The choroid plexus, or plica choroidea, is a

plexus In anatomy, a plexus (from the Latin term for 'braid') is a branching network of blood vessels, lymphatic vessels, or nerves. The nerves are typically axons outside the central nervous system. The standard plural form in English is plexuses. Al ...

of cells that arises from the

tela choroidea The tela choroidea (or tela chorioidea) is a region of meninges, meningeal pia mater that adheres to the underlying ependyma, and gives rise to the choroid plexus in each of the brain’s Ventricular system, four ventricles. ''Tela'' is Latin for ...

in each of the ventricles of the brain. Regions of the choroid plexus produce and secrete most of the

cerebrospinal fluid Cerebrospinal fluid (CSF) is a clear, colorless Extracellular fluid#Transcellular fluid, transcellular body fluid found within the meninges, meningeal tissue that surrounds the vertebrate brain and spinal cord, and in the ventricular system, ven ...

(CSF) of the

central nervous system The central nervous system (CNS) is the part of the nervous system consisting primarily of the brain, spinal cord and retina. The CNS is so named because the brain integrates the received information and coordinates and influences the activity o ...

. The choroid plexus consists of modified

ependymal cells The ependyma is the thin neuroepithelial ( simple columnar ciliated epithelium) lining of the ventricular system of the brain and the central canal of the spinal cord. The ependyma is one of the four types of neuroglia in the central nervous sys ...

surrounding a core of

capillaries A capillary is a small blood vessel, from 5 to 10 micrometres in diameter, and is part of the microcirculation system. Capillaries are microvessels and the smallest blood vessels in the body. They are composed of only the tunica intima (the in ...

and

loose connective tissue Loose connective tissue, also known as areolar tissue, is a cellular connective tissue with thin and relatively sparse collagen fibers. They have a semi-fluid matrix with lesser proportions of fibers. Its ground substance occupies more vol ...

. Multiple

cilia The cilium (: cilia; ; in Medieval Latin and in anatomy, ''cilium'') is a short hair-like membrane protrusion from many types of eukaryotic cell. (Cilia are absent in bacteria and archaea.) The cilium has the shape of a slender threadlike proj ...

on the ependymal cells move to circulate the cerebrospinal fluid.

Structure

Location

There is a choroid plexus in each of the four ventricles. In the

lateral ventricles The lateral ventricles are the two largest ventricles of the brain and contain cerebrospinal fluid. Each cerebral hemisphere contains a lateral ventricle, known as the left or right lateral ventricle, respectively. Each lateral ventricle resemb ...

, it is found in the

body Body may refer to: In science * Physical body, an object in physics that represents a large amount, has mass or takes up space * Body (biology), the physical material of an organism * Body plan, the physical features shared by a group of anim ...

, and continued in an enlarged amount in the atrium. There is no choroid plexus in the anterior horn. In the

third ventricle The third ventricle is one of the four connected cerebral ventricles of the ventricular system within the mammalian brain. It is a slit-like cavity formed in the diencephalon between the two thalami, in the midline between the right and lef ...

, there is a small amount in the roof that is continuous with that in the body, via the interventricular foramina, the channels that connect the lateral ventricles with the third ventricle. A choroid plexus is in part of the roof of the

fourth ventricle The fourth ventricle is one of the four connected fluid-filled cavities within the human brain. These cavities, known collectively as the ventricular system, consist of the left and right lateral ventricles, the third ventricle, and the fourth ...

Microanatomy

The choroid plexus consists of a layer of cuboidal epithelial cells surrounding a core of

and

. The

epithelium Epithelium or epithelial tissue is a thin, continuous, protective layer of cells with little extracellular matrix. An example is the epidermis, the outermost layer of the skin. Epithelial ( mesothelial) tissues line the outer surfaces of man ...

of the choroid plexus is continuous with the

ependymal cell The ependyma is the thin neuroepithelial ( simple columnar ciliated epithelium) lining of the ventricular system of the brain and the central canal of the spinal cord. The ependyma is one of the four types of neuroglia in the central nervous sys ...

layer (ventricular layer) that lines the ventricular system. Progenitor ependymal cells are monociliated but they differentiate into multiciliated ependymal cells. Unlike the ependyma, the choroid plexus epithelial layer has

tight junctions Tight junctions, also known as occluding junctions or ''zonulae occludentes'' (singular, ''zonula occludens''), are multiprotein junctional complexes between epithelial cells, sealing and preventing leakage of solutes and water. They also play a ...

between the cells on the side facing the ventricle (apical surface). These tight junctions prevent the majority of substances from crossing the cell layer into the cerebrospinal fluid (CSF); thus the choroid plexus acts as a blood–CSF barrier. The choroid plexus folds into many villi around each capillary, creating frond-like processes that project into the ventricles. The villi, along with a brush border of microvilli, greatly increase the surface area of the choroid plexus. CSF is formed as plasma is filtered from the blood through the epithelial cells. Choroid plexus epithelial cells actively transport sodium ions into the ventricles and water follows the resulting osmotic gradient. The choroid plexus consists of many capillaries, separated from the ventricles by choroid epithelial cells. Fluid filters through these cells from blood to become cerebrospinal fluid. There is also much

active transport In cellular biology, active transport is the movement of molecules or ions across a cell membrane from a region of lower concentration to a region of higher concentration—against the concentration gradient. Active transport requires cellula ...

of substances into, and out of, the CSF as it is made.

Function

The choroid plexus regulates the production and composition of

(CSF), that provides the protective buoyancy for the brain. CSF acts as a medium for the glymphatic filtration system that facilitates the removal of metabolic waste from the brain, and the exchange of

biomolecules A biomolecule or biological molecule is loosely defined as a molecule produced by a living organism and essential to one or more typically biological processes. Biomolecules include large macromolecules such as proteins, carbohydrates, lipi ...

and

xenobiotics A xenobiotic is a chemical substance found within an organism that is not naturally produced or expected to be present within the organism. It can also cover substances that are present in much higher concentrations than are usual. Natural compo ...

into and out of the brain. In this way the choroid plexus has a very important role in helping to maintain the delicate extracellular environment required by the brain to function optimally. The choroid plexus is also a major source of

transferrin Transferrins are glycoproteins found in vertebrates which bind and consequently mediate the transport of iron (Fe) through blood plasma. They are produced in the liver and contain binding sites for two Iron(III), Fe3+ ions. Human transferrin is ...

secretion that plays a part in iron homeostasis in the brain.

Blood–cerebrospinal fluid barrier

The blood–cerebrospinal fluid barrier (BCSFB) is a fluid–brain barrier that is composed of a pair of membranes that separate blood from CSF at the capillary level and CSF from brain tissue. The blood–CSF boundary at the choroid plexus is a membrane composed of

epithelial cells Epithelium or epithelial tissue is a thin, continuous, protective layer of cells with little extracellular matrix. An example is the epidermis, the outermost layer of the skin. Epithelial ( mesothelial) tissues line the outer surfaces of man ...

and

tight junction Tight junctions, also known as occluding junctions or ''zonulae occludentes'' (singular, ''zonula occludens''), are multiprotein Cell junction, junctional complexes between epithelial cells, sealing and preventing leakage of solutes and water. Th ...

s that link them. There is a CSF-brain barrier at the level of the pia mater, but only in the embryo. Similar to the

blood–brain barrier The blood–brain barrier (BBB) is a highly selective semipermeable membrane, semipermeable border of endothelium, endothelial cells that regulates the transfer of solutes and chemicals between the circulatory system and the central nervous system ...

, the blood–CSF barrier functions to prevent the passage of most blood-borne substances into the brain, while selectively permitting the passage of specific substances (such as nutrients) into the brain and facilitating the removal of brain metabolites and metabolic products into the blood. Despite the similar function between the BBB and BCSFB, each facilitates the transport of different substances into the brain due to the distinctive structural characteristics of each of the two barrier systems. For a number of substances, the BCSFB is the primary site of entry into brain tissue. The blood–cerebrospinal fluid barrier has also been shown to modulate the entry of leukocytes from the blood to the central nervous system. The choroid plexus cells secrete

cytokine Cytokines () are a broad and loose category of small proteins (~5–25 kDa) important in cell signaling. Cytokines are produced by a broad range of cells, including immune cells like macrophages, B cell, B lymphocytes, T cell, T lymphocytes ...

s that recruit monocyte-derived macrophages, among other cells, to the brain. This cellular trafficking has implications both in normal brain homeostasis and in neuroinflammatory processes.

Clinical significance

Choroid plexus cysts

During

fetal development Prenatal development () involves the development of the embryo and of the fetus during a viviparous animal's gestation. Prenatal development starts with fertilization, in the germinal stage of embryonic development, and continues in fetal deve ...

, some choroid plexus cysts may form. These fluid-filled cysts can be detected by a detailed second trimester ultrasound. The finding is relatively common, with a prevalence of ~1%. Choroid plexus cysts are usually an isolated finding. The cysts typically disappear later during pregnancy, and are usually harmless. They have no effect on infant and early childhood development. Choroid plexus cysts are associated with a 1% risk of fetal

aneuploidy Aneuploidy is the presence of an abnormal number of chromosomes in a cell (biology), cell, for example a human somatic (biology), somatic cell having 45 or 47 chromosomes instead of the usual 46. It does not include a difference of one or more plo ...

. The risk of aneuploidy increases to 10.5-12% if other risk factors or ultrasound findings are noted. Size, location, disappearance or progression, and whether the cysts are found on both sides or not do not affect the risk of aneuploidy. 44-50% of

Edwards syndrome Edwards may refer to: People * Edwards (surname), an English surname * Edwards family, a prominent family from Chile * Edwards Barham (1937–2014), American politician * Edwards Davis (1873–1936), American actor, producer, and playwright * Edwa ...

(trisomy 18) cases will present with choroid plexus cysts, as well 1.4% of Down syndrome (trisomy 21) cases. ~75% of abnormal karyotypes associated with choroid plexus cysts are trisomy 18, while the remainder are trisomy 21.

Other

There are three graded types of choroid plexus tumor that mainly affect young children. These types of

cancer Cancer is a group of diseases involving Cell growth#Disorders, abnormal cell growth with the potential to Invasion (cancer), invade or Metastasis, spread to other parts of the body. These contrast with benign tumors, which do not spread. Po ...

are rare.

Etymology

Choroid plexus translates from the Latin ,Suzuki, S., Katsumata, T., Ura, R. Fujita, T., Niizima, M. & Suzuki, H. (1936). Über die Nomina Anatomica Nova. ''Folia Anatomica Japonica, 14'', 507-536. which mirrors

Ancient Greek Ancient Greek (, ; ) includes the forms of the Greek language used in ancient Greece and the classical antiquity, ancient world from around 1500 BC to 300 BC. It is often roughly divided into the following periods: Mycenaean Greek (), Greek ...

. The word ''chorion'' was used by

Galen Aelius Galenus or Claudius Galenus (; September 129 – AD), often Anglicization, anglicized as Galen () or Galen of Pergamon, was a Ancient Rome, Roman and Greeks, Greek physician, surgeon, and Philosophy, philosopher. Considered to be one o ...

to refer to the outer membrane enclosing the fetus. Both meanings of the word plexus are given as pleating, or braiding. As often happens language changes and the use of both ''choroid'' or ''chorioid'' is both accepted.

Nomina Anatomica ''Nomina Anatomica'' (''NA'') was the international standard on human anatomic terminology from 1895 until it was replaced by '' Terminologia Anatomica'' in 1998. In the late nineteenth century some 30,000 terms for various body parts were in us ...

(now

Terminologia Anatomica ''Terminologia Anatomica'' (commonly abbreviated TA) is the international standard for human anatomy, human anatomical terminology. It is developed by the Federative International Programme on Anatomical Terminology (FIPAT) a program of the Inter ...

) reflected this dual usage.

Additional images

File:Gray749.png, Coronal section of inferior horn of lateral ventricle. File:Choroid Plexus Histology 40x.png, Choroid plexus histology 40x File:Slide2ff.JPG, Choroid plexus File:Slide3oo.JPG, Choroid plexus File:Choroid plexus.jpg, Choroid plexus

References

Sources

* *

External links

3-Dimensional images of choroid plexus (marked red)
*

Images of Choroid Plexus * More info a
BrainInfo
{{DEFAULTSORT:Choroid Plexus Meninges Ventricular system