In the past decade, evidence for a fluid clearance pathway in the central nervous system known as the glymphatic system has grown. According to the glymphatic system concept, cerebrospinal fluid flows directionally through the brain and non-selectively clears the interstitium of metabolic waste. Importantly, the glymphatic system may be modulated by particular drugs such as anaesthetics, as well as by non-pharmacological factors such as sleep, and its dysfunction has been implicated in central nervous system disorders such as Alzheimer disease. Although the glymphatic system is best described in rodents, reports using multiple neuroimaging modalities indicate that a similar transport system exists in the human brain. Here, we overview the evidence for the glymphatic system and its role in disease and discuss opportunities to harness the glymphatic system therapeutically; for example, by improving the effectiveness of intrathecally delivered drugs.

在过去的十年中，中枢神经系统中称为淋巴系统的液体清除途径的证据越来越多。根据 glymphatic 系统的概念，脑脊液定向流经大脑，非选择性地清除间质中的代谢废物。重要的是，glymphatic 系统可能受到特定药物（如麻醉剂）以及非药理学因素（如睡眠）的调节，其功能障碍与中枢神经系统疾病（如阿尔茨海默病）有关。虽然在啮齿动物中最好地描述了 glymphatic 系统，但使用多种神经成像模式的报告表明，人类大脑中存在类似的运输系统。这里，我们概述了 glymphatic 系统的证据及其在疾病中的作用，并讨论了在治疗上利用 glymphatic 系统的机会；例如，通过提高鞘内给药药物的有效性。