Sun Zhe, Li Chenyang, Leitner Dominique, Wu Michelle, Zhang Jiangyang, Wisniewski Thomas, Ge Yulin
Department of Radiology, NYU Grossman School of Medicine, New York, NY, USA.
Vilcek Institute of Graduate Medical Sciences at NYU Grossman School of Medicine, New York, NY, USA.
Aging Dis. 2025 Aug 28. doi: 10.14336/AD.2025.0735.
The choroid plexus (ChP), a highly vascularized brain structure responsible for cerebrospinal fluid (CSF) production, undergoes significant age-related changes that may contribute to neurodegenerative diseases involving disrupted immune regulation, fluid homeostasis and waste clearance. Compared to other brain regions, vascular research on the ChP remains limited despite its critical role as a central interface between the blood and CSF. This review focuses on age-related vascular and structural alterations in the ChP from both histopathological and neuroimaging perspectives, and explores their impact on CSF dynamics, immune regulation, and the integrity of the blood-CSF barrier (BCSFB). Rather than shrinking, the aging ChP often enlarges due to dystrophic changes, as shown in volumetric MRI studies. Histological studies reveal epithelial degeneration, basement membrane thickening, and stromal fibrosis in the normal aging process. In dementia such as Alzheimer's disease (AD), proteomic studies have identified upregulation of AD- and immune-related proteins, along with downregulation of proteins linked to CSF clearance and metabolic support. Emerging high-resolution contrast-enhanced MRI techniques now allow in vivo visualization of microvascular changes within the ChP, shedding light on its normal and abnormal aging processes. Understanding these alterations is critical, as they may influence the onset and progression of various neurological diseases such as AD, Parkinson's disease (PD), normal pressure hydrocephalus, and amyotrophic lateral sclerosis (ALS). The recent advancements and challenges described in this study underscore the need for deeper investigation into ChP aging to inform future diagnostic and therapeutic strategies of neurodegenerative diseases.
脉络丛（ChP）是一种高度血管化的脑结构，负责脑脊液（CSF）的生成，它会经历显著的与年龄相关的变化，这些变化可能导致涉及免疫调节紊乱、液体稳态和废物清除的神经退行性疾病。与其他脑区相比，尽管脉络丛作为血液和脑脊液之间的核心界面起着关键作用，但其血管研究仍然有限。本综述从组织病理学和神经影像学角度关注脉络丛中与年龄相关的血管和结构改变，并探讨它们对脑脊液动力学、免疫调节和血脑脊液屏障（BCSFB）完整性的影响。如容积MRI研究所示，衰老的脉络丛并非萎缩，而是常因营养不良性变化而增大。组织学研究揭示了正常衰老过程中的上皮退变、基底膜增厚和间质纤维化。在诸如阿尔茨海默病（AD）等痴呆症中，蛋白质组学研究已确定与AD和免疫相关的蛋白质上调，以及与脑脊液清除和代谢支持相关的蛋白质下调。新兴的高分辨率对比增强MRI技术现在能够在体内可视化脉络丛内的微血管变化，为其正常和异常衰老过程提供线索。了解这些改变至关重要，因为它们可能影响各种神经疾病如AD、帕金森病（PD）、正常压力脑积水和肌萎缩侧索硬化症（ALS）的发病和进展。本研究中描述的最新进展和挑战强调了深入研究脉络丛衰老以指导未来神经退行性疾病诊断和治疗策略的必要性。
