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Glymphatic System a Window on TBI Pathophysiology: A Systematic Review
Michela Ferrara1, Giuseppe Bertozzi2, Gianpietro Volonnino1
1Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, 00161 Rome, Italy.
International Journal of Molecular Sciences
|August 26, 2022
Summary
The glymphatic system, crucial for clearing brain waste via AQP4 channels, is impaired in traumatic brain injury (TBI). This impairment links to TBI markers and brain edema, necessitating further research.
Area of Science:
- Neuroscience
- Neuropathology
- Biomedical Engineering
Background:
- The glymphatic system, a brain waste clearance pathway, has gained attention due to its role in neuropathologies.
- Its function is closely linked to Aquaporin-4 (AQP4) glial channels, identified in 2012.
- Traumatic brain injury (TBI) is a key area of investigation for glymphatic system dysfunction.
Purpose of the Study:
- To systematically review the literature on the glymphatic system's role in TBI pathogenesis.
- To identify key molecular markers and pathological changes associated with glymphatic dysfunction post-TBI.
Main Methods:
- A systematic literature review was conducted following PRISMA guidelines.
- Searches were performed on SCOPUS and Medline (PubMed) databases on March 23, 2022.
- The review included 12 selected articles.
Main Results:
- Alterations in AQP4 are associated with increased levels of S100b, GFAP, and NSE, recognized TBI markers.
- Impaired AQP4 function contributes to brain edema, a secondary injury mechanism.
- Specific brain regions show susceptibility to glymphatic pathway alterations following TBI.
Conclusions:
- Glymphatic system dysfunction, particularly AQP4 alterations, plays a significant role in TBI.
- Further research is essential to fully elucidate these mechanisms.
- A cadaver-based study protocol is proposed to advance TBI and glymphatic system research.
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