这些血管在维持中枢神经系统（CNS）的正常生理功能中起着至关重要的作用。脑膜淋巴管参与各种中枢神经系统疾病的病理生理过程，包括神经退行性疾病、脑血管疾病和脑肿瘤。在衰老和各种中枢神经系统疾病中，已观察到脑膜淋巴管的损伤和功能障碍，导致有毒物质异常积聚并加剧神经损伤。通过将摄取了大脑内抗原的抗原呈递细胞运输至dCLNs，脑膜淋巴管调节外周免疫细胞的激活及其向脑损伤部位的迁移和浸润。某些药物干预或物理治疗可以调节脑膜淋巴管的引流功能，有效改善中枢神经系统疾病的预后。本综述详细介绍了脑膜淋巴管在中枢神经系统疾病中的解剖结构、生理作用和研究进展。此外，我们提出了针对脑膜淋巴管治疗中枢神经系统疾病的新策略。
