Lymphatic system in central nervous system

The considerable metabolic activity of the central nervous system (CNS) requires an efficient system of tissue drainage and detoxification. The CNS is however devoid of lymphatic vessels, a vasculature ensuring interstitial fluid drainage and immune survey in other organs. A unique system of drainage has recently been identified between the cerebrospinal fluid (CSF), brain interstitial fluids and meningeal lymphatic vessels. This system is coupling a cerebral glymphatic flow with a meningeal lymphatic vasculature. The glymphatic system includes perivascular spaces and astrocytes, and drains interstitial fluids, from and towards the CSF. Meningeal lymphatic vessels are functionally linked to the cerebral glymphatic efflux by clearing intracerebral macromolecules and antigens towards the peripheral lymphatic system. The glymphatic -meningeal lymphatics system is potentially offering new therapeutic targets to improve cerebral drainage and immune survey in human CNS diseases.