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Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Nat+Rev+Neurol 2015 ; 11 (8): 457-70 Nephropedia Template TP
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Clearance systems in the brain?implications for Alzheimer disease #MMPMID26195256
Nat Rev Neurol 2015[Aug]; 11 (8): 457-70 PMID26195256show ga
Accumulation of toxic protein aggregates?amyloid-? (A?) plaques and hyperphosphorylated tau tangles?is the pathological hallmark of Alzheimer disease (AD). A? accumulation has been hypothesized to result from an imbalance between A? production and clearance; indeed, A? clearance seems to be impaired in both early and late forms of AD. To develop efficient strategies to slow down or halt AD, it is critical to understand how A? is cleared from the brain. Extracellular A? deposits can be removed from the brain by various clearance systems, most importantly, transport across the blood?brain barrier. Findings from the past few years suggest that astroglial-mediated interstitial fluid (ISF) bulk flow, known as the glymphatic system, might contribute to a larger portion of extracellular A? (eA?) clearance than previously thought. The meningeal lymphatic vessels, discovered in 2015, might provide another clearance route. Because these clearance systems act together to drive eA? from the brain, any alteration to their function could contribute to AD. An understanding of A? clearance might provide strategies to reduce excess A? deposits and delay, or even prevent, disease onset. In this Review, we describe the clearance systems of the brain as they relate to proteins implicated in AD pathology, with the main focus on A?.