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Fluids Barriers CNS. 2015 Jun 29;12:16. doi: 10.1186/s12987-015-0012-z.

A new glaucoma hypothesis: a role of glymphatic system dysfunction.

Author information

1
Department of Psychiatry, PC Sint-Amandus, Reigerlostraat 10, 8730, Beernem, Belgium. wostyn.peter@skynet.be.
2
Department of Biomedical Sciences, Laboratory of Neurochemistry and Behavior, Institute Born-Bunge, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium. debby.vandam@uantwerpen.be.
3
Department of Psychiatry, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium. kaudenae@me.com.
4
Department of Ophthalmology, Kantonsspital Aarau, Buchserstrasse, Aarau, 5001, Switzerland. Hanspeter.Killer@ksa.ch.
5
Department of Biomedical Sciences, Laboratory of Neurochemistry and Behavior, Institute Born-Bunge, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium. dedeyn@skynet.be.
6
Department of Neurology and Memory Clinic, Middelheim General Hospital (ZNA), Lindendreef 1, 2020, Antwerp, Belgium. dedeyn@skynet.be.
7
Department of Neurology and Alzheimer Research Center, University of Groningen and University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands. dedeyn@skynet.be.
8
Department of Ophthalmology, Antwerp University Hospital, Wilrijkstraat 10, 2650, Antwerp, Belgium. Veva.DeGroot@uza.be.

Abstract

In a recent review article titled "A new look at cerebrospinal fluid circulation", Brinker et al. comprehensively described novel insights from molecular and cellular biology as well as neuroimaging research, which indicate that cerebrospinal fluid (CSF) physiology is much more complex than previously believed. The glymphatic system is a recently defined brain-wide paravascular pathway for CSF and interstitial fluid exchange that facilitates efficient clearance of interstitial solutes, including amyloid-β, from the brain. Although further studies are needed to substantiate the functional significance of the glymphatic concept, one implication is that glymphatic pathway dysfunction may contribute to the deficient amyloid-β clearance in Alzheimer's disease. In this paper, we review several lines of evidence suggesting that the glymphatic system may also have potential clinical relevance for the understanding of glaucoma. As a clinically acceptable MRI-based approach to evaluate glymphatic pathway function in humans has recently been developed, a unique opportunity now exists to investigate whether suppression of the glymphatic system contributes to the development of glaucoma. The observation of a dysfunctional glymphatic system in patients with glaucoma would provide support for the hypothesis recently proposed by our group that CSF circulatory dysfunction may play a contributory role in the pathogenesis of glaucomatous damage. This would suggest a new hypothesis for glaucoma, which, just like Alzheimer's disease, might be considered then as an imbalance between production and clearance of neurotoxins, including amyloid-β.

PMID:
26118970
PMCID:
PMC4485867
DOI:
10.1186/s12987-015-0012-z
[Indexed for MEDLINE]
Free PMC Article

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