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脉络丛在健康和疾病中的作用:脑内外的对话。

The choroid plexus in health and in disease: dialogues into and out of the brain.

机构信息

Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal.

Universidade de Lisboa, Faculty of Pharmacy, Research Institute for Medicines (iMed.ULisboa) and Department of Biochemistry and Human Biology, Lisboa, Portugal.

出版信息

Neurobiol Dis. 2017 Nov;107:32-40. doi: 10.1016/j.nbd.2016.08.011. Epub 2016 Aug 18.

Abstract

This article brings the choroid plexus into the context of health and disease. It is remarkable that the choroid plexus, composed by a monolayer of epithelial cells that lie in a highly vascularized stroma, floating within the brain ventricles, gets so little attention in major physiology and medicine text books and in the scientific literature in general. Consider that it is responsible for producing most of the about 150mL of cerebrospinal fluid that fills the brain ventricles and the subarachnoid space and surrounds the spinal cord in the adult human central nervous system, which is renewed approximately 2-3 times daily. As such, its activity influences brain metabolism and function, which will be addressed. Reflect that it contains an impressive number of receptors and transporters, both in the apical and basolateral sides of the epithelial cells, and as such is a key structure for the communication between the brain and the periphery. This will be highlighted in the context of neonatal jaundice, multiple sclerosis and Alzheimer's disease. Realize that the capillaries that irrigate the choroid plexus stroma do not possess tight junctions and that the blood flow to the choroid plexus is five times higher than that in the brain parenchyma, allowing for a rapid sensing system and delivery of molecules such as nutrients and metals as will be revised. Recognize that certain drugs reach the brain parenchyma solely through the choroid plexus epithelia, which has potential to be manipulated in diseases such as neonatal jaundice and Alzheimer's disease as will be discussed. Without further notice, it must be now clear that understanding the choroid plexus is necessary for comprehending the brain and how the brain is modulated and modulates all other systems, in health and in disease. This review article intends to address current knowledge on the choroid plexus, and to motivate the scientific community to consider it when studying normal brain physiology and diseases of the central nervous system. It will guide the reader through several aspects of the choroid plexus in normal physiology, in diseases characteristic of various periods of life (newborns-kernicterus, young adults-multiple sclerosis and the elder-Alzheimer's disease), and how sex-differences may relate to disease susceptibility.

摘要

本文将脉络丛置于健康和疾病的背景下进行探讨。值得注意的是,脉络丛由一层单层上皮细胞组成,这些上皮细胞位于富含血管的基质中,漂浮在脑室内,在主要的生理学和医学教科书以及一般的科学文献中都没有得到太多关注。要知道,脉络丛负责产生大约 150 毫升脑脊液,这些脑脊液填充在成人中枢神经系统的脑室内和蛛网膜下腔,并环绕着脊髓,其每日更新约 2-3 次。因此,其活动会影响大脑代谢和功能,这将在文中进行讨论。请思考一下,脉络丛的上皮细胞的顶侧和基底外侧都含有大量的受体和转运体,因此是大脑与外周之间进行通讯的关键结构。这将在新生儿黄疸、多发性硬化症和阿尔茨海默病的背景下进行强调。要意识到,滋养脉络丛基质的毛细血管没有紧密连接,脉络丛的血流是脑实质的 5 倍,这使得它能够快速感知系统并输送营养物质和金属等分子,这些内容将在下文进行回顾。请认识到,某些药物仅通过脉络丛上皮进入脑实质,这在新生儿黄疸和阿尔茨海默病等疾病中具有潜在的可操作性,我们将在下文进行讨论。无需进一步说明,现在应该清楚的是,理解脉络丛对于理解大脑以及大脑如何调节和调节所有其他系统,无论是在健康还是疾病状态下,都是必要的。本文综述旨在介绍脉络丛的当前知识,并促使科学界在研究正常大脑生理学和中枢神经系统疾病时考虑到这一点。它将引导读者了解脉络丛在正常生理、生命各个阶段的疾病(新生儿-核黄疸、年轻人-多发性硬化症和老年人-阿尔茨海默病)中的几个方面,以及性别差异如何与疾病易感性相关。

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