The Paravascular Pathway for Brain Waste Clearance: Current Understanding, Significance and Controversy.
The Paravascular Pathway for Brain Waste Clearance: Current Understanding, Significance and Controversy.
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DOI：
10.3389/fnana.2017.00101
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发表时间：
2017
影响因子：
2.9
通讯作者：
Hu J
中科院分区：
文献类型：
--
作者：
Bacyinski A;Xu M;Wang W;Hu J
血管旁通路，也被称为“淋巴”通路，是最近被描述的大脑废物清除系统。根据该模型，脑脊液（CSF）进入脑穿透动脉周围的血管旁间隙，与实质中的间质液（ISF）和溶质混合，并沿引流静脉的血管旁间隙排出。研究表明，代谢废物和溶质，包括参与神经退行性疾病发病机制的蛋白质，如淀粉样蛋白，可能通过这一途径被清除。因此，越来越多的研究开始探索淋巴功能障碍与各种疾病状态之间的关系。然而，关于废物清除的方向以及包含废物-液体混合物的解剖空间，文献中存在重大争议。一些研究没有发现沿静脉血管旁间隙间隙溶质清除的证据。相反，他们证明了一种血管周围途径，在这种途径中，废物沿着解剖学上独特的血管周围空间从大脑中清除，其方向与血管旁血流相反。虽然已经提出了可能的解释，但没有一个能够完全调和文献中的差异，许多问题仍然存在。鉴于对脑废物清除途径的全面了解可能提供的治疗潜力，进一步的研究和澄清是非常必要的。
The paravascular pathway, also known as the “glymphatic” pathway, is a recently described system for waste clearance in the brain. According to this model, cerebrospinal fluid (CSF) enters the paravascular spaces surrounding penetrating arteries of the brain, mixes with interstitial fluid (ISF) and solutes in the parenchyma, and exits along paravascular spaces of draining veins. Studies have shown that metabolic waste products and solutes, including proteins involved in the pathogenesis of neurodegenerative diseases such as amyloid-beta, may be cleared by this pathway. Consequently, a growing body of research has begun to explore the association between glymphatic dysfunction and various disease states. However, significant controversy exists in the literature regarding both the direction of waste clearance as well as the anatomical space in which the waste-fluid mixture is contained. Some studies have found no evidence of interstitial solute clearance along the paravascular space of veins. Rather, they demonstrate a perivascular pathway in which waste is cleared from the brain along an anatomically distinct perivascular space in a direction opposite to that of paravascular flow. Although possible explanations have been offered, none have been able to fully reconcile the discrepancies in the literature, and many questions remain. Given the therapeutic potential that a comprehensive understanding of brain waste clearance pathways might offer, further research and clarification is highly warranted.
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影响因子：
12.7
作者：
Arbel-Ornath M;Hudry E;Eikermann-Haerter K;Hou S;Gregory JL;Zhao L;Betensky RA;Frosch MP;Greenberg SM;Bacskai BJ
通讯作者：
Bacskai BJ
影响因子：
7.3
作者：
Bedussi B;van Lier MG;Bartstra JW;de Vos J;Siebes M;VanBavel E;Bakker EN
通讯作者：
Bakker EN
影响因子：
4
作者：
Bakker EN;Bacskai BJ;Arbel-Ornath M;Aldea R;Bedussi B;Morris AW;Weller RO;Carare RO
通讯作者：
Carare RO
影响因子：
17.1
作者：
Iliff JJ;Wang M;Liao Y;Plogg BA;Peng W;Gundersen GA;Benveniste H;Vates GE;Deane R;Goldman SA;Nagelhus EA;Nedergaard M
通讯作者：
Nedergaard M
影响因子：
4.4
作者：
Jessen NA;Munk AS;Lundgaard I;Nedergaard M
通讯作者：
Nedergaard M