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Vascular basement membranes as pathways for the passage of fluid into and out of the brain
Open accessAbstract
In the absence of conventional lymphatics, drainage of interstitial fluid and solutes from the brain parenchyma to cervical lymph nodes is along basement membranes in the walls of cerebral capillaries and tunica media of arteries. Perivascular pathways are also involved in the entry of CSF into the brain by the convective influx/glymphatic system. The objective of this study is to differentiate the cerebral vascular basement membrane pathways by which fluid passes out of the brain from the pathway by which CSF enters the brain. Experiment 1: 0.5 µl of soluble biotinylated or fluorescent Aβ, or 1 µl 15 nm gold nanoparticles was injected into the mouse hippocampus and their distributions determined at 5 min by transmission electron microscopy. Aβ was distributed within the extracellular spaces of the hippocampus and within basement membranes of capillaries and tunica media of arteries. Nanoparticles did not enter capillary basement membranes from the extracellular spaces. Experiment 2: 2 µl of 15 nm nanoparticles were injected into mouse CSF. Within 5 min, groups of nanoparticles were present in the pial-glial basement membrane on the outer aspect of cortical arteries between the investing layer of pia mater and the glia limitans. The results of this study and previous research suggest that cerebral vascular basement membranes form the pathways by which fluid passes into and out of the brain but that different basement membrane layers are involved. The significance of these findings for neuroimmunology, Alzheimer's disease, drug delivery to the brain and the concept of the Virchow-Robin space are discussed.
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![Fig. 6 Schematic representation of the lymphatic drainage and convective influx/glymphatic systems of the brain. An artery enters the brain from the subarachnoid space and an arteriole divides into capillaries. At the top of the figure, the artery is lined by endothelium (Endo), and coated by the tunica media (TM) composed of smooth muscle cells and by the outermost tunica adventitia (TA) composed of connective tissue. As it enters the brain, the artery loses the tunica adventitia but is still coated by a layer of pia-arachnoid (Pia) that intervenes between the artery and the glia limitans (GL) of the brain. As the arteriole divides into capillaries, the tunica media and the layer of pia mater are lost. Thus, at the level of the capillary, the glia limitans is in direct contact with the wall of the capillary. On the right-hand side of the diagram, the red arrows indicate the intramural perivascular lymphatic drainage pathway by which interstitial fluid (ISF) and solutes pass out of the brain along basement membranes in the walls of capillaries and along basement membranes surrounding smooth muscle cells in the tunica media of arterioles and arteries [7]. Tracers in the CSF enter the brain along the pial-glial basement membrane between the pia mater and the glia limitans (indicated by a green arrow) and enter the brain parenchyma and interstitial fluid by an aquaporin 4-dependent mechanism, which is the convective influx/glymphatic pathway](/paper-figures/0c628835b1a3425fac9be35a704e7d37/vascular-basement-membranes-as-pathways-for-the-passage-of-fluid-into-and-out-of-figure-6.jpg)

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“Moreover, animal studies report diverging findings regarding the sites of perivascular brain influx and efflux and direction of perivascular flow (7, 15, 16).”
From Brain-wide glymphatic enhancement and clearance in humans assessed with MRI. (2018) · cites this paper as [16]
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“For example, in the cortex, a packed barrier of endothelial cells, basement membrane, and glia limitans surrounds penetrating arteries, leaving little to no fluid-filled space, whereas the lenticulostriate branches in the basal ganglia are surrounded by a larger perivascular space (13).”
From The anatomy and immunology of vasculature in the central nervous system (2019) · cites this paper as [13]
In the citing paper
“Movement of ISF from the brain parenchyma occurs primarily between basement membranes in the perivascular spaces of capillaries and arteries. This continues along basement membranes in the tunica media of cerebral and leptomeningeal arteries (13).”
From The anatomy and immunology of vasculature in the central nervous system (2019) · cites this paper as [13]
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A pericyte-to-myofibroblast transition links APOE4 to cerebrovascular degeneration
Schuldt, B. R., Haworth-Staines, D., Arévalo, A. P., Broekaart, D. W. M., Harlock, A., Wang, L., Bright, A., Gallagher, G., Rabinowitz, G., Goate, A., et al. (2026) · Cell · doi:10.1016/j.cell.2026.08.058 · Cited by 2
Changes in Adrenergic and Cholinergic Receptors on Human Cerebral Vessels
Gatherer, M., Brown, C. M., Chinezu, L., Manu, D. R., Williams, A., Pendower, A., Ainslie, J., Walker, L., Attems, J., Kelly, L., et al. (2026) · Pharmaceuticals · doi:10.3390/ph19101518
Self-citation
Metadata
- Authors
- Morris, A. W. J., Sharp, M. M., Albargothy, N. J., Fernandes, R., Hawkes, C. A., Verma, A., Weller, R. O., & Carare, R. O.
- Affiliations
- Southampton General Hospital (GB)
- The Open University (GB)
- Biogen (United States) (US)
- Corresponding author
- Carare, Roxana O.
- ORCID
- Venue
- Acta Neuropathologica
- Published
- 2016-03-14
- Volume
- 131
- Issue
- 5
- Pages
- 725-736
- ISSN
- 0001-6322 (ISSN-L)
- 1432-0533
- PMC
- PMC4835509
- OpenAlex
- W2298591538
- Cited by
- 289
- References
- 29
- Citations by year
- 2026: 14 · 2025: 19 · 2024: 18 · 2023: 22 · 2022: 35 · 2021: 28 · 2020: 48 · 2019: 33 · 2018: 29 · 2017: 34 · 2016: 9
- FWCI
- 19.63
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Acta Neuropathologica (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Open Research Online - ORO (The Open University) (acceptedVersion)
- ePrints Soton (University of Southampton) (acceptedVersion)
- Lancaster EPrints (Lancaster University) (submittedVersion)
- Funders
- Biotechnology and Biological Sciences Research Council (BB/K015540/1)
- Age UK (PhD-368)
- Biogen Idec
- Topics
- Health Sciences › Medicine › Clinical Neurology › Cerebrospinal fluid and hydrocephalus
- Life Sciences › Neuroscience › Neurology › Barrier Structure and Function Studies
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Ion Transport and Channel Regulation
- Keywords
- vascular basement membrane, cerebrospinal fluid, glymphatic system, interstitial fluid drainage, amyloid-beta, gold nanoparticles, glia limitans, cerebral microvasculature, perivascular spaces, brain drug delivery, neuroimmunology, Alzheimer's disease, hippocampus
- MeSH terms
- Actins, Animals, Basement Membrane, Blood Vessels, Cerebrospinal Fluid, Cisterna Magna, Extracellular Space, Fluorescent Dyes, Hippocampus, Laminin, Male, Mice, Inbred C57BL, Peptide Fragments, Amyloid beta-Peptides, Biotinylation, Microscopy, Electron, Transmission, Mice, Metal Nanoparticles
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