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Resolving the mysteries of brain clearance and immune surveillance

Kipnis, Jonathan ; Benveniste, Helene ; Eichmann, Anne ; Thomas, Jean Leon ; Reich, Daniel S. ; Lewis, Laura D. ; Tsai, Li Huei ; Drieu, Antoine ; Bakker, Erik N.T.P. and Kelley, Douglas H. , et al. (2025) In Neuron 113(23). p.3908-3923
Abstract

Recent advances are transforming our understanding of brain fluid dynamics, highlighting cerebrospinal fluid (CSF) flow as a key process in brain waste clearance. While debates persist regarding its anatomical pathways and regulatory mechanisms, certain core principles have become widely accepted. CSF influx occurs primarily along periarterial spaces, solute clearance follows multiple routes, and glymphatic and meningeal lymphatic systems are functionally connected. Brain clearance is influenced by vascular pulsation, neural activity, and sleep. Immune cells at brain-border niches both monitor solute efflux and modulate flow, linking brain clearance to neuroimmune interactions. A deeper understanding of brain clearance could unlock new... (More)

Recent advances are transforming our understanding of brain fluid dynamics, highlighting cerebrospinal fluid (CSF) flow as a key process in brain waste clearance. While debates persist regarding its anatomical pathways and regulatory mechanisms, certain core principles have become widely accepted. CSF influx occurs primarily along periarterial spaces, solute clearance follows multiple routes, and glymphatic and meningeal lymphatic systems are functionally connected. Brain clearance is influenced by vascular pulsation, neural activity, and sleep. Immune cells at brain-border niches both monitor solute efflux and modulate flow, linking brain clearance to neuroimmune interactions. A deeper understanding of brain clearance could unlock new therapeutic avenues for autoimmune, neurodegenerative, neoplastic, and psychiatric disorders.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
CSF drainage, glymphatics, immune surveillance, meningeal lymphatics, meninges, neuroimmunology
in
Neuron
volume
113
issue
23
pages
16 pages
publisher
Cell Press
external identifiers
  • pmid:41289996
  • scopus:105023439274
ISSN
0896-6273
DOI
10.1016/j.neuron.2025.10.036
language
English
LU publication?
yes
id
df09600e-a6d8-4654-8647-bcf69367cb7f
date added to LUP
2026-01-14 11:14:06
date last changed
2026-01-15 03:00:17
@article{df09600e-a6d8-4654-8647-bcf69367cb7f,
  abstract     = {{<p>Recent advances are transforming our understanding of brain fluid dynamics, highlighting cerebrospinal fluid (CSF) flow as a key process in brain waste clearance. While debates persist regarding its anatomical pathways and regulatory mechanisms, certain core principles have become widely accepted. CSF influx occurs primarily along periarterial spaces, solute clearance follows multiple routes, and glymphatic and meningeal lymphatic systems are functionally connected. Brain clearance is influenced by vascular pulsation, neural activity, and sleep. Immune cells at brain-border niches both monitor solute efflux and modulate flow, linking brain clearance to neuroimmune interactions. A deeper understanding of brain clearance could unlock new therapeutic avenues for autoimmune, neurodegenerative, neoplastic, and psychiatric disorders.</p>}},
  author       = {{Kipnis, Jonathan and Benveniste, Helene and Eichmann, Anne and Thomas, Jean Leon and Reich, Daniel S. and Lewis, Laura D. and Tsai, Li Huei and Drieu, Antoine and Bakker, Erik N.T.P. and Kelley, Douglas H. and Lundgaard, Iben and Mestre, Humberto and Zott, Benedikt and Eide, Per Kristian and van Osch, Matthias J.P. and van Veluw, Susanne J. and Iliff, Jeffrey and Yang, Andrew C. and Santambrogio, Laura and Da Mesquita, Sandro and Daneman, Richard and Rustenhoven, Justin and Goldman, Steven A. and Nedergaard, Maiken}},
  issn         = {{0896-6273}},
  keywords     = {{CSF drainage; glymphatics; immune surveillance; meningeal lymphatics; meninges; neuroimmunology}},
  language     = {{eng}},
  number       = {{23}},
  pages        = {{3908--3923}},
  publisher    = {{Cell Press}},
  series       = {{Neuron}},
  title        = {{Resolving the mysteries of brain clearance and immune surveillance}},
  url          = {{http://dx.doi.org/10.1016/j.neuron.2025.10.036}},
  doi          = {{10.1016/j.neuron.2025.10.036}},
  volume       = {{113}},
  year         = {{2025}},
}