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Blending Established and New Perspectives on Choroid Plexus-CSF Dynamics

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Role of the Choroid Plexus in Health and Disease

Part of the book series: Physiology in Health and Disease ((PIHD))

Abstract

Modern cerebrospinal fluid (CSF) physiologic investigation accelerated after World War II with the advent of radio-isotopes to quantify choroid plexus (CP) ion transport and CSF flow dynamics. Hugh Davson, Malcolm Segal, Michael Bradbury, Michael Pollay, Keasley Welch, Helen Cserr, John Pappenheimer, and colleagues, developed laboratory preparations to assess tracer uptake/release by CP and associated flow dynamics within the ventricular-brain system. This canonical research established several basic physiologic concepts: differences between CP and blood-brain barrier, CP as primary site of CSF formation, ependymal permeability, intimate CSF and brain interstitial fluid association, CSF sink action for excretion, and a quasi-lymphatic function of CSF flow/drainage to cervical lymph. Their seminal findings constitute a reliable foundation on which to build contemporary models of CP transport/CSF dynamics, including functional interaction with the newly-described glymphatic system. The 1980s–1990s provided research findings on CSF regulation by neurotransmitters and neuropeptides; also, many new pharmacologic agents were tested for controlling CSF formation. Over the past 2–3 decades, the advent/refinement of diverse immunohistochemical, neuroendocrine and molecular techniques has delineated the expression and function of basolateral and apical transporters at the blood-CSF interface. Recently, CP gene knock-out models and transcriptomic approaches have engendered specific analysis of CP transport and metabolism. Increasing attention is being paid to the CP role in diseases such as Alzheimer’s, Parkinson’s, stroke, intracranial hypertension and hydrocephalus. The physiologic impact of CP-CSF fluid generation, pressure and homeostasis on the putative glymphatic system is a promising topic. There is an increasing need to blend transport/fluid phenomena at the BCSFB with the BBB and ependymal CSF-brain interface. Integrated models that incorporate all CNS transport interfaces will provide a key impetus for advances in translational neuromedicine.

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Acknowledgments

This study was supported by grants to RFK: NS-093399, and NS-106746 from the National Institutes of Health (NIH). NIH funding to CEJ, as NS-27601 and NIA-AG027910, helped to produce some of the information and concepts in this chapter.

Conflicts of Interest

The authors have no conflicts of interest to declare.

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Authors and Affiliations

  1. Department of Neurosurgery, Alpert Medical School at Brown University, Providence, RI, USA

    Conrad E. Johanson

  2. Department of Neurosurgery, University of Michigan, Ann Arbor, MI, USA

    Richard F. Keep

Authors
  1. Conrad E. Johanson
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  2. Richard F. Keep
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Correspondence to Conrad E. Johanson .

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Editors and Affiliations

  1. Department of Biomedicine, Faculty of Health, Aarhus University, Aarhus, Denmark

    Jeppe Praetorius

  2. Department of Biology, Indiana University – Purdue University Indianapolis, Indianapolis, IN, USA

    Bonnie Blazer-Yost

  3. Department of Biomedicine, Faculty of Health, Aarhus University, Aarhus, Denmark

    Helle Damkier

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Johanson, C.E., Keep, R.F. (2020). Blending Established and New Perspectives on Choroid Plexus-CSF Dynamics. In: Praetorius, J., Blazer-Yost, B., Damkier, H. (eds) Role of the Choroid Plexus in Health and Disease. Physiology in Health and Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-0716-0536-3_2

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