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Inicio Medicina Clínica (English Edition) The glymphatic system and its involvement in disorders of the nervous system
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Vol. 156. Issue 7.
Pages 339-343 (April 2021)
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Vol. 156. Issue 7.
Pages 339-343 (April 2021)
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DOI: 10.1016/j.medcle.2021.03.003
The glymphatic system and its involvement in disorders of the nervous system
El sistema glinfático y su implicación en las enfermedades del sistema nervioso
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María Toriello, Vicente González-Quintanilla, Julio Pascual
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juliopascualgomez@gmail.com

Corresponding author.
Servicio de Neurología, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria e IDIVAL, Santander, Spain
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Abstract

The central nervous system was thought to be devoid of lymphatics. Recently, the existence of an authentic brain lymphatic system, known as the glymphatic system, composed of paravascular channels penetrating arterial and venous brain vessels and dural lymphatics cleaning the interstitial space, has been demonstrated. Aquaporin-4, located in astrocyte feet attached to the paravascular spaces, plays a key role in the clearance of waste molecules, such as beta-amyloid or tau proteins. The activity of this system is increased during sleep, mainly in the slow wave phase and while sleeping on one side, and with exercise, and is reduced with aging. Even though data are still preliminary, the glymphatic system could be decisively involved in the pathophysiology of neurological disorders such as neurodegenerative and demyelinating diseases, normal pressure hydrocephalus, stroke or certain headaches. The discovery of this system should provide new opportunities for the treatment of these neurological disorders.

Keywords:
Aquaporin-4
Beta-amyloid
Cerebrospinal fluid
Glymphatic system
Neurodegenerative disorders
Resumen

Se pensaba que el sistema nervioso central no contaba con sistema linfático. Recientemente se ha demostrado la existencia de un auténtico sistema linfático cerebral, denominado sistema glinfático, constituido por los espacios paravasculares arteriales y venosos y linfáticos durales, encargado de limpiar el espacio intersticial cerebral. La proteína acuaporina-4, localizada en los pies astrocitarios apuestos a los espacios paravasculares, juega un papel crucial en la eliminación de moléculas de desecho, tales como la proteína beta-amiloide o la tau. El sistema glinfático se activa durante el sueño, sobre todo durante la fase de ondas lentas y si se duerme de lado, con el ejercicio físico y se deteriora con el envejecimiento. Aunque disponemos de datos preliminares, probablemente el sistema glinfático interviene de forma decisiva en la fisiopatología de enfermedades neurológicas tales como enfermedades neurodegenerativas, desmielinizantes, hidrocefalia a presión normal, ictus o determinadas cefaleas. La descripción de este sistema debería conllevar nuevas posibilidades de tratamiento para estas enfermedades.

Palabras clave:
Acuaporina-4
Beta-amiloide
Enfermedades neurodegenerativas
Líquido céfalo-raquídeo
Sistema glinfático

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