The Glymphatic System

Cancer care has been revolutionized by targeted therapies since 1982 when I took my first nursing job on an inpatient oncology unit. Every once in a while I fantasize about amazing advances to come in the treatment of dementia.

Today I want to take a dive into one therapy that might target Alzheimer’s related mechanisms. I gotta start with the fact that I don’t remember ever hearing of the glymphatic system. The lymphatic system yes, with its vessels and nodes clearing fluids and toxins from the body alongside the vascular system.

Turns out there is a specific system that does that in the brain called the glymphatic system. This system flushes out toxins in the brain including amyloid beta and tau proteins using the cerebrospinal fluid pathways. This system is particularly active during “deep” sleep when the space between brain cells increases such that toxins can be “washed through.”

In Alzheimer’s Disease this sytem becomes clogged, which prevents the clearance of dementia-causing proteins.

One of the targets that scientists are looking at is the AQP4 component, known as the “master valve” of the glymphatic system. Apologize for getting into the weeds a little bit here but this structure promotes better flow of fluid during the washing out of toxins. These channels are held in place by a kind of “molecular glue.” In Alzheimer’s disease these structures are displaced, reducing the normal flow of the glymphatic system.

There are a number of research avenues looking at how to prevent this displacement from occurring including development of drugs to strengthen the “glue.” Basic science research is underway in this field. This seems like a targeted therapy with promise in treating or preventing Alzheimer’s and I think we all need to have hope for amazing breakthroughs on the horizon.

Let’s keep pushing for new innovative basic science that leads to clinically significant reversal.

Share