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Volume 625 Issue 7996, 25 January 2024

Brain drain

Cerebrospinal fluid (CSF) circulates around the brain and the spinal column, providing mechanical support and nourishment, and helping to clear away impurities. Although it has long been known that CSF drains through the lymphatic system, the precise connections and regulation for the process have proved elusive. In this week’s issue, Gou Young Koh and colleagues use fluorescent tracers in mice to reveal a network of lymphatic vessels at the back of the nose, called the nasopharyngeal lymphatic plexus, which facilitates CSF flow from the brain to lymph nodes in the neck — shown on the cover, where green highlights the direct connection of the plexus (upper region) to deep-neck lymphatics (middle and lower regions), blue indicates blood vessels and red is smooth muscles. The researchers note that the plexus is regressed and loses functionality with age, which could inhibit clearance of disease-linked proteins such as amyloid-β, but they show that it is possible to pharmacologically stimulate deep neck lymphatics to counteract the age-related drop in the hub’s functionality.

Cover image: Hokyung Jin/Jin-Hui Yoon

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