Cerebrospinal fluid proteins articles from across Nature Portfolio

The elimination of amyloid-β (Aβ) from the brain is already impaired at the prodromal stage of Alzheimer disease (AD), so restoration of the clearance systems of the brain might delay the onset of AD. This Review provides a comprehensive update on the brain's clearance systems, including the recent discoveries of the glymphatic system and meningeal lymphatic vessels—findings that have important implications for understanding the disrupted elimination of toxic proteins in AD.

The health of the vertebrate brain is dependent on appropriate levels of cerebrospinal fluid (CSF), which is secreted by the choroid plexus (ChP). In this Review, Lehtinen and colleagues examine ChP structure and development and explore recently discovered functions of the ChP–CSF system.

Brain-iron elevation is implicated in Alzheimer’s disease (AD), but the impact of the metal on disease outcomes has not been analysed in a longitudinal study. Here, the authors examine the association between the levels of ferritin, an iron storage protein, in the cerebrospinal fluid (CSF) of AD patients and show that CSF ferritin levels predict AD outcomes.

A European working group has provided a new set of recommendations for the use of cerebrospinal fluid (CSF) biomarkers in the diagnostic evaluation of Alzheimer disease and mild cognitive impairment. These recommendations represent an important step towards the implementation of CSF biomarker tests in the clinic, but several challenges remain.