The brain washing system in sepsis-associated encephalopathy

Sepsis-associated encephalopathy (SAE) represents a prevalent and serious complication in patients with sepsis, contributing to substantial cognitive dysfunction and persistent neurological deficits. The cerebral clearance mechanism, consisting of the glymphatic system and meningeal lymphatic vessels (MLVs), serves a pivotal function in cerebrospinal fluid (CSF) drainage and the elimination of metabolic byproducts. The study demonstrated that intraperitoneal administration of LPS (3 mg/kg) resulted in a reduction in Aβ clearance 28 h post-injection. Moreover, acute exposure to a lower dose of LPS (1 mg/kg) led to a decreased distribution of CSF around the middle cerebral artery as early as 3 h. These concurrent observations imply that compromised functionality of this clearance mechanism may contribute to cognitive impairments induced by sepsis. This review comprehensively investigates the involvement of the cerebral clearance mechanism in the pathophysiological processes of SAE, with the objective of uncovering innovative therapeutic approaches.