Over the past decade, repeated studies demonstrated that the vertebrate brain had a specialized lymphatic transport pathway, which overturned the traditional concept of central nervous system (CNS) immune privilege. Despite the lack of lymphatic vessels, the glymphatic system and the meningeal lymphatic vessels provide a unique pathway for solutes transport and metabolites clearance in the brain. Sleep, circadian rhythm, arterial pulsation, and other physiological factors modulate this specialized lymphatic drainage pathway. It has also changed significantly under pathological conditions. These modulatory mechanisms may arise critical targets for the therapeutic of CNS disorders. This review highlights the latest research progress on the modulation of lymphatic transport in the CNS under physiological and pathological conditions. Furthermore, we examined the possible upstream and downstream relation networks between these regulatory mechanisms.
Keywords: central nervous system; glymphatic system; lymphatic vessels; regulation; sleep.
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