There is currently a renaissance of interest in the many functions of cerebrospinal fluid (CSF). Altered flow of CSF, for example, has been shown to impair the clearance of pathogenic inflammatory proteins involved in neurodegenerative diseases, such as amyloid-β. In addition, the role of CSF in the newly discovered lymphatic system of the brain has become a prominently researched area in clinical neuroscience, as CSF serves as a conduit between the central nervous system and immune system. This article will review the importance of CSF in regulating normal brain development and function, from the prenatal period throughout the lifespan, and highlight recent research that CSF abnormalities in autism spectrum disorder (ASD) are present in infancy, are detectable by conventional structural MRI, and could serve as an early indicator of altered neurodevelopment. The identification of early CSF abnormalities in children with ASD, along with emerging knowledge of the underlying pathogenic mechanisms, has the potential to serve as early stratification biomarkers that separate children with ASD into biological subtypes that share a common pathophysiology. Such subtypes could help parse the phenotypic heterogeneity of ASD and map on to targeted, biologically based treatments.

中文翻译：

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脑脊液和自闭症的早期大脑发育

目前，人们对脑脊液（CSF）的许多功能产生了兴趣。例如，脑脊液流量的变化已显示出会损害与神经退行性疾病有关的病原性炎症蛋白（如淀粉样蛋白-β）的清除。此外，CSF在新发现的大脑淋巴系统中的作用已成为临床神经科学领域的重要研究领域，因为CSF充当中枢神经系统和免疫系统之间的通道。本文将回顾从整个生命周期的产前期开始，脑脊液在调节正常大脑发育和功能中的重要性，并重点介绍最近的研究，即婴儿期存在自闭症谱系障碍（ASD）的脑脊液异常，可以通过常规结构MRI检测到，并可以作为神经发育改变的早期指标。对ASD儿童早期CSF异常的识别以及对潜在致病机制的新认识，有可能作为早期分层生物标志物，将ASD儿童分为具有共同病理生理学的生物学亚型。此类亚型可以帮助解析ASD的表型异质性，并定位到针对性的，基于生物学的治疗方法。