Unclogging the Brain's 'Drain' Enhances Alzheimer's Meds

A study published in Nature suggests the brain's meningeal lymphatics system plays an important role in neurodegenerative disease, and that fixing this faulty drainage system could improve certain Alzheimer's medications, reports Futurity . "Alzheimer's and other neurodegenerative diseases . . . are characterized by protein aggregation in the brain," said Washington University School of Medicine in St. Louis (WUSM) Professor Jonathan Kipnis. "If you break up these aggregates but you have no way to get rid of the debris because your sink is clogged, you didn't accomplish much. You have to unclog the sink to really solve the problem." The researchers disabled the meningeal lymphatics of mice genetically prone to forming amyloid plaques, comparing the patterns of genes expressed by microglia to those in mice whose lymphatics were left intact. Microglia in the lymphatic dysfunction group shifted to a state more likely to promote neurodegeneration, and this same pattern was observed in humans. "Maybe an understanding of this system is a part of what the field of Alzheimer's drug development has been missing, and with increased attention to it we will better translate some of these promising drug candidates into therapies that provide meaningful benefits to people living with this devastating disease," said WUSM Professor David Holtzman.