ESOC 2022 | Factors affecting waste clearance from the brain

Work from Roxana Carare, MD, PhD, University of Southampton, Southampton, UK, and her team has demonstrated that interstitial fluid and solutes are drained from the brain through basement membranes in the walls of cerebral capillaries and arteries, via a system of intramural periarterial drainage (IPAD). As cerebral vessels become stiffer with age, lymphatic drainage of the brain becomes less efficient, leading to the build up of amyloid beta and other solutes, cerebral amyloid angiopathy (CAA), and a loss of homeostasis in the extracellular environment. Apart from age, other factors have been shown to impact amyloid clearance: APOE ε4, which causes premature aging of the IPAD pathways; hypertension, via changes in the walls of the vasculature; and hyperlipidemia. This interview took place at European Stroke Organisation Conference 2022 in Lyon, France.