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深入了解淋巴系统在出血后脑积水发病机制中的作用

Insights into the Role of the Glymphatic System in the Pathogenesis of Post-hemorrhagic Hydrocephalus.

作者信息

Massoud Ahmed T, Noltensmeyer Dillon A, Juranek Jenifer, Cox Charles S, Velasquez Fred Christian, Zhu Banghe, Sevick-Muraca Eva M, Shah Manish N

机构信息

Department of Pediatric Surgery, Division of Neurosurgery, McGovern Medical School at UTHealth, Houston, TX, USA.

Department of Neurosurgery, McGovern Medical School, UTHealth Houston, Houston, TX, USA.

出版信息

Mol Neurobiol. 2025 May;62(5):6537-6543. doi: 10.1007/s12035-025-04692-0. Epub 2025 Jan 16.

Abstract

Recently, it has been well-established that the glymphatic or glial-lymphatic system plays a vital role in the pathophysiology of various neurological compromise, especially hydrocephalus (HCP). Till now, the complete pathway is not yet fully understood, and little evidence is available from the literature that links hydrocephalus to disorders of the glymphatic system. Most published molecular studies and animal research have shown that, in models with hydrocephalus, the drainage of cerebrospinal fluid (CSF) via the glymphatic system is disrupted. This is strongly observed in normal pressure and post-hemorrhagic hydrocephalus cases. A thorough search of the literature to date yields scarce evidence on studies conducted on humans. Despite major similarities between non-human and human glymphatic pathways, the need for studies conducted on humans is becoming more urgent as the glymphatic pathway has been shown to be a good candidate for therapeutic intervention. In this review, we collect and report the most updated evidence addressing the glymphatic drainage pathways and their associations with the development of various types of hydrocephalus. In addition, we reveal the current scientific gap in human studies and our recommendations for the conduction of future clinical studies.

摘要

最近,已有充分证据表明,神经胶质淋巴系统在各种神经功能损害的病理生理学中,尤其是在脑积水(HCP)中起着至关重要的作用。到目前为止,其完整路径尚未完全明确,文献中也几乎没有证据表明脑积水与神经胶质淋巴系统紊乱有关。大多数已发表的分子研究和动物研究表明,在脑积水模型中,通过神经胶质淋巴系统的脑脊液(CSF)引流受到破坏。这在正常压力脑积水和出血后脑积水病例中得到了强烈证实。对迄今为止的文献进行全面检索后发现,关于人类的研究证据很少。尽管非人类和人类的神经胶质淋巴途径有很多主要相似之处,但由于神经胶质淋巴途径已被证明是治疗干预的良好候选对象,对人类进行研究的需求变得更加迫切。在这篇综述中,我们收集并报告了关于神经胶质淋巴引流途径及其与各种类型脑积水发展的关联的最新证据。此外,我们揭示了人类研究中当前存在的科学空白以及我们对未来临床研究开展的建议。

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