Almost 150 papers about brain lymphatics have been published in the last 150 years. Recently, the information in these papers has been synthesized into a picture of central nervous system (CNS) “glymphatics,” but the fine structure of lymphatic elements in the human brain based on imaging specific markers of lymphatic endothelium has not been described. We used LYVE1 and PDPN antibodies to visualize lymphatic marker-positive cells (LMPCs) in postmortem human brain samples, meninges, cavernous sinus (cavum trigeminale), and cranial nerves and bolstered our findings with a VEGFR3 antibody. LMPCs were present in the perivascular space, the walls of small and large arteries and veins, the media of large vessels along smooth muscle cell membranes, and the vascular adventitia. Lymphatic marker staining was detected in the pia mater, in the arachnoid, in venous sinuses, and among the layers of the dura mater. There were many LMPCs in the perineurium and endoneurium of cranial nerves. Soluble waste may move from the brain parenchyma via perivascular and paravascular routes to the closest subarachnoid space and then travel along the dura mater and/or cranial nerves. Particulate waste products travel along the laminae of the dura mater toward the jugular fossa, lamina cribrosa, and perineurium of the cranial nerves to enter the cervical lymphatics. CD3-positive T cells appear to be in close proximity to LMPCs in perivascular/perineural spaces throughout the brain. Both immunostaining and qPCR confirmed the presence of adhesion molecules in the CNS known to be involved in T cell migration.

过去 150 年来，已发表了近 150 篇有关脑淋巴管的论文。最近，这些论文中的信息已被合成为中枢神经系统（CNS）“淋巴管”的图片，但尚未描述基于淋巴管内皮特异性标记物成像的人脑中淋巴管元件的精细结构。我们使用 LYVE1 和 PDPN 抗体对死后人脑样本、脑膜、海绵窦（三叉腔）和脑神经中的淋巴标记物阳性细胞 (LMPC) 进行可视化，并用 VEGFR3 抗体支持了我们的发现。LMPC 存在于血管周围空间、小动脉和大动脉和静脉的壁、沿着平滑肌细胞膜的大血管中层以及血管外膜中。在软脑膜、蛛网膜、静脉窦和硬脑膜各层中检测到淋巴标记染色。脑神经的神经束膜和神经内膜中存在大量的LMPC。可溶性废物可能从脑实质通过血管周围和血管旁路径移动到最近的蛛网膜下腔，然后沿着硬脑膜和/或脑神经移动。颗粒废物沿着硬脑膜层流向颈静脉窝、筛板和颅神经神经束膜，进入颈部淋巴管。CD3 阳性 T 细胞似乎与整个大脑血管周围/神经周围空间的 LMPC 非常接近。免疫染色和 qPCR 均证实 CNS 中存在已知参与 T 细胞迁移的粘附分子。