Redesigning Alzheimer’s Modalities around Clearance
Redesigning Alzheimer’s Modalities around Clearance Author: KJ Lavan The most radical shift in Alzheimer’s disease (AD) may not be what we target—but how we move things out of the brain. For decades we’ve chased amyloid production. The emerging clearance science says: follow the flow. ⸻ 1. From “amyloid problem” to “clearance problem” New work visualizing how amyloid-β (Aβ) is cleared from the human brain adds weight to a simple but disruptive idea: AD is as much a fluid-dynamics disorder as a proteinopathy. The glymphatic–meningeal lymphatic system—glial-supported perivascular channels plus dural lymphatic vessels—acts as the brain’s waste-clearance network, moving cerebrospinal fluid (CSF) in, mixing with interstitial fluid, and exporting Aβ, tau, and other toxins to cervical lymph nodes. When this system falters, toxic proteins accumulate even if production hasn’t changed. Human imaging now directly tracks CSF–waste flow along the...