Shentu Wuyue, Kong Qi, Zhang Yier, Li Wenyao, Chen Qiulu, Yan Sicheng, Wang Junjun, Lai Qilun, Xu Qi, Qiao Song
The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China.
Department of Neurology, Zhejiang Hospital, Hangzhou, Zhejiang Province, China.
Neural Regen Res. 2025 Dec 1;20(12):3430-3447. doi: 10.4103/NRR.NRR-D-24-01049. Epub 2025 Jan 13.
Various pathological mechanisms represent distinct therapeutic targets for cognitive disorders, but a balance between clearance and production is essential for maintaining the stability of the brain's internal environment. Thus, the glymphatic system may represent a common pathway by which to address cognitive disorders. Using the established model of the glymphatic system as our foundation, this review disentangles and analyzes the components of its clearance mechanism, including the initial inflow of cerebrospinal fluid, the mixing of cerebrospinal fluid with interstitial fluid, and the outflow of the mixed fluid and the clearance. Each section summarizes evidence from experimental animal models and human studies, highlighting the normal physiological properties of key structures alongside their pathological manifestations in cognitive disorders. The same pathologic manifestations of different cognitive disorders appearing in the glymphatic system and the same upstream influences are main points of interest of this review. We conclude this article by discussing new findings and outlining the limitations identified in current research progress.
多种病理机制代表了认知障碍的不同治疗靶点，但清除与生成之间的平衡对于维持大脑内部环境的稳定至关重要。因此，类淋巴系统可能是解决认知障碍的一条共同途径。本综述以已建立的类淋巴系统模型为基础，剖析并分析了其清除机制的组成部分，包括脑脊液的初始流入、脑脊液与组织间液的混合，以及混合液的流出与清除。每一部分都总结了来自实验动物模型和人体研究的证据，突出了关键结构的正常生理特性及其在认知障碍中的病理表现。类淋巴系统中出现的不同认知障碍的相同病理表现以及相同的上游影响是本综述的主要关注点。我们通过讨论新发现并概述当前研究进展中确定的局限性来结束本文。
