We are analyzing https://link.springer.com/article/10.1007/s10571-015-0273-8.

Title:
Lymphatic Clearance of the Brain: Perivascular, Paravascular and Significance for Neurodegenerative Diseases | Cellular and Molecular Neurobiology
Description:
The lymphatic clearance pathways of the brain are different compared to the other organs of the body and have been the subject of heated debates. Drainage of brain extracellular fluids, particularly interstitial fluid (ISF) and cerebrospinal fluid (CSF), is not only important for volume regulation, but also for removal of waste products such as amyloid beta (Aβ). CSF plays a special role in clinical medicine, as it is available for analysis of biomarkers for Alzheimer’s disease. Despite the lack of a complete anatomical and physiological picture of the communications between the subarachnoid space (SAS) and the brain parenchyma, it is often assumed that Aβ is cleared from the cerebral ISF into the CSF. Recent work suggests that clearance of the brain mainly occurs during sleep, with a specific role for peri- and para-vascular spaces as drainage pathways from the brain parenchyma. However, the direction of flow, the anatomical structures involved and the driving forces remain elusive, with partially conflicting data in literature. The presence of Aβ in the glia limitans in Alzheimer’s disease suggests a direct communication of ISF with CSF. Nonetheless, there is also the well-described pathology of cerebral amyloid angiopathy associated with the failure of perivascular drainage of Aβ. Herein, we review the role of the vasculature and the impact of vascular pathology on the peri- and para-vascular clearance pathways of the brain. The different views on the possible routes for ISF drainage of the brain are discussed in the context of pathological significance.
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Keywords {🔍}

brain, pubmed, google, scholar, csf, article, perivascular, cas, basement, fluid, flow, arteries, drainage, isf, cerebral, tracers, space, clearance, cells, central, paravascular, spaces, sas, blood, membranes, weller, pathways, amyloid, solutes, lymphatic, parenchyma, vessels, disease, walls, membrane, matter, carare, extracellular, studies, cerebrospinal, ecs, iliff, alzheimers, diffusion, pathway, interstitial, arterial, system, tracer, leptomeningeal,

Topics {✒️}

amyloid-β-degrading therapeutic strategy article download pdf ldl receptor-related protein-1 atp-binding cassette transporters soluble amyloid á-protein radio-iodinated serum albumin central nervous system phase-contrast cine mr blood–cerebrospinal fluid barrier aβ-expressing transgenic mice full size image peri-/para-vascular spaces peri-/para-vascular flow intracerebral convection-enhanced delivery para-vascular clearance pathways injecting 125i-labelled aβ classical virchow–robin space magnetic resonance imaging peri-/para-vascular compartment privacy choices/manage cookies cortical para-arterial pathway carare–weller group suggest smooth muscle cells cerebral peri-arterial spaces cerebrovascular amyloid burden medium-sized leptomeningeal arteries dead-space microdomains cervical lymph nodes cerebrovascular basement membranes van de nes leptomeningeal cerebrovascular amyloid lipid soluble toxins blood–brain barrier structure smooth muscle layers periventricular white matter michal arbel-ornath entire lymphatic system nervous system depends high-molecular-weight molecules cerebrovascular basement membrane molecular neurobiology aims pre-existent pathology para-vascular pathways values remain unaffected para-vascular spaces cerebral amyloid angiopathy vivo imaging reveals integrative optical imaging dural lymphatic vessels young transgenic hosts

Questions {❓}

Charidimou A, Hong YT, Jäger HR, Fox Z, Aigbirhio FI, Fryer TD, Menon DK, Warburton EA, Werring DJ, Baron J-C (2015) white matter perivascular spaces on magnetic resonance imaging marker of cerebrovascular amyloid burden?
However, could some of the conditions studied not only alter the dimensions of interstitial spaces, but also CSF production in general?
One intriguing question is: does Aβ drain from brain to cervical lymph nodes in humans?
Secondly, how does the pulsation of arteries provide directionality to the paravascular flow?
Smith AJ, Jin BJ, Verkman AS (2015) Muddying the water in brain edema?

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      headline:Lymphatic Clearance of the Brain: Perivascular, Paravascular and Significance for Neurodegenerative Diseases
      description:The lymphatic clearance pathways of the brain are different compared to the other organs of the body and have been the subject of heated debates. Drainage of brain extracellular fluids, particularly interstitial fluid (ISF) and cerebrospinal fluid (CSF), is not only important for volume regulation, but also for removal of waste products such as amyloid beta (Aβ). CSF plays a special role in clinical medicine, as it is available for analysis of biomarkers for Alzheimer’s disease. Despite the lack of a complete anatomical and physiological picture of the communications between the subarachnoid space (SAS) and the brain parenchyma, it is often assumed that Aβ is cleared from the cerebral ISF into the CSF. Recent work suggests that clearance of the brain mainly occurs during sleep, with a specific role for peri- and para-vascular spaces as drainage pathways from the brain parenchyma. However, the direction of flow, the anatomical structures involved and the driving forces remain elusive, with partially conflicting data in literature. The presence of Aβ in the glia limitans in Alzheimer’s disease suggests a direct communication of ISF with CSF. Nonetheless, there is also the well-described pathology of cerebral amyloid angiopathy associated with the failure of perivascular drainage of Aβ. Herein, we review the role of the vasculature and the impact of vascular pathology on the peri- and para-vascular clearance pathways of the brain. The different views on the possible routes for ISF drainage of the brain are discussed in the context of pathological significance.
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