Recent discoveries of the glymphatic system and of meningeal lymphatic vessels have generated a lot of excitement, along with some degree of skepticism. Here, we summarize the state of the field and point out the gaps of knowledge that should be filled through further research. We discuss the glymphatic system as a system that allows CNS perfusion by the cerebrospinal fluid (CSF) and interstitial fluid (ISF). We also describe the recently characterized meningeal lymphatic vessels and their role in drainage of the brain ISF, CSF, CNS-derived molecules, and immune cells from the CNS and meninges to the peripheral (CNS-draining) lymph nodes. We speculate on the relationship between the two systems and their malfunction that may underlie some neurological diseases. Although much remains to be investigated, these new discoveries have changed our understanding of mechanisms underlying CNS immune privilege and CNS drainage. Future studies should explore the communications between the glymphatic system and meningeal lymphatics in CNS disorders and develop new therapeutic modalities targeting these systems.

最近对类淋巴系统和脑膜淋巴管的发现引起了极大的兴奋，但也引起了一定程度的怀疑。在这里，我们总结了该领域的现状，并指出了应该通过进一步研究来填补的知识空白。我们将类淋巴系统讨论为允许脑脊液（CSF）和间质液（ISF）灌注中枢神经系统的系统。我们还描述了最近表征的脑膜淋巴管及其在脑 ISF、CSF、CNS 衍生分子和免疫细胞从 CNS 和脑膜引流到外周（CNS 引流）淋巴结中的作用。我们推测这两个系统之间的关系及其可能导致某些神经系统疾病的功能障碍。尽管仍有许多问题有待研究，但这些新发现改变了我们对中枢神经系统免疫特权和中枢神经系统引流机制的理解。未来的研究应该探索中枢神经系统疾病中类淋巴系统和脑膜淋巴管之间的通讯，并开发针对这些系统的新治疗方式。