Glymphatics and meningeal lymphatics unlock the brain-immune code

From Eric Topol on Twitter; The gylmphatics of our brain, which clear waste products, interact with our immune system and are key to preserving brain health, modulating its aging process, and propensity for neurodegenerative diseases A superb review
@jonykipnis
@ImmunityCP

https://twitter.com/user/status/1919091479365976522


https://www.cell.com/immunity/fulltext/S1074-7613(25)00125-6

 

I am afraid I have come to the conclusion that Eric Topol is a sort of meme-disseminating machine.

I doubt the lymphatics are of much interest to anyone, and certainly not immunologists.

 

Why?

 

Why would they be? In other tissues lymphatics are mostly of interest in the process of recruiting T cells immigration via antigen presenting cell emigration. T cells do not normally get into brains. Immunological brain disease is about lymphocytes or antibody getting IN, that shouldn't. So far, I cannot see anything very interesting about glymphatics.

They don't clear waste products anyway - that is done by back diffusion into venules. The physiology of lymph is very poorly understood by most physicians in other tissues as well.I spent some years working on the role of lymphatics in joints and limbs alongside Rodney Levick, a contemporary from Oxford student days. What medical students get taught and is in the textbooks is mostly wrong. This seems to be just a perpetuation of these myths.

 

But he uses pretty coloured graphics, so it must be true!

Since the glymph system was only recently (re)discovered, I'm not surprised that it's poorly understood, and that unethical people would try to boost themselves via that lack of real knowledge.

 

I am tempted to suggest that since it has only recently been discovered it probably doesn't do much of relevance to human disease!