Neurohumoral gate for the entry of coronavirus into the central nervous system through the cribriform plate of the skull

Abstract

Recent research has shown that there are different drainage systems in the brain. During the drainage of cerebrospinal and interstitial fluids, intracerebral (intracranial) lymph is formed, which becomes part of the glymphatic system. Later, the glymphatic system was subdivided into periand paravascular spaces, but their existence has not yet been proven. The article contains data on the anatomy of the lamina cribrosa, its age-related changes, the characteristics of the lymphatic system and the theory of the existence of glymphatic vessels in this area. We also hypothesize that in addition to the classical view, which assumes that viruses enter the central nervous system (CNS) through the blood-brain barrier or with the help of immune cells, there are other routes of pathogen entry, for example through the glymphatic system. Possible routes of movement of cerebrospinal and interstitial fluids through the structures of the nervous system and other systems are considered. The lamina cribrosa is considered a possible portal of entry for viruses into the CNS, in particular for the SARS-CoV-2 virus. In our review, we analyzed the likely mechanisms of SARS-CoV-2 spread in the central nervous system and the possible consequences of previous viral disease.

Keywords

• cribriform plate
• glymphatic system
• covid-19
• olfactory epithelium
• blood-brain barrier