Nasopharyngeal lymphatic plexus is a hub for cerebrospinal fluid drainage

Nasopharyngeal lymphatic plexus is a hub for cerebrospinal fluid drainage

10 January 2024 | Jin-Hui Yoon, Hokyung Jin, Hae Jin Kim, Seon Pyo Hong, Myung Jin Yang, Ji Hoon Ahn, Young-Chan Kim, Jincheol Seo, Yongjeon Lee, Donald M. McDonald, Michael J. Davis, Gou Young Koh
The nasopharyngeal lymphatic plexus (NPLP) is identified as a major hub for cerebrospinal fluid (CSF) drainage to deep cervical lymph nodes. Using fluorescent CSF tracers in *Prox1-GFP* reporter mice, researchers found that the NPLP, characterized by unusual valves and short lymphangions without smooth muscle coverage, transports CSF from the subarachnoid space to deep cervical lymph nodes. In contrast, downstream deep cervical lymphatics, which have typical semilunar valves, long lymphangions, and smooth muscle coverage, are responsible for transporting CSF to lymph nodes. α-Adrenergic and nitric oxide signaling in smooth muscle cells regulate CSF drainage through these lymphatics. During aging, the NPLP atrophies, but deep cervical lymphatics remain unchanged, and CSF outflow can still be increased by pharmacological activation of these lymphatics. Single-cell analysis of gene expression in lymphatic endothelial cells of aged mice revealed increased type I interferon signaling and other inflammatory cytokines. The study highlights the importance of the NPLP as a CSF outflow hub and suggests that pharmacological activation of deep cervical lymphatics can be a potential approach to enhance CSF clearance in age-related neurological conditions.The nasopharyngeal lymphatic plexus (NPLP) is identified as a major hub for cerebrospinal fluid (CSF) drainage to deep cervical lymph nodes. Using fluorescent CSF tracers in *Prox1-GFP* reporter mice, researchers found that the NPLP, characterized by unusual valves and short lymphangions without smooth muscle coverage, transports CSF from the subarachnoid space to deep cervical lymph nodes. In contrast, downstream deep cervical lymphatics, which have typical semilunar valves, long lymphangions, and smooth muscle coverage, are responsible for transporting CSF to lymph nodes. α-Adrenergic and nitric oxide signaling in smooth muscle cells regulate CSF drainage through these lymphatics. During aging, the NPLP atrophies, but deep cervical lymphatics remain unchanged, and CSF outflow can still be increased by pharmacological activation of these lymphatics. Single-cell analysis of gene expression in lymphatic endothelial cells of aged mice revealed increased type I interferon signaling and other inflammatory cytokines. The study highlights the importance of the NPLP as a CSF outflow hub and suggests that pharmacological activation of deep cervical lymphatics can be a potential approach to enhance CSF clearance in age-related neurological conditions.
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