郑州大学第一附属医院王雪晶、滕军放以及马明明团队合作取得最新进展。他们发现特发性帕金森病（iPD）的脑膜淋巴引流受损。这一研究成果发表在2021年1月18日出版的国际学术期刊《自然-医学》上。

他们使用动态对比增强磁共振成像来评估认知正常对照和iPD或非典型帕金森病（AP）疾病患者的脑膜淋巴液流动。他们发现，与AP患者相比，iPD患者流经上矢状窦和乙状窦的脑膜淋巴管（mLVs）流量显著减少，并且颈深淋巴结灌注明显延迟。iPD或AP患者与对照组的mLV大小（横截面积）无显著差异。

在注射了α-突触核蛋白（α-syn）预制纤维的小鼠中，他们显示出α-syn病理学的出现是随后的脑膜淋巴引流延迟，脑膜淋巴管内皮细胞之间紧密连接的丧失和脑膜炎症的增加。最后，在用α-syn预制原纤维处理的小鼠中阻断通过mLV的血流会增加α-syn的病理状态，并加剧运动和记忆缺陷。

这些结果表明，脑膜淋巴引流功能障碍加重了α-syn病理，并促进了PD的进展。

据悉，动物研究表明，脑膜淋巴功能障碍与神经退行性疾病（例如阿尔茨海默氏病和帕金森氏病）的发病机理有关。然而，人们没有直接证据支持这种作用。

附：英文原文

Title: Impaired meningeal lymphatic drainage in patients with idiopathic Parkinson’s disease

Author: Xue-Bing Ding, Xin-Xin Wang, Dan-Hao Xia, Han Liu, Hai-Yan Tian, Yu Fu, Yong-Kang Chen, Chi Qin, Jiu-Qi Wang, Zhi Xiang, Zhong-Xian Zhang, Qin-Chen Cao, Wei Wang, Jia-Yi Li, Erxi Wu, Bei-Sha Tang, Ming-Ming Ma, Jun-Fang Teng, Xue-Jing Wang

Issue&Volume: 2021-01-18

Abstract: Animal studies implicate meningeal lymphatic dysfunction in the pathogenesis of neurodegenerative diseases such as Alzheimer’s disease and Parkinson’s disease (PD). However, there is no direct evidence in humans to support this role1,2,3,4,5. In this study, we used dynamic contrast-enhanced magnetic resonance imaging to assess meningeal lymphatic flow in cognitively normal controls and patients with idiopathic PD (iPD) or atypical Parkinsonian (AP) disorders. We found that patients with iPD exhibited significantly reduced flow through the meningeal lymphatic vessels (mLVs) along the superior sagittal sinus and sigmoid sinus, as well as a notable delay in deep cervical lymph node perfusion, compared to patients with AP. There was no significant difference in the size (cross-sectional area) of mLVs in patients with iPD or AP versus controls. In mice injected with α-synuclein (α-syn) preformed fibrils, we showed that the emergence of α-syn pathology was followed by delayed meningeal lymphatic drainage, loss of tight junctions among meningeal lymphatic endothelial cells and increased inflammation of the meninges. Finally, blocking flow through the mLVs in mice treated with α-syn preformed fibrils increased α-syn pathology and exacerbated motor and memory deficits. These results suggest that meningeal lymphatic drainage dysfunction aggravates α-syn pathology and contributes to the progression of PD.

DOI: 10.1038/s41591-020-01198-1

Source: https://www.nature.com/articles/s41591-020-01198-1