Abstract

Water is the key medium to transport numerous constituents and to provide a platform for physiological processes to take place in the living organisms in general; it also participates actively in many of these processes. In humans, there are different vehicles to contain water and its constituents. Our objective is to find out whether there is an overall water-base circulation system in the human body by analyzing the updated findings of different research groups on the physiological functions of various seemingly isolated fluid systems. By 1963, there were five separate fluid systems discovered in mammalians: (i) The Primo Vasculature Fluid (PVF) with protein precursors and micro cells held in the Primo Vasculature System (PVS). (ii) Blood with its constituents held in the cardio vasculature. (iii) Extracranial interstitial fluid (ISF) whose vehicle had a very irregular structure—the interstitium all over the body. (iv) The cerebrospinal fluid had been considered to be within the brain ventricles and spinal canal. (v) The extra-cranial lymphatic system which drained ISF, and had been known to join the subclavian vein. Fluid (i) was first reported in 1963 and fluids (ii) to (v) have been known for many decades, but the failure to detect a lymphatic system inside the skull has also been a mystery for many decades. The intra-cranial ISF (which we name as BISF) has drawn little attention, apart from discussing the mechanism of the blood-brain-barrier. During the past decade, there has been direct evidence indicating that CSF and BISF are actually mixed. After that, the intracranial lymphatic system was discovered and confirmed in animal models only slightly over one year back, and we called such fluid as glymphatic-fluid. After reviewing the stated “classical” five fluid systems together with the new findings in Sections 2 - 7, we propose, for the first time, that the PVF, the blood, ISF, a mixture of CSF-BISF, and a mixture of glymphatic-fluid and lymph form an integrative circulation system in water base in the human and other mammalian bodies, as schematically represented in the last section. In this paper, we point out the positive correlation of chronic neuro degenerative diseases such as Alzheimer’s disease, Parkinson’s diseases and the insufficient brain wastes clearance by the glymphatic system. We also discuss the role played by the venous vessels as part of such clearance in upright posture. Moreover, simple non-invasive maneuver techniques are introduced here, as one example of enhancement of glymphatic fluid flow out of the skull to join the lymphatic system. A series of questions are raised in Section 8, the answers to which would help us to understand the transition from physio- to pathological states in the development of many diseases. Detailed analysis of this paper leads us to consider that research in understanding this integrative circulation system is only at the infancy stage, and fluid dynamics investigation seems to be the plausible modality of approach in the near future.

Highlights

  • Water molecules have polar structure, and form protons/hydronium ions, hydroxyl ions among the water molecules themselves, making water a special fluid to function as the most convenient medium to transport both hydrophilic and hydrophobic bio-molecules, and as a medium for numerous biochemical and biophysical interactions in the body

  • By 1963, there were five separate fluid systems discovered in mammalians: (i) The Primo Vasculature Fluid (PVF) with protein precursors and micro cells held in the Primo Vasculature System (PVS). (ii) Blood with its constituents held in the cardio vasculature. (iii) Extracranial interstitial fluid (ISF) whose vehicle had a very irregular structure—the interstitium all over the body. (iv) The cerebrospinal fluid had been considered to be within the brain ventricles and spinal canal. (v) The extra-cranial lymphatic system which drained ISF, and had been known to join the subclavian vein

  • After reviewing the stated “classical” five fluid systems together with the new findings in Sections 2 - 7, we propose, for the first time, that the PVF, the blood, ISF, a mixture of cerebrospinal fluid (CSF)-BISF, and a mixture of glymphatic-fluid and lymph form an integrative circulation system in water base in the human and other mammalian bodies, as schematically represented in the last section

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Summary

Introduction

The cardio-vasculature system is proposed to be the Second Fluid circulation system, which has already been extensively studied. From the fluid dynamics point of view, perhaps an interesting comparison is to relate the total cross-section area diameter of one or more blood vessels at a particular region (where the vessels, artery or venous, are located) with the flow speed. Note that the volume of blood passing through per second (found by multiplying the total cross-sectional area with the average flow speed), based on the above numbers, fall in the following ranges: (i) 120 - 200 cm; (ii) 210 cm; (iii) 135 - 180 cm3 These figures are of the same order of magnitude, but should not be equal, because there is water excreting outside the vessels to the “Third Fluid system—the interstitial fluid”, as will be explained, and represented schematically in Figure 2 there. It is tempting to speculate that long term massage treatment might in turn induce a higher elastin-collagen ratio to be developed in the veins

The Primo Vasculature System
Proposed Functions of the PVS at the Embryo
Cardiomyocytes Beat Best on a Matrix with Elasticity Similar to the Heart
Circulation Function of the Emissary Veins
A Brief Sketch of the Interstitium
An Updated Concept of Cerebrospinal Fluid Generation
CSF Follows Special Pathways to Mix with BISF in the Brain Parenchyma
Structure of the Lymphatic System
Intrinsic Propulsion of Fluid by the Lymph Pump
Extrinsic Forces Can Affect the Flow Characteristics
Proper Exercise or Massage Enhances Lymph Flow
The Glymphatic System
Findings
On Drainage during Sleep
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