Perivascular spaces, glymphatic dysfunction, and small vessel disease.
Perivascular spaces, glymphatic dysfunction, and small vessel disease.
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血管周空间，肾小球功能障碍和小血管疾病。
DOI：
10.1042/cs20160381
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发表时间：
2017-09-01
期刊：
影响因子：
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通讯作者：
Nedergaard M
中科院分区：
文献类型：
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作者：
Mestre H;Kostrikov S;Mehta RI;Nedergaard M
脑小血管疾病（SVD）的病因范围很广，但病理学有明显重叠。SVD的特征包括血管周围空间扩大和腔外蛋白沉积的形成，不能完全用假定的病理生理学解释。最近发现的胶质淋巴系统提供了一个新的视角来潜在地解决这些差距。这项工作提供了一个全面的审查已知的因素，调节胶质淋巴功能和胶质淋巴损伤的疾病机制，强调水通道蛋白4（AQP4）内衬血管周围空间，脑血管搏动，代谢物清除在正常的中枢神经系统生理发挥的作用。这篇综述还讨论了胶质淋巴损伤可能对SVD发病和进展的影响，旨在探索新的治疗靶点，并强调仍有待回答的关键问题。
Cerebral small vessel diseases (SVD) range broadly in etiology but share a remarkably overlapping pathology. Features of SVD including enlarged perivascular spaces and formation of abluminal protein deposits cannot be completely explained by the putative pathophysiology. The recently discovered glymphatic system provides a new perspective to potentially address these gaps. This work provides a comprehensive review of the known factors that regulate glymphatic function and the disease mechanisms underlying glymphatic impairment emphasizing the role that aquaporin-4 (AQP4)-lined perivascular spaces, cerebrovascular pulsatility, and metabolite clearance play in normal CNS physiology. This review also discusses the implications that glymphatic impairment may have on SVD inception and progression with the aim of exploring novel therapeutic targets and highlighting the key questions that remain to be answered.