中国神经再生研究(英文版) ›› 2025, Vol. 20 ›› Issue (12): 3430-3447.doi: 10.4103/NRR.NRR-D-24-01049

• 综述:脑损伤修复保护与再生 • 上一篇    下一篇

中枢类淋巴系统在认知障碍疾病中的生理和病理功能

  

  • 出版日期:2025-12-15 发布日期:2025-03-13

Functional abnormalities of the glymphatic system in cognitive disorders

Wuyue Shentu1, #, Qi Kong2, #, Yier Zhang1 , Wenyao Li3 , Qiulu Chen4 , Sicheng Yan5 , Junjun Wang2 , Qilun Lai2 , Qi Xu6, *, Song Qiao2, *   

  1. 1 The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China;  2 Department of Neurology, Zhejiang Hospital, Hangzhou, Zhejiang Province, China;  3 Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China;  4 Department of Neurology, Zhejiang Medical & Health Group Hangzhou Hospital, Hangzhou, Zhejiang Province, China;  5 Department of Neurology, Liuzhou People’s Hospital, Liuzhou, Guangxi Zhuang Autonomous Region, China;  6 Department of Radiology, Zhejiang Hospital, Hangzhou, Zhejiang Province, China
  • Online:2025-12-15 Published:2025-03-13
  • Contact: Song Qiao, MD, qiaosong@zju.edu.cn; Qi Xu, MD, 285502508@qq.com.
  • Supported by:
    This work was supported by Zhejiang Provincial Medical and Health Science and Technology Project, Nos. 2022KY008 (to JW), 2023KY001 (to JW), 2023KY006 (to QL) and Zhejiang Provincial Traditional Chinese Medicine Science and Technology Project, No. 2023ZL220 (to QL).

摘要:

中枢类淋巴系统是脑内一种重要的清除机制,填补了大脑实质内微循环的空白。类淋巴系统主要由三个组成部分构成,即脑脊液由血管周围间隙进入大脑实质,大脑实质内脑脊液和组织间液的混合,以及混合液的流出和经外周通路的清除。目前,老龄化人口中认知障碍的患病率迅速增加,迫切需要新的解决方案,而类淋巴系统的研究发展使认知障碍的诊疗出现了新的方向。文章将类淋巴系统的组成部分拆解,总结了各组成部分的生理组成和认知障碍疾病中可以呈现的病理改变。在病理改变的部分,着重探讨了各认知障碍疾病(如阿尔茨海默病、帕金森病和其他具有典型认知障碍表现的疾病)可导致的相同表现。最后,在总结和展望部分他们回顾了当前类淋巴系统上的影像学现状和诊疗干预手段的新进展。中枢类淋巴系统的病理改变为认知障碍疾病提供了相似的诊疗途径。尽管不同的认知障碍疾病具有不同的病理特征,但在类淋巴系统的各个组成部分上都可以观察到他们共同的病理改变。这种共性预示着似乎可以通过改善类淋巴系统的功能为解决认知障碍提供一个共同的方案。但当前对类淋巴系统的认识任存在较多的空白,对具体机制和区域差异的分析仍需要进一步的探索。

https://orcid.org/0000-0002-8590-0926 (Song Qiao); https://orcid.org/0009-0000-0593-5604 (Qi Xu) 

关键词: 类淋巴系统, 中枢神经系统, 认知障碍, 脑脊液动力学, 星形胶质细胞, 水通道蛋白4

Abstract: Various pathological mechanisms represent distinct therapeutic targets for cognitive disorders, but a balance between clearance and production is essential for maintaining the stability of the brain’s internal environment. Thus, the glymphatic system may represent a common pathway by which to address cognitive disorders. Using the established model of the glymphatic system as our foundation, this review disentangles and analyzes the components of its clearance mechanism, including the initial inflow of cerebrospinal fluid, the mixing of cerebrospinal fluid with interstitial fluid, and the outflow of the mixed fluid and the clearance. Each section summarizes evidence from experimental animal models and human studies, highlighting the normal physiological properties of key structures alongside their pathological manifestations in cognitive disorders. The same pathologic manifestations of different cognitive disorders appearing in the glymphatic system and the same upstream influences are main points of interest of this review. We conclude this article by discussing new findings and outlining the limitations identified in current research progress.

Key words: aquaporin-4, astrocyte, cerebrospinal fluid dynamics, cognitive disorders, glymphatic system