Nature https://doi.org/10.1038/s41586-018-0368-8 (2018)

The discovery of brain lymphatics has challenged the concept that the healthy brain is an immunoprivileged organ; however, the function of these lymphatics in disease states has been unclear. In Nature, Kipnis and colleagues investigate the potential homeostatic and pathophysiological roles of brain lymphatics. Genetic and pharmacological disruption of brain lymphatics results in less drainage of the cerebrospinal and interstitial fluids to the cervical lymph nodes. Such disruption also results in select cognitive impairment and behavioral alterations. Increasing the diameter of brain lymphatics via administration of recombinant growth factor VEGF improves the drainage of macromolecules to the cervical lymph nodes of aged mice. Finally, disruption of brain lymphatics worsens mouse models of Alzheimer’s disease. Collectively, these findings suggest that dysfunction of brain lymphatics might provide an important contribution to age-related cognitive decline and neurodegenerative disease.