Meta-Environment No17: Glymphatic System and Meningeal Lymphatic Vessels

For a long time, the central nervous system (CNS) was thought to be an "immune-privileged" territory, devoid of mechanisms for removing metabolic waste. This view has been revised since the discovery of the glymphatic system (2012) and meningeal lymphatic vessels (2015). The glymphatic system is the pathway by which cerebrospinal fluid (CSF) enters the brain parenchyma along the periarterial spaces, exchanges with interstitial fluid via aquaporin-4 (AQP4) at the astrocytic terminal pedicles, and is excreted through the perivenous spaces. The system works most effectively during slow-wave sleep, controlled by norepinephrine fluctuations and vasomotion. Meningeal lymphatic vessels (MLS), located in the dura mater, form the interface between the CNS and the peripheral lymphatic circulation, draining CSF and macromolecules into the deep cervical lymph nodes. The article substantiates that the glymphatic system and the MLS form an active meta-medium No17 that meets all four criteria. Particular attention is paid to age-related degradation of the system—decreased clearance, AQP4 dysfunction, MLS fibrosis, and accumulation of AGEs—as a key factor in neurodegeneration. Systemic restoration in the Quatotron method through multimodal physical action aimed at improving perivascular transport, restoring AQP4, stimulating lymphangiogenesis and reducing neuroinflammation is presented.