Waste clearance (WC) is an essential process for brain homeostasis, which is required for the proper and healthy functioning of all cerebrovascular and parenchymal brain cells. This review features our current understanding of brain WC, both within and external to the brain parenchyma. We describe the interplay of the blood-brain barrier (BBB), interstitial fluid (ISF), and perivascular spaces within the brain parenchyma for brain WC directly into the blood and/or cerebrospinal fluid (CSF). We also discuss the relevant role of the CSF and its exit routes in mediating WC. Recent discoveries of the glymphatic system and meningeal lymphatic vessels, and their relevance to brain WC are highlighted. Controversies related to brain WC research and potential future directions are presented.

中文翻译：

---

大脑中的废物清除

废物清除 (WC) 是大脑稳态的重要过程，这是所有脑血管和实质脑细胞正常和健康运作所必需的。这篇综述展示了我们目前对大脑 WC 的理解，包括大脑实质内部和外部。我们描述了脑 WC 直接进入血液和/或脑脊液 (CSF) 的脑实质内血脑屏障 (BBB)、间质液 (ISF) 和血管周围空间的相互作用。我们还讨论了 CSF 的相关作用及其退出路线在调解 WC 中的作用。突出了淋巴系统和脑膜淋巴管的最新发现，以及它们与脑 WC 的相关性。提出了与脑 WC 研究和潜在的未来方向相关的争议。