Could dexmedetomidine be repurposed as a glymphatic enhancer?




Persson Niklas Daniel Åke, Uusalo Panu, Nedergaard Maiken, Lohela Terhi J, Lilius Tuomas O

PublisherELSEVIER SCIENCE LONDON

2022

Trends in Pharmacological Sciences

TRENDS IN PHARMACOLOGICAL SCIENCES

TRENDS PHARMACOL SCI

43

12

1030

1040

11

0165-6147

1873-3735

DOIhttps://doi.org/10.1016/j.tips.2022.09.007

https://doi.org/10.1016/j.tips.2022.09.007

https://research.utu.fi/converis/portal/detail/Publication/177207864



Cerebrospinal fluid (CSF) flows through the central nervous system (CNS) via the glymphatic pathway to clear the interstitium of metabolic waste. In preclinical studies, glymphatic fluid flow rate increases with low central noradrenergic tone and slow-wave activity during natural sleep and general anesthesia. By contrast, sleep deprivation reduces glymphatic clearance and leads to intracerebral accumulation of metabolic waste, suggesting an underlying mechanism linking sleep disturbances with neurodegenerative diseases. The selective alpha(2)-adrenergic agonist dexmedetomidine is a sedative drug that induces slow waves in the electroencephalogram, suppresses central noradrenergic tone, and preserves glymphatic outflow. As recently developed dexmedetomidine formulations enable self-administration, we suggest that dexmedetomidine could serve as a sedative-hypnotic drug to enhance clearance of harmful waste from the brain of those vulnerable to neurodegeneration.

Last updated on 2024-26-11 at 18:24