中国神经再生研究(英文版) ›› 2023, Vol. 18 ›› Issue (6): 1249-1256.doi: 10.4103/1673-5374.355741

• 综述:神经损伤修复保护与再生 • 上一篇    下一篇

淋巴引流系统:神经系统疾病的关键调节者

  

  • 出版日期:2023-06-15 发布日期:2022-12-22
  • 基金资助:
    国家自然科学基金重点项目(82030071)
    长沙市科技局重大科技攻关项目(kh2103008)

The lymphatic system: a therapeutic target for central nervous system disorders

Jia-Qi Xu1, 2, 3, 4, Qian-Qi Liu1, 2, 3, 4, Sheng-Yuan Huang5, Chun-Yue Duan1, 2, 3, 4, Hong-Bin Lu2, 3, 4, 6, *, Yong Cao1, 2, 3, 4, *, Jian-Zhong Hu1, 2, 3, 4, *   

  1. 1Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China;  2Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, Hunan Province, China;  3Mobile Health Ministry of Education - China Mobile Joint Laboratory, Changsha, Hunan Province, China;  4National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan Province, China;  5Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China;  6Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
  • Online:2023-06-15 Published:2022-12-22
  • Contact: Yong Cao, XYcaoyong@csu.edu.cn or Caoyong1912@163.com; Hong-Bin Lu, hongbinlu@hotmail.com; Jian-Zhong Hu, jianzhonghu@hotmail.com.
  • Supported by:
    This work was supported by the Key Program of the National Natural Science Foundation of China, No. 82030071 and the Science and Technology Major Project of Changsha, No. kh2103008 (both to JZH).

摘要:

淋巴脉管系统形成的网络在液体稳态、代谢物清除和免疫监视中发挥作用。既往,大脑作为中枢神经系统的组成部分,由于缺乏淋巴管,被认为是具有免疫豁免的器官。近年来,科学家全面解析了脑膜中的淋巴管的结构和功能时,给这一领域带来了巨大的进步。淋巴引流系统成为了神经系统疾病的关键调节者。脑膜淋巴管具有独特的特征,它有助于阐明控制体液、免疫细胞和大分子从中枢神经系统进出的机制。文章从脑和脊髓的淋巴引流系统,包括胶质淋巴系统、脑膜淋巴管和颈淋巴结的解剖和功能特征出发,总结了中枢神经流体动力学,免疫功能的最新进展。并基于此探讨了靶向淋巴系统在神经退行性疾病、神经炎症疾病、脑损伤、脊髓损伤、脑血管病变、脑肿瘤等中的作用。目前的研究已经揭示了淋巴系统与神经疾病之间的密切关系,有证据支持靶向淋巴系统可为损伤后修复提供新的策略。通过血管内皮生长因子C递送增强淋巴功能在增强神经毒性物质清除和治疗神经退行性疾病方面显示出较好的效果。这种干预主要对淋巴功能缺陷的老年或及疾病状态小鼠有效,而在自身免疫性疾病或脑缺血中,淋巴通路的阻断反过来可以减轻炎症。

https://orcid.org/0000-0002-9618-4734 (Yong Cao)

Abstract: The lymphatic vasculature forms an organized network that covers the whole body and is involved in fluid homeostasis, metabolite clearance, and immune surveillance. The recent identification of functional lymphatic vessels in the meninges of the brain and the spinal cord has provided novel insights into neurophysiology. They emerge as major pathways for fluid exchange. The abundance of immune cells in lymphatic vessels and meninges also suggests that lymphatic vessels are actively involved in neuroimmunity. The lymphatic system, through its role in the clearance of neurotoxic proteins, autoimmune cell infiltration, and the transmission of pro-inflammatory signals, participates in the pathogenesis of a variety of neurological disorders, including neurodegenerative and neuroinflammatory diseases and traumatic injury. Vascular endothelial growth factor C is the master regulator of lymphangiogenesis, a process that is critical for the maintenance of central nervous system homeostasis. In this review, we summarize current knowledge and recent advances relating to the anatomical features and immunological functions of the lymphatic system of the central nervous system and highlight its potential as a therapeutic target for neurological disorders and central nervous system repair.

Key words: central nervous system, central nervous system injury, glymphatic system, lymphatic vessels, meninges, neurodegenerative disorders, neuroinflammatory diseases, vascular endothelial growth factor C