BACKGROUND： Presently, over 40 kinds of dural grafts have been successively used in clinic. Among them, lyophilized human dura mater with good histocompatibility and less complications is applied most widely. But the...BACKGROUND： Presently, over 40 kinds of dural grafts have been successively used in clinic. Among them, lyophilized human dura mater with good histocompatibility and less complications is applied most widely. But there are a few reports on cases of infected spongiform encephalopathy following application of lyodura. More ideal repair materials deserve to be further investigated. OBJECTIVE： To investigate the efficiency and safety of biological dural graft made by meninges from porkers to repair meningeal injury. DESIGN： A self-control observation. SETTING： Wuhan General Hospital of Guangzhou Military Area Command of Chinese PLA. MATERIALS： Sixteen New Zealand Rabbits, of either gender, weighing from 2 to 3 kg, of clean grade Ⅱ, with the age of 0.5 - 1 year, were involved in this experiment. The involved rabbits were provided by the Animal Experimental Center of the First Military Medical University of Chinese PLA. Biological surgical patch （dural graft） was developed by Guangdong Guanhao Biotechnological Co.,Ltd. It was processed by using meninges from porkers by tissue engineering technology. METHODS： This experiment was carried out in the Experimental Center of the 157 Hospital of Chinese PLA between December 2003 and June 2004. ①The experimental rabbits were anesthetized. Dura mater was exposed from two sides ofpostmedial line of coronal suture. A rectangular dura mater about 8 mm ×8 mm in size was cut off. Then a biological surgical patch （dural graft） was sheared into insert with 8 mm diameter and sutured. The left dura mater was untouched and used as control. Scalp was sutured, and postoperative wound healing and recovery were observed. ②The anesthetized rabbits were sacrificed at postoperative 3, 14, 30 and 90 days, 4 rabbits once. The whole head was cut off, and its scalp was removed. Afterwards, the head was fixed by formalin. Tissues in operative site were obtained, performed routine paraffin embedding, sliced and conducted HE staining, finally, the sections were observed. White blood cells in venous blood were counted before operation and execution, separately. The obtained data were statistically analyzed. MAIN OUTCOME MEASURES： ①Wound healing and recovery following implantation of dural graft. ②The amount of white blood cells in venous blood from rabbits at each time point before operation and before execution. ③Histological examination results of operative site. RESULTS： Sixteen experimental rabbits were involved in the final analysis. ①The experimental rabbits of each group had no local infection, effusion and abnormal appearance. They had good wound healing and were normal to access to food. ②There were no significant differences in amount of white blood cells in venous blood from experimental rabbits between at each time point after modeling and before operation （P 〉 0.05）. ③Pathological observation of operative site ： At postoperative 3 days, local acute inflammation repair reaction appeared; At postoperative 2 weeks, chronic inflammatory reaction appeared, endodermis in artificial dural graft formed, and artificial dural graft and host dura mater healed; In postoperative 1 month, wound began to chronically recover; In postoperative 3 months, host blood capillary began to form in artificial dural graft based on chronic repair. In all the control sides, fibroplasia was found, and a few neutrophils were found at postoperative 2 weeks. CONCLUSION： Biological surgical patch has high stability and good histocompatibility. It can provide dural epithelial epithelium, effectively prevent against the conglutination of scalp tissue and brain tissue, and avoid the leakage ofcerebrospinal fluid.展开更多
We report a new application of optical coherence tomography（OCT） to investigate the cranial meninges in an animal model of brain injury in vivo. The injury is induced in a mouse due to skull thinning, in which the r...We report a new application of optical coherence tomography（OCT） to investigate the cranial meninges in an animal model of brain injury in vivo. The injury is induced in a mouse due to skull thinning, in which the repeated and excessive drilling exerts mechanical stress on the mouse brain through the skull, resulting in acute and mild brain injury. Transcranial OCT imaging reveals an interesting virtual space between the cranial meningeal layers post skull thinning, which is gradually closed within hours. The finding suggests a promise of OCT as an effective tool to monitor the mechanical trauma in the small animal model of brain injury.展开更多
Meningeal lymphatic vessels form a relationship between the nervous system and periphery, which is relevant in both health and disease. Meningeal lymphatic vessels not only play a key role in the drainage of brain met...Meningeal lymphatic vessels form a relationship between the nervous system and periphery, which is relevant in both health and disease. Meningeal lymphatic vessels not only play a key role in the drainage of brain metabolites but also contribute to antigen delivery and immune cell activation. The advent of novel genomic technologies has enabled rapid progress in the characterization of myeloid and lymphoid cells and their interactions with meningeal lymphatic vessels within the central nervous system. In this review, we provide an overview of the multifaceted roles of meningeal lymphatic vessels within the context of the central nervous system immune network, highlighting recent discoveries on the immunological niche provided by meningeal lymphatic vessels. Furthermore, we delve into the mechanisms of crosstalk between meningeal lymphatic vessels and immune cells in the central nervous system under both homeostatic conditions and neurodegenerative diseases, discussing how these interactions shape the pathological outcomes. Regulation of meningeal lymphatic vessel function and structure can influence lymphatic drainage, cerebrospinal fluid-borne immune modulators, and immune cell populations in aging and neurodegenerative disorders, thereby playing a key role in shaping meningeal and brain parenchyma immunity.展开更多
BACKGROUND Middle meningeal artery embolization(MMAE)is emerging as a promising treatment for chronic subdural hematoma(CSDH),serving both as an adjunct to surgery and as a primary therapeutic option depending on pati...BACKGROUND Middle meningeal artery embolization(MMAE)is emerging as a promising treatment for chronic subdural hematoma(CSDH),serving both as an adjunct to surgery and as a primary therapeutic option depending on patient presentation.Due to its low recurrence rate and minimal complications,MMAE has gained increasing acceptance among clinicians in recent years.This report presents a case of diplopia following MMAE due to the presence of a potential anastomotic artery,aiming to enhance awareness of this complication.CASE SUMMARY A 60-year-old male patient presented with a headache following head trauma,and cranial computed tomography revealed a left-sided CSDH.The patient underwent left MMAE;however,polyvinyl alcohol particles inadvertently flowed into the lacrimal artery through an anastomotic artery,resulting in diplopia due to impaired abduction of the left eye.The diplopia resolved by postoperative day 40.The patient’s headache resolved by postoperative day 7,and the hematoma completely resolved by postoperative day 108.CONCLUSION Potential anastomotic arteries in the middle meningeal artery(MMA)can lead to serious complications.Superselective angiography of the MMA or its branches prior to embolization is essential.Performing embolization distal to potential anastomotic sites can reduce risks,and the presence of an anastomosis may warrant coil embolization or termination of the procedure.展开更多
BACKGROUND Aseptic meningitis is defined as meningeal inflammation caused by various etio-logies with negative cerebrospinal fluid(CSF)bacterial culture.The most common etiologies are viruses[enteroviruses,arboviruses...BACKGROUND Aseptic meningitis is defined as meningeal inflammation caused by various etio-logies with negative cerebrospinal fluid(CSF)bacterial culture.The most common etiologies are viruses[enteroviruses,arboviruses,and herpes simplex virus type 2(HSV-2)].Aseptic meningitis can have various presentations,including sensori-neural deafness.While sensorineural deafness from mumps meningoencephalitis has been reported,cases of HSV-2-induced hearing loss are rare.Herein,we re-port a case of HSV-2-induced meningitis that presented with sudden deafness.CASE SUMMARY A 68-year-old man experienced a profound sudden onset of left-sided hearing loss for one day.Pure-tone audiograms demonstrated sudden left-sided sensorineural hearing loss(thresholds 80-90 dB).After treatment with high-dose steroids for 1 week,he experienced an acute consciousness change with left hemiparesis.The laboratory data showed no significant abnormalities.Brain computed tomography without contrast and magnetic resonance imaging revealed no intracranial hemo-rrhage or obvious brain lesion.The CSF analysis and the Multiplex PCR panels showed HSV-2 positivity.Hence,under the diagnosis of herpes meningoenceph-alitis,acyclovir was prescribed and his symptoms gradually resolved.CONCLUSION This case report further demonstrates that a viral infection could be a cause of sudden sensorineural hearing loss.展开更多
Objective:To evaluate laboratory findings that predict bacterial meningitis in emergency service and their diagnostic effectiveness.Methods:This retrospective cohort study analyzed data from patients presenting with m...Objective:To evaluate laboratory findings that predict bacterial meningitis in emergency service and their diagnostic effectiveness.Methods:This retrospective cohort study analyzed data from patients presenting with meningitis symptoms at a referral hospital in Mersin,Turkey,between January 2019 and January 2022.Clinical findings and laboratory results,including leukocyte count,C-reactive protein(CRP),and procalcitonin levels in blood,were examined.Logistic regression,Chi square test,and receiver operating characteristics(ROC)curve analyses assessed the predictive value of these parameters.Results:A total of 199 participants were included in the study;99 patients were diagnosed with meningitis after lumbar puncture and 100 served as controls.Patients with meningitis exhibited significantly higher leukocyte counts(median:11890×10^(3)/μL vs.7905×10^(3)/μL,P<0.001)and CRP levels(median:6.00 mg/dL vs.0.95 mg/dL,P<0.001)compared to controls.Procalcitonin levels were significantly elevated in meningitis patients(median:0.21 ng/mL vs.0.10 ng/mL,P<0.001).Logistic regression identified albumin(OR=0.16,95%CI=0.06-0.40),and CRP(OR=1.18,95%CI=1.08-1.28)as independent predictors of meningitis.ROC analysis for CRP demonstrated a sensitivity of 80.6%and specificity of 70.0%at a cut-off value of 2.23 mg/dL(AUC=0.792).Conclusions:Elevated albumin levels and CRP contents in the blood were significant predictors of meningitis in emergency service.Early identification of predictive markers may aid in timely lumbar puncture and management of atypical cases.展开更多
Streptococcus agalactiae(Sa)infection can result in severe economic losses in tilapia aquaculture.This study offered insights into the therapeutic potential of florfenicol(FFC)and the histopathological changes in the ...Streptococcus agalactiae(Sa)infection can result in severe economic losses in tilapia aquaculture.This study offered insights into the therapeutic potential of florfenicol(FFC)and the histopathological changes in the forebrain and midbrain of Sa-infected Oreochromis niloticus.Healthy tilapia(n=225)were divided into three groups:control,Sa-challenged and untreated,and Sa-challenged and FFC-treated.The Sa-infection was induced by intramuscular injection of 1.32×107 cells/fish,and the infected fish received FFC orally at 15 mg/kg biomass/day for 10 consecutive days.Sa exerted serious pathological effects on the forebrain and midbrain of O.niloticus.These effects include focal hemorrhage,mononuclear cell infiltration,lifting of the superficial layer,spongiform encephalopathy,intracellular edema,edematous optic tectum,connective tissue damage,and meningitis.Compared with the untreated group,the treated group demonstrated that FFC is a potential therapeutic agent for mitigating Sa-induced infections by reducing mortality and improving the overall brain histoarchitecture of O.niloticus.展开更多
Age is a limiting factor in the efficacy of photobiomodulation(PBM)for brain drainage and cognitive functions.Meningeal lymphatic vessels(MLVs)are“tunnels”for removal of toxins from the brain and the target of PBM.A...Age is a limiting factor in the efficacy of photobiomodulation(PBM)for brain drainage and cognitive functions.Meningeal lymphatic vessels(MLVs)are“tunnels”for removal of toxins from the brain and the target of PBM.Age-related decline in the MLV functions is one of the mechanisms by which the effects of PBM on brain drainage and cognitive process are limited.Sleep is a time of natural activation of brain drainage.Recent findings have shown that PBM during sleep has greater effects on lymphatic clearance of beta-amyloid and cognitive function in young and middle-age mice.Based on these data,this study tested the hypothesis that sleep enhances the effects of PBM on MLVs and cognitive function in the aging brain.Indeed,the results revealed that PBM during sleep,but not during wakefulness,has stimulatory effects on lymphatic clearance of beta-amyloid from the brain of old mice that improves memory.In sleep deficit experiments,it was found that chronic sleep deprivation is accompanied by suppression of brain drainage and removal of metabolites from the brain,such as beta-amyloid,tau,glutamate,lactate and glucose in young,middle-aged and most significantly in old mice.The course of PBM during sleep contributed better than in wakefulness to the restoration of the brain level of tested metabolites in young and middle-aged mice,while in old mice only PBM during sleep was effective.These results open a new strategy for the use of PBM during sleep to improve the efficacy of PBM on clearance of toxic metabolites from the brain,especially in aged subjects in whom the efficacy of PBM during wakefulness is limited.展开更多
Objective Pseudomonas aeruginosa(P.aeruginosa)is a prevalent pathogenic bacterium involved in meningitis;however,the virulence factors contributing to this disease remain poorly understood.Methods The virulence of the...Objective Pseudomonas aeruginosa(P.aeruginosa)is a prevalent pathogenic bacterium involved in meningitis;however,the virulence factors contributing to this disease remain poorly understood.Methods The virulence of the P.aeruginosa A584,isolated from meningitis samples,was evaluated by constructing in vitro blood-brain barrier and in vivo systemic infection models.qPCR,whole-genome sequencing,and drug efflux assays of A584 were performed to analyze the virulence factors.Results Genomic sequencing showed that A584 formed a phylogenetic cluster with the reference strains NY7610,DDRC3,Pa58,and Pa124.Its genome includes abundant virulence factors,such as hemolysin,the Type IV secretion system,and pyoverdine.A584 is a multidrug-resistant strain,and its wide-spectrum resistance is associated with enhanced drug efflux.Moreover,this strain caused significantly more severe damage to the blood-brain barrier than the standard strain,PAO1.qPCR assays further revealed the downregulation of the blood-brain barrier-associated proteins Claudin-5 and Occludin by A584.During systemic infection,A584 exhibited a higher capacity of brain colonization than PAO1(37.1×10^(6) CFU/g brain versus 2.5×10^(6) CFU/g brain),leading to higher levels of the proinflammatory factors IL-1βand TNF-α.Conclusion This study sheds light on the virulence factors of P.aeruginosa involved in meningitis.展开更多
Streptococcus suis serotype 2(SS2)is an emerging zoonotic pathogen that causes meningitis in humans and pigs.This pathogen generates substantial economic losses in the swine industry while posing a significant threat ...Streptococcus suis serotype 2(SS2)is an emerging zoonotic pathogen that causes meningitis in humans and pigs.This pathogen generates substantial economic losses in the swine industry while posing a significant threat to public health security.The mechanisms through which SS2 penetrates the brain and induces meningitis remain incompletely understood.This study examines the role and mechanism of SS2 collagenase-like protease(Clp)in facilitating bacterial passage across the blood-brain barrier(BBB).The research demonstrates that SS2 Clp enhanced virulence and tissue colonization while promoting BBB degradation in mice.The Δclp mutant exhibited reduced ability to traverse human brain microvascular endothelial(hCMEC/D3)cell monolayers compared to wild-type SS2,while the addition of recombinant protein rClp increased permeability.Furthermore,rClp significantly enhanced SS2 adhesion to hCMEC/D3,suppressed the expression of intercellular tight junction proteins ZO-1,Occludin,and Claudin-5 independent of its enzyme activity,and triggered hCMEC/D3 apoptosis through cell receptor ligand apoptosis and mitochondrial apoptosis pathways,partially dependent on its enzyme activity,leading to BBB disruption and enhanced permeability.Additionally,Clp enhanced the infiltration of macrophages(F4/80+),monocytes(F4/80-Ly6C+),and neutrophils(Ly6G+)into the brain following SS2 infection.These findings establish that SS2 Clp is essential for bacterial passage across the BBB,offering a theoretical foundation for improved prevention and treatment strategies for SS2-induced meningitis.展开更多
Chronic subdural hematoma is essentially managed by surgical intervention.In recent times,middle meningeal artery embolisation has emerged as a less invasive procedure in such cases.The use of fine catheters to select...Chronic subdural hematoma is essentially managed by surgical intervention.In recent times,middle meningeal artery embolisation has emerged as a less invasive procedure in such cases.The use of fine catheters to selectively embolise the specific involved branches of the middle meningeal artery using polyvinyl alcohol particles looks promising;however,the presence of anastomotic arteries can result in reflux and embolisation of these atypical branches,causing a myriad of complications.There is a need to identify these abnormal vessels in time to have a positive outcome with the least complications.展开更多
Background:Invasive meningococcal disease is a potentially life-threatening infection caused by Neisseria meningitidis.Vaccination is highly effective in preventing meningitis and reducing its associated complications...Background:Invasive meningococcal disease is a potentially life-threatening infection caused by Neisseria meningitidis.Vaccination is highly effective in preventing meningitis and reducing its associated complications.This study aims to assess the United Arab Emirates(UAE)parents meningitis knowledge and explore vaccination attitudes and practices.Methodology:An observational cross-sectional study was conducted between March and May 2024 across the UAE using convenience sampling through social media,electronic mail,and word of mouth.A 58-item questionnaire collected information regarding demographics,meningitis knowledge,attitudes and practices,and meningococcal vaccination knowledge and practices.Results:Of 443 parents included,more than a third had no knowledge about meningitis.Symptoms and severity were well-recognized overall,but clear gaps were evident regarding complications and meningococcal vaccines.Only 10.38%(46/443)identified themselves as knowledgeable/very knowledgeable regarding meningococcal vaccines.A healthcare provider recommendation was the strongest factor encouraging parents to vaccinate their child.Most vaccine hesitancy was seen regarding side effects.Views and practices regarding the two vaccines aligned closely,with more than four-fifths of participants needing more information and the major reasons for not vaccinating a child being a lack of information or lack of recommendation.Social media and governmental websites were the most common sources for learning more about meningitis,with doctors ranking third.In fact,trust in doctors varied with less than half having moderate or strong trust in their main paediatrician.Multivariate logistic regression revealed that coronavirus disease 2019 vaccination status[adjusted odds ratio(AOR):0.365,95%confidence interval(CI):0.172 to 0.774,P=0.013]and female gender(AOR:2.741,95%CI:1.184 to 6.347,P=0.019)were significant predictors of vaccine hesitancy.Conclusion:Meningococcal vaccine hesitancy is a significant concern,primarily driven by fears of side effects and lack of knowledge and physician recommendation.However,vaccine attitudes were overall positive and highly dependent on physician involvement.There is a need for targeted educational initiatives enhancing meningitis disease awareness and vaccine uptake.展开更多
The presence of the blood–brain barrier limits the drug concentration in the brain,while low concentrations of antibiotics make it difficult to kill infecting bacteria and tends to induce drug resistance,making the c...The presence of the blood–brain barrier limits the drug concentration in the brain,while low concentrations of antibiotics make it difficult to kill infecting bacteria and tends to induce drug resistance,making the clinical treatment of bacterial meningitis challenging.Herein,a nose-to-brain delivery strategy of small-sized nanozyme has been fabricated for combating bacterial meningitis,to overcome the low drug concentration and drug resistance.This strategy was achieved by a proteinsupported Au nanozyme(ANZ).With a particle size of less than 10 nm,it possesses both glucose oxidase-like and peroxidase-like activities and can generate large amounts of reactive oxygen species through a cascade effect without the addition of external H_(2)O_(2).Benefiting from the cascade catalytic amplification effect generated by its dual enzymelike activities,ANZ shows significant broad-spectrum antibacterial activity without inducing bacterial resistance in vitro.Notably,small-sized ANZ exhibits higher brain entry efficiency and greater accumulation after intranasal administration compared to oral or intravenous administration.In a mouse model of bacterial meningitis,the mice treated with ANZ had lower bacterial loads in the brain and higher survival and clinical behavior scores compared to the classical antibiotic ceftriaxone.Additionally,the meningitis mice exhibited undamaged cognitive and behavioral abilities,indicating the excellent biocompatibility of ANZ.The above results demonstrate that nose-to-brain delivery of ANZ exhibits high intracerebral accumulation,strong antibacterial efficacy and does not lead to bacterial resistance.It holds broad prospects for the treatment of bacterial meningitis.展开更多
BACKGROUND Angiostrongylus cantonensis-induced acute parasitic infection is a rare food-borne disease in clinical practice.Lack of its specific laboratory markers and subsequent difficulty in detecting pathogens cause...BACKGROUND Angiostrongylus cantonensis-induced acute parasitic infection is a rare food-borne disease in clinical practice.Lack of its specific laboratory markers and subsequent difficulty in detecting pathogens cause high misdiagnosis and missed diagnosis rates.CASE SUMMARY A 20-year-old male developed persistent neck and back pain after consuming raw snail meat,followed by urinary retention and low fever.After admission,the patient was misdiagnosed as viral infection and Mycobacterium tuberculosis in central nervous system.After detection of Angiostrongylus cantonensis in blood and cerebrospinal fluid by metagenomics next generation sequencing,albendazole was administered with ceftriaxone and methylprednisolone treatment simultaneously.With effective antiparasitic treatment,the patient weaned from mechanical ventilation successfully and transferred out of intensive care unit for hyperbaric oxygen and rehabilitation treatment.CONCLUSION This case highlights the diagnostic challenges of Angiostrongylus cantonensis infection and the importance of advanced sequencing techniques in identifying rare pathogens.展开更多
Tuberculous meningitis(TBM),which accounts for 1%-5%of global tuberculosis cases,is a severe neurological infection with a mortality rate of 30%-50%.Its high fatality and disability rates disproportionately affect low...Tuberculous meningitis(TBM),which accounts for 1%-5%of global tuberculosis cases,is a severe neurological infection with a mortality rate of 30%-50%.Its high fatality and disability rates disproportionately affect low-and middle-income regions(e.g.,sub-Saharan Africa and Southeast Asia),threatening the lives of patients and imposing significant psychosocial burdens.Recent studies have highlighted the crucial role of psychosocial factors,including socioeconomic status,disease severity,and social support systems in recovery.However,research gaps persist in developing TBM-specific psychosocial interventions.This narrative review summarizes and organizes the key findings of observational studies,cohort studies,and intervention trials published between 2015 and 2024.Databases including PubMed,Scopus,and Web of Science were searched for terms related to TBM,psychosocial risk factors and mental health interventions.Studies were screened for relevance and quality,focusing on those that examined the psychological and social determinants of mental health outcomes in patients with TBM.展开更多
Mild cognitive impairment(MCI),which is a high-risk transitional phase leading to Alzheimer’s disease,is characterized by mild memory deficits and specific cognitive dysfunctions.Without effective intervention,a sign...Mild cognitive impairment(MCI),which is a high-risk transitional phase leading to Alzheimer’s disease,is characterized by mild memory deficits and specific cognitive dysfunctions.Without effective intervention,a significant proportion of patients with MCI progress to dementia.However,current pharmacological treatments are characterized by side effects and poor patient compliance.Therefore,it is necessary to develop effective,noninvasive alternative treatments.Repetitive transcranial magnetic stimulation(rTMS)is becoming a widely studied noninvasive treatment for central nervous system disease.The therapeutic effects of rTMS on patients with MCI and its underlying mechanism are noteworthy issues.Recently,a growing number of studies have shown that meningeal lymphatic vessel damage may be related to cognitive dysfunction.Whether the improvement of the meningeal lymphatic system is an important mechanism through which rTMS improves the clinical manifestations of MCI is worthy of further study.展开更多
Middle meningeal artery embolization(MMAE)has revolutionized chronic subdural hematoma management,yet procedural risks persist due to anatomical variability.We analyze a case report by Zhao et al describing transient ...Middle meningeal artery embolization(MMAE)has revolutionized chronic subdural hematoma management,yet procedural risks persist due to anatomical variability.We analyze a case report by Zhao et al describing transient diplopia caused by inadvertent embolization of the lacrimal artery via a dynamic middle meningeal–ophthalmic anastomosis.This correspondence advances three critical innovations in MMAE safety.First,intraoperative anastomotic unmasking—exposing occult middle meningeal-ophthalmic collaterals during particle injection—reveals dynamic vascular behavior missed by preoperative angiography,underscoring the need for adaptive imaging protocols.Second,hybrid embolization(liquid agents for proximal occlusion+particles for distal control)balances precision and safety,reducing reflux risks compared to monotherapy.Third,a 108-day follow-up establishes a benchmark for functional recovery,challenging assumptions about irreversible cranial nerve injuries and emphasizing structured postprocedural care.Collectively,these findings advocate for procedural agility,multimodal embolic strategies,and sustained rehabilitation to optimize MMAE outcomes while minimizing iatrogenic harm.展开更多
Traumatic carotid-cavernous arteriovenous fistula(TCCAVF)is a rare but severe cerebrovascular disorder,often resulting from head trauma with temporal bone fractures.The pathogenesis involves vessel wall injury due to ...Traumatic carotid-cavernous arteriovenous fistula(TCCAVF)is a rare but severe cerebrovascular disorder,often resulting from head trauma with temporal bone fractures.The pathogenesis involves vessel wall injury due to traction,frequently associated with fractures near the middle meningeal artery.This case highlights the typical clinical presentation,diagnostic approaches,and therapeutic management of TCCAVF,emphasizing the challenges in treating this condition.Transcatheter embolization proved effective in occluding the fistula,underscoring its role as a key intervention for traumatic meningeal arteriovenous fistulas.展开更多
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 vesse...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.展开更多
文摘BACKGROUND： Presently, over 40 kinds of dural grafts have been successively used in clinic. Among them, lyophilized human dura mater with good histocompatibility and less complications is applied most widely. But there are a few reports on cases of infected spongiform encephalopathy following application of lyodura. More ideal repair materials deserve to be further investigated. OBJECTIVE： To investigate the efficiency and safety of biological dural graft made by meninges from porkers to repair meningeal injury. DESIGN： A self-control observation. SETTING： Wuhan General Hospital of Guangzhou Military Area Command of Chinese PLA. MATERIALS： Sixteen New Zealand Rabbits, of either gender, weighing from 2 to 3 kg, of clean grade Ⅱ, with the age of 0.5 - 1 year, were involved in this experiment. The involved rabbits were provided by the Animal Experimental Center of the First Military Medical University of Chinese PLA. Biological surgical patch （dural graft） was developed by Guangdong Guanhao Biotechnological Co.,Ltd. It was processed by using meninges from porkers by tissue engineering technology. METHODS： This experiment was carried out in the Experimental Center of the 157 Hospital of Chinese PLA between December 2003 and June 2004. ①The experimental rabbits were anesthetized. Dura mater was exposed from two sides ofpostmedial line of coronal suture. A rectangular dura mater about 8 mm ×8 mm in size was cut off. Then a biological surgical patch （dural graft） was sheared into insert with 8 mm diameter and sutured. The left dura mater was untouched and used as control. Scalp was sutured, and postoperative wound healing and recovery were observed. ②The anesthetized rabbits were sacrificed at postoperative 3, 14, 30 and 90 days, 4 rabbits once. The whole head was cut off, and its scalp was removed. Afterwards, the head was fixed by formalin. Tissues in operative site were obtained, performed routine paraffin embedding, sliced and conducted HE staining, finally, the sections were observed. White blood cells in venous blood were counted before operation and execution, separately. The obtained data were statistically analyzed. MAIN OUTCOME MEASURES： ①Wound healing and recovery following implantation of dural graft. ②The amount of white blood cells in venous blood from rabbits at each time point before operation and before execution. ③Histological examination results of operative site. RESULTS： Sixteen experimental rabbits were involved in the final analysis. ①The experimental rabbits of each group had no local infection, effusion and abnormal appearance. They had good wound healing and were normal to access to food. ②There were no significant differences in amount of white blood cells in venous blood from experimental rabbits between at each time point after modeling and before operation （P 〉 0.05）. ③Pathological observation of operative site ： At postoperative 3 days, local acute inflammation repair reaction appeared; At postoperative 2 weeks, chronic inflammatory reaction appeared, endodermis in artificial dural graft formed, and artificial dural graft and host dura mater healed; In postoperative 1 month, wound began to chronically recover; In postoperative 3 months, host blood capillary began to form in artificial dural graft based on chronic repair. In all the control sides, fibroplasia was found, and a few neutrophils were found at postoperative 2 weeks. CONCLUSION： Biological surgical patch has high stability and good histocompatibility. It can provide dural epithelial epithelium, effectively prevent against the conglutination of scalp tissue and brain tissue, and avoid the leakage ofcerebrospinal fluid.
基金supported in part by research grants from the National Institutes of Health(Nos.RO1EB009682 and RO1HL093140)
文摘We report a new application of optical coherence tomography（OCT） to investigate the cranial meninges in an animal model of brain injury in vivo. The injury is induced in a mouse due to skull thinning, in which the repeated and excessive drilling exerts mechanical stress on the mouse brain through the skull, resulting in acute and mild brain injury. Transcranial OCT imaging reveals an interesting virtual space between the cranial meningeal layers post skull thinning, which is gradually closed within hours. The finding suggests a promise of OCT as an effective tool to monitor the mechanical trauma in the small animal model of brain injury.
基金supported by the National Natural Science Foundation of China, No.82274616the Key Laboratory Project for General Universities in Guangdong Province, No.2019KSYS005Guangdong Province Science and Technology Plan International Cooperation Project, No.2020A0505100052 (all to QW)。
文摘Meningeal lymphatic vessels form a relationship between the nervous system and periphery, which is relevant in both health and disease. Meningeal lymphatic vessels not only play a key role in the drainage of brain metabolites but also contribute to antigen delivery and immune cell activation. The advent of novel genomic technologies has enabled rapid progress in the characterization of myeloid and lymphoid cells and their interactions with meningeal lymphatic vessels within the central nervous system. In this review, we provide an overview of the multifaceted roles of meningeal lymphatic vessels within the context of the central nervous system immune network, highlighting recent discoveries on the immunological niche provided by meningeal lymphatic vessels. Furthermore, we delve into the mechanisms of crosstalk between meningeal lymphatic vessels and immune cells in the central nervous system under both homeostatic conditions and neurodegenerative diseases, discussing how these interactions shape the pathological outcomes. Regulation of meningeal lymphatic vessel function and structure can influence lymphatic drainage, cerebrospinal fluid-borne immune modulators, and immune cell populations in aging and neurodegenerative disorders, thereby playing a key role in shaping meningeal and brain parenchyma immunity.
文摘BACKGROUND Middle meningeal artery embolization(MMAE)is emerging as a promising treatment for chronic subdural hematoma(CSDH),serving both as an adjunct to surgery and as a primary therapeutic option depending on patient presentation.Due to its low recurrence rate and minimal complications,MMAE has gained increasing acceptance among clinicians in recent years.This report presents a case of diplopia following MMAE due to the presence of a potential anastomotic artery,aiming to enhance awareness of this complication.CASE SUMMARY A 60-year-old male patient presented with a headache following head trauma,and cranial computed tomography revealed a left-sided CSDH.The patient underwent left MMAE;however,polyvinyl alcohol particles inadvertently flowed into the lacrimal artery through an anastomotic artery,resulting in diplopia due to impaired abduction of the left eye.The diplopia resolved by postoperative day 40.The patient’s headache resolved by postoperative day 7,and the hematoma completely resolved by postoperative day 108.CONCLUSION Potential anastomotic arteries in the middle meningeal artery(MMA)can lead to serious complications.Superselective angiography of the MMA or its branches prior to embolization is essential.Performing embolization distal to potential anastomotic sites can reduce risks,and the presence of an anastomosis may warrant coil embolization or termination of the procedure.
文摘BACKGROUND Aseptic meningitis is defined as meningeal inflammation caused by various etio-logies with negative cerebrospinal fluid(CSF)bacterial culture.The most common etiologies are viruses[enteroviruses,arboviruses,and herpes simplex virus type 2(HSV-2)].Aseptic meningitis can have various presentations,including sensori-neural deafness.While sensorineural deafness from mumps meningoencephalitis has been reported,cases of HSV-2-induced hearing loss are rare.Herein,we re-port a case of HSV-2-induced meningitis that presented with sudden deafness.CASE SUMMARY A 68-year-old man experienced a profound sudden onset of left-sided hearing loss for one day.Pure-tone audiograms demonstrated sudden left-sided sensorineural hearing loss(thresholds 80-90 dB).After treatment with high-dose steroids for 1 week,he experienced an acute consciousness change with left hemiparesis.The laboratory data showed no significant abnormalities.Brain computed tomography without contrast and magnetic resonance imaging revealed no intracranial hemo-rrhage or obvious brain lesion.The CSF analysis and the Multiplex PCR panels showed HSV-2 positivity.Hence,under the diagnosis of herpes meningoenceph-alitis,acyclovir was prescribed and his symptoms gradually resolved.CONCLUSION This case report further demonstrates that a viral infection could be a cause of sudden sensorineural hearing loss.
文摘Objective:To evaluate laboratory findings that predict bacterial meningitis in emergency service and their diagnostic effectiveness.Methods:This retrospective cohort study analyzed data from patients presenting with meningitis symptoms at a referral hospital in Mersin,Turkey,between January 2019 and January 2022.Clinical findings and laboratory results,including leukocyte count,C-reactive protein(CRP),and procalcitonin levels in blood,were examined.Logistic regression,Chi square test,and receiver operating characteristics(ROC)curve analyses assessed the predictive value of these parameters.Results:A total of 199 participants were included in the study;99 patients were diagnosed with meningitis after lumbar puncture and 100 served as controls.Patients with meningitis exhibited significantly higher leukocyte counts(median:11890×10^(3)/μL vs.7905×10^(3)/μL,P<0.001)and CRP levels(median:6.00 mg/dL vs.0.95 mg/dL,P<0.001)compared to controls.Procalcitonin levels were significantly elevated in meningitis patients(median:0.21 ng/mL vs.0.10 ng/mL,P<0.001).Logistic regression identified albumin(OR=0.16,95%CI=0.06-0.40),and CRP(OR=1.18,95%CI=1.08-1.28)as independent predictors of meningitis.ROC analysis for CRP demonstrated a sensitivity of 80.6%and specificity of 70.0%at a cut-off value of 2.23 mg/dL(AUC=0.792).Conclusions:Elevated albumin levels and CRP contents in the blood were significant predictors of meningitis in emergency service.Early identification of predictive markers may aid in timely lumbar puncture and management of atypical cases.
基金the Indian Council of Agricultural Research,New Delhi,India,under the All-India Network Project on Fish Health(No.CIBA/AINP-FH/201516 dated 02.06.2015)。
文摘Streptococcus agalactiae(Sa)infection can result in severe economic losses in tilapia aquaculture.This study offered insights into the therapeutic potential of florfenicol(FFC)and the histopathological changes in the forebrain and midbrain of Sa-infected Oreochromis niloticus.Healthy tilapia(n=225)were divided into three groups:control,Sa-challenged and untreated,and Sa-challenged and FFC-treated.The Sa-infection was induced by intramuscular injection of 1.32×107 cells/fish,and the infected fish received FFC orally at 15 mg/kg biomass/day for 10 consecutive days.Sa exerted serious pathological effects on the forebrain and midbrain of O.niloticus.These effects include focal hemorrhage,mononuclear cell infiltration,lifting of the superficial layer,spongiform encephalopathy,intracellular edema,edematous optic tectum,connective tissue damage,and meningitis.Compared with the untreated group,the treated group demonstrated that FFC is a potential therapeutic agent for mitigating Sa-induced infections by reducing mortality and improving the overall brain histoarchitecture of O.niloticus.
基金supported by grant(No.23-75-30001),TA,AS,NN,SGA,TM,BI,and FI were supported by grant(No.24-75-10047)from the Russian Science Foundation.
文摘Age is a limiting factor in the efficacy of photobiomodulation(PBM)for brain drainage and cognitive functions.Meningeal lymphatic vessels(MLVs)are“tunnels”for removal of toxins from the brain and the target of PBM.Age-related decline in the MLV functions is one of the mechanisms by which the effects of PBM on brain drainage and cognitive process are limited.Sleep is a time of natural activation of brain drainage.Recent findings have shown that PBM during sleep has greater effects on lymphatic clearance of beta-amyloid and cognitive function in young and middle-age mice.Based on these data,this study tested the hypothesis that sleep enhances the effects of PBM on MLVs and cognitive function in the aging brain.Indeed,the results revealed that PBM during sleep,but not during wakefulness,has stimulatory effects on lymphatic clearance of beta-amyloid from the brain of old mice that improves memory.In sleep deficit experiments,it was found that chronic sleep deprivation is accompanied by suppression of brain drainage and removal of metabolites from the brain,such as beta-amyloid,tau,glutamate,lactate and glucose in young,middle-aged and most significantly in old mice.The course of PBM during sleep contributed better than in wakefulness to the restoration of the brain level of tested metabolites in young and middle-aged mice,while in old mice only PBM during sleep was effective.These results open a new strategy for the use of PBM during sleep to improve the efficacy of PBM on clearance of toxic metabolites from the brain,especially in aged subjects in whom the efficacy of PBM during wakefulness is limited.
基金supported by National Natural Science Foundation of China,China(32170102)Natural Science Foundation of Tianjin(21JCYBJC01420)the Fundamental Research Funds for the Central Universities(63233050)。
文摘Objective Pseudomonas aeruginosa(P.aeruginosa)is a prevalent pathogenic bacterium involved in meningitis;however,the virulence factors contributing to this disease remain poorly understood.Methods The virulence of the P.aeruginosa A584,isolated from meningitis samples,was evaluated by constructing in vitro blood-brain barrier and in vivo systemic infection models.qPCR,whole-genome sequencing,and drug efflux assays of A584 were performed to analyze the virulence factors.Results Genomic sequencing showed that A584 formed a phylogenetic cluster with the reference strains NY7610,DDRC3,Pa58,and Pa124.Its genome includes abundant virulence factors,such as hemolysin,the Type IV secretion system,and pyoverdine.A584 is a multidrug-resistant strain,and its wide-spectrum resistance is associated with enhanced drug efflux.Moreover,this strain caused significantly more severe damage to the blood-brain barrier than the standard strain,PAO1.qPCR assays further revealed the downregulation of the blood-brain barrier-associated proteins Claudin-5 and Occludin by A584.During systemic infection,A584 exhibited a higher capacity of brain colonization than PAO1(37.1×10^(6) CFU/g brain versus 2.5×10^(6) CFU/g brain),leading to higher levels of the proinflammatory factors IL-1βand TNF-α.Conclusion This study sheds light on the virulence factors of P.aeruginosa involved in meningitis.
基金supported by the National Key Research and Development Program of China(2021FYD1800405)the National Natural Science Foundation of China(32072823).
文摘Streptococcus suis serotype 2(SS2)is an emerging zoonotic pathogen that causes meningitis in humans and pigs.This pathogen generates substantial economic losses in the swine industry while posing a significant threat to public health security.The mechanisms through which SS2 penetrates the brain and induces meningitis remain incompletely understood.This study examines the role and mechanism of SS2 collagenase-like protease(Clp)in facilitating bacterial passage across the blood-brain barrier(BBB).The research demonstrates that SS2 Clp enhanced virulence and tissue colonization while promoting BBB degradation in mice.The Δclp mutant exhibited reduced ability to traverse human brain microvascular endothelial(hCMEC/D3)cell monolayers compared to wild-type SS2,while the addition of recombinant protein rClp increased permeability.Furthermore,rClp significantly enhanced SS2 adhesion to hCMEC/D3,suppressed the expression of intercellular tight junction proteins ZO-1,Occludin,and Claudin-5 independent of its enzyme activity,and triggered hCMEC/D3 apoptosis through cell receptor ligand apoptosis and mitochondrial apoptosis pathways,partially dependent on its enzyme activity,leading to BBB disruption and enhanced permeability.Additionally,Clp enhanced the infiltration of macrophages(F4/80+),monocytes(F4/80-Ly6C+),and neutrophils(Ly6G+)into the brain following SS2 infection.These findings establish that SS2 Clp is essential for bacterial passage across the BBB,offering a theoretical foundation for improved prevention and treatment strategies for SS2-induced meningitis.
文摘Chronic subdural hematoma is essentially managed by surgical intervention.In recent times,middle meningeal artery embolisation has emerged as a less invasive procedure in such cases.The use of fine catheters to selectively embolise the specific involved branches of the middle meningeal artery using polyvinyl alcohol particles looks promising;however,the presence of anastomotic arteries can result in reflux and embolisation of these atypical branches,causing a myriad of complications.There is a need to identify these abnormal vessels in time to have a positive outcome with the least complications.
文摘Background:Invasive meningococcal disease is a potentially life-threatening infection caused by Neisseria meningitidis.Vaccination is highly effective in preventing meningitis and reducing its associated complications.This study aims to assess the United Arab Emirates(UAE)parents meningitis knowledge and explore vaccination attitudes and practices.Methodology:An observational cross-sectional study was conducted between March and May 2024 across the UAE using convenience sampling through social media,electronic mail,and word of mouth.A 58-item questionnaire collected information regarding demographics,meningitis knowledge,attitudes and practices,and meningococcal vaccination knowledge and practices.Results:Of 443 parents included,more than a third had no knowledge about meningitis.Symptoms and severity were well-recognized overall,but clear gaps were evident regarding complications and meningococcal vaccines.Only 10.38%(46/443)identified themselves as knowledgeable/very knowledgeable regarding meningococcal vaccines.A healthcare provider recommendation was the strongest factor encouraging parents to vaccinate their child.Most vaccine hesitancy was seen regarding side effects.Views and practices regarding the two vaccines aligned closely,with more than four-fifths of participants needing more information and the major reasons for not vaccinating a child being a lack of information or lack of recommendation.Social media and governmental websites were the most common sources for learning more about meningitis,with doctors ranking third.In fact,trust in doctors varied with less than half having moderate or strong trust in their main paediatrician.Multivariate logistic regression revealed that coronavirus disease 2019 vaccination status[adjusted odds ratio(AOR):0.365,95%confidence interval(CI):0.172 to 0.774,P=0.013]and female gender(AOR:2.741,95%CI:1.184 to 6.347,P=0.019)were significant predictors of vaccine hesitancy.Conclusion:Meningococcal vaccine hesitancy is a significant concern,primarily driven by fears of side effects and lack of knowledge and physician recommendation.However,vaccine attitudes were overall positive and highly dependent on physician involvement.There is a need for targeted educational initiatives enhancing meningitis disease awareness and vaccine uptake.
基金financially supported by the National Natural Science Foundation of China(No.32172855)Fundamental Research Funds for the Central Universities(Nos.2632024ZD07,2632024TD02)the Open Project of Jiangsu Provincial Science and Technology Resources(Clinical Resources)Coordination Service Platform(No.TC2023B001)。
文摘The presence of the blood–brain barrier limits the drug concentration in the brain,while low concentrations of antibiotics make it difficult to kill infecting bacteria and tends to induce drug resistance,making the clinical treatment of bacterial meningitis challenging.Herein,a nose-to-brain delivery strategy of small-sized nanozyme has been fabricated for combating bacterial meningitis,to overcome the low drug concentration and drug resistance.This strategy was achieved by a proteinsupported Au nanozyme(ANZ).With a particle size of less than 10 nm,it possesses both glucose oxidase-like and peroxidase-like activities and can generate large amounts of reactive oxygen species through a cascade effect without the addition of external H_(2)O_(2).Benefiting from the cascade catalytic amplification effect generated by its dual enzymelike activities,ANZ shows significant broad-spectrum antibacterial activity without inducing bacterial resistance in vitro.Notably,small-sized ANZ exhibits higher brain entry efficiency and greater accumulation after intranasal administration compared to oral or intravenous administration.In a mouse model of bacterial meningitis,the mice treated with ANZ had lower bacterial loads in the brain and higher survival and clinical behavior scores compared to the classical antibiotic ceftriaxone.Additionally,the meningitis mice exhibited undamaged cognitive and behavioral abilities,indicating the excellent biocompatibility of ANZ.The above results demonstrate that nose-to-brain delivery of ANZ exhibits high intracerebral accumulation,strong antibacterial efficacy and does not lead to bacterial resistance.It holds broad prospects for the treatment of bacterial meningitis.
基金Supported by the Hainan Provincial Natural Science Foundation of China,No.824MS173 and No.823MS165the Project of Hainan Province Clinical Medical Center.
文摘BACKGROUND Angiostrongylus cantonensis-induced acute parasitic infection is a rare food-borne disease in clinical practice.Lack of its specific laboratory markers and subsequent difficulty in detecting pathogens cause high misdiagnosis and missed diagnosis rates.CASE SUMMARY A 20-year-old male developed persistent neck and back pain after consuming raw snail meat,followed by urinary retention and low fever.After admission,the patient was misdiagnosed as viral infection and Mycobacterium tuberculosis in central nervous system.After detection of Angiostrongylus cantonensis in blood and cerebrospinal fluid by metagenomics next generation sequencing,albendazole was administered with ceftriaxone and methylprednisolone treatment simultaneously.With effective antiparasitic treatment,the patient weaned from mechanical ventilation successfully and transferred out of intensive care unit for hyperbaric oxygen and rehabilitation treatment.CONCLUSION This case highlights the diagnostic challenges of Angiostrongylus cantonensis infection and the importance of advanced sequencing techniques in identifying rare pathogens.
文摘Tuberculous meningitis(TBM),which accounts for 1%-5%of global tuberculosis cases,is a severe neurological infection with a mortality rate of 30%-50%.Its high fatality and disability rates disproportionately affect low-and middle-income regions(e.g.,sub-Saharan Africa and Southeast Asia),threatening the lives of patients and imposing significant psychosocial burdens.Recent studies have highlighted the crucial role of psychosocial factors,including socioeconomic status,disease severity,and social support systems in recovery.However,research gaps persist in developing TBM-specific psychosocial interventions.This narrative review summarizes and organizes the key findings of observational studies,cohort studies,and intervention trials published between 2015 and 2024.Databases including PubMed,Scopus,and Web of Science were searched for terms related to TBM,psychosocial risk factors and mental health interventions.Studies were screened for relevance and quality,focusing on those that examined the psychological and social determinants of mental health outcomes in patients with TBM.
基金Supported by the Heilongjiang Provincial Health Commission Scientific Research Project,No.20230404040027the Scientific Technology Project of Qiqihar City,No.CSFGG-2025030.
文摘Mild cognitive impairment(MCI),which is a high-risk transitional phase leading to Alzheimer’s disease,is characterized by mild memory deficits and specific cognitive dysfunctions.Without effective intervention,a significant proportion of patients with MCI progress to dementia.However,current pharmacological treatments are characterized by side effects and poor patient compliance.Therefore,it is necessary to develop effective,noninvasive alternative treatments.Repetitive transcranial magnetic stimulation(rTMS)is becoming a widely studied noninvasive treatment for central nervous system disease.The therapeutic effects of rTMS on patients with MCI and its underlying mechanism are noteworthy issues.Recently,a growing number of studies have shown that meningeal lymphatic vessel damage may be related to cognitive dysfunction.Whether the improvement of the meningeal lymphatic system is an important mechanism through which rTMS improves the clinical manifestations of MCI is worthy of further study.
文摘Middle meningeal artery embolization(MMAE)has revolutionized chronic subdural hematoma management,yet procedural risks persist due to anatomical variability.We analyze a case report by Zhao et al describing transient diplopia caused by inadvertent embolization of the lacrimal artery via a dynamic middle meningeal–ophthalmic anastomosis.This correspondence advances three critical innovations in MMAE safety.First,intraoperative anastomotic unmasking—exposing occult middle meningeal-ophthalmic collaterals during particle injection—reveals dynamic vascular behavior missed by preoperative angiography,underscoring the need for adaptive imaging protocols.Second,hybrid embolization(liquid agents for proximal occlusion+particles for distal control)balances precision and safety,reducing reflux risks compared to monotherapy.Third,a 108-day follow-up establishes a benchmark for functional recovery,challenging assumptions about irreversible cranial nerve injuries and emphasizing structured postprocedural care.Collectively,these findings advocate for procedural agility,multimodal embolic strategies,and sustained rehabilitation to optimize MMAE outcomes while minimizing iatrogenic harm.
文摘Traumatic carotid-cavernous arteriovenous fistula(TCCAVF)is a rare but severe cerebrovascular disorder,often resulting from head trauma with temporal bone fractures.The pathogenesis involves vessel wall injury due to traction,frequently associated with fractures near the middle meningeal artery.This case highlights the typical clinical presentation,diagnostic approaches,and therapeutic management of TCCAVF,emphasizing the challenges in treating this condition.Transcatheter embolization proved effective in occluding the fistula,underscoring its role as a key intervention for traumatic meningeal arteriovenous fistulas.
基金supported by the Key Program of the National Natural Science Foundation of ChinaNo.82030071+1 种基金the Science and Technology Major Project of ChangshaNo.kh2103008(both to JZH)
文摘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.
