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J Neurosci. 2015 Jan 14;35(2):518-26. doi: 10.1523/JNEUROSCI.3742-14.2015.

Biomarkers of traumatic injury are transported from brain to blood via the glymphatic system.

Author information

1
Center for Translational Neuromedicine, Department of Neurosurgery and Department of Pathology, University of Rochester Medical Center, Rochester, New York 14642.
2
Center for Translational Neuromedicine, Department of Neurosurgery and.
3
Center for Translational Neuromedicine, Department of Neurosurgery and Maiken_Nedergaard@URMC.Rochester.edu.

Abstract

The nonspecific and variable presentation of traumatic brain injury (TBI) has motivated an intense search for blood-based biomarkers that can objectively predict the severity of injury. However, it is not known how cytosolic proteins released from traumatized brain tissue reach the peripheral blood. Here we show in a murine TBI model that CSF movement through the recently characterized glymphatic pathway transports biomarkers to blood via the cervical lymphatics. Clinically relevant manipulation of glymphatic activity, including sleep deprivation and cisternotomy, suppressed or eliminated TBI-induced increases in serum S100β, GFAP, and neuron specific enolase. We conclude that routine TBI patient management may limit the clinical utility of blood-based biomarkers because their brain-to-blood transport depends on glymphatic activity.

KEYWORDS:

CSF; biomarker; clearance; lymphatic; traumatic brain injury

PMID:
25589747
PMCID:
PMC4293408
DOI:
10.1523/JNEUROSCI.3742-14.2015
[Indexed for MEDLINE]
Free PMC Article

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