Choroid Plexus
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The choroid plexus, or plica choroidea, is a
plexus In neuroanatomy, a plexus (from the Latin term for "braid") is a branching network of vessels or nerves. The vessels may be blood vessels (veins, capillaries) or lymphatic vessels. The nerves are typically axons outside the central nervous syste ...
of cells that arises from the
tela choroidea The tela choroidea (or tela chorioidea) is a region of meningeal pia mater that adheres to the underlying ependyma, and gives rise to the choroid plexus in each of the brain’s four ventricles. ''Tela'' is Latin for ''woven'' and is used to desc ...
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 body fluid found within the tissue that surrounds the brain and spinal cord of all vertebrates. CSF is produced by specialised ependymal cells in the choroid plexus of the ventricles of the bra ...
(CSF) of the
central nervous system The central nervous system (CNS) is the part of the nervous system consisting primarily of the brain and spinal cord. The CNS is so named because the brain integrates the received information and coordinates and influences the activity of all par ...
. 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 (μm) in diameter. Capillaries are composed of only the tunica intima, consisting of a thin wall of simple squamous endothelial cells. They are the smallest blood vessels in the body: ...
and
loose connective tissue Loose connective tissue, sometimes called areolar tissue, is a cellular connective tissue with thin and relatively sparse collagen fibers. Its ground substance occupies more volume than the fibers do. It has a viscous to gel-like consistenc ...
. Multiple
cilia The cilium, plural cilia (), is a membrane-bound organelle found on most types of eukaryotic cell, and certain microorganisms known as ciliates. Cilia are absent in bacteria and archaea. The cilium has the shape of a slender threadlike projecti ...
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 (CSF). Each cerebral hemisphere contains a lateral ventricle, known as the left or right ventricle, respectively. Each lateral ventricle resemble ...
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 anima ...
, and continued in an enlarged amount in the
atrium Atrium may refer to: Anatomy * Atrium (heart), an anatomical structure of the heart * Atrium, the genital structure next to the genital aperture in the reproductive system of gastropods * Atrium of the ventricular system of the brain * Pulmona ...
. There is no choroid plexus in the anterior horn. In the
third ventricle The third ventricle is one of the four connected 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 left lateral v ...
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 ve ...
.


Microanatomy

The choroid plexus consists of a layer of cuboidal epithelial cells surrounding a core of
capillaries A capillary is a small blood vessel from 5 to 10 micrometres (μm) in diameter. Capillaries are composed of only the tunica intima, consisting of a thin wall of simple squamous endothelial cells. They are the smallest blood vessels in the body: ...
and
loose connective tissue Loose connective tissue, sometimes called areolar tissue, is a cellular connective tissue with thin and relatively sparse collagen fibers. Its ground substance occupies more volume than the fibers do. It has a viscous to gel-like consistenc ...
. The
epithelium Epithelium or epithelial tissue is one of the four basic types of animal tissue, along with connective tissue, muscle tissue and nervous tissue. It is a thin, continuous, protective layer of compactly packed cells with a little intercellul ...
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 syst ...
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 whose canonical function is to prevent leakage of solutes and water and seals between the epith ...
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 cellul ...
of substances into, and out of, the CSF as it is made.


Function

The choroid plexus regulates the production and composition of
cerebrospinal fluid Cerebrospinal fluid (CSF) is a clear, colorless body fluid found within the tissue that surrounds the brain and spinal cord of all vertebrates. CSF is produced by specialised ependymal cells in the choroid plexus of the ventricles of the bra ...
(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 a loosely used term for molecules present in organisms that are essential to one or more typically biological processes, such as cell division, morphogenesis, or development. Biomolecules include large ...
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 to and consequently mediate the transport of iron (Fe) through blood plasma. They are produced in the liver and contain binding sites for two Fe3+ ions. Human transferrin is encode ...
secretion that plays a part in
iron homeostasis Human iron metabolism is the set of chemical reactions that maintain human homeostasis of iron at the systemic and cellular level. Iron is both necessary to the body and potentially toxic. Controlling iron levels in the body is a critically imp ...
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 one of the four basic types of animal tissue, along with connective tissue, muscle tissue and nervous tissue. It is a thin, continuous, protective layer of compactly packed cells with a little intercell ...
and
tight junction Tight junctions, also known as occluding junctions or ''zonulae occludentes'' (singular, ''zonula occludens''), are multiprotein junctional complexes whose canonical function is to prevent leakage of solutes and water and seals between the epith ...
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 prevents solutes in the circulating blood from ''non-selectively'' crossing into the extracellular fluid of ...
, 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 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 peptides and cannot cross the lipid bilayer of cells to enter the cytoplasm. Cytokines have been shown to be involved in autocrin ...
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 () includes 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 devel ...
, 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. Cysts confers a 1% risk of fetal
aneuploidy Aneuploidy is the presence of an abnormal number of chromosomes in a cell, for example a human cell having 45 or 47 chromosomes instead of the usual 46. It does not include a difference of one or more complete sets of chromosomes. A cell with any ...
. 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 syndrome, also known as trisomy 18, is a genetic disorder caused by the presence of a third copy of all or part of chromosome 18. Many parts of the body are affected. Babies are often born small and have heart defects. Other features in ...
(trisomy 18) cases will present with choroid plexus cysts, as well 1.4% of
Down syndrome Down syndrome or Down's syndrome, also known as trisomy 21, is a genetic disorder caused by the presence of all or part of a third copy of chromosome 21. It is usually associated with physical growth delays, mild to moderate intellectual dis ...
(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 abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal b ...
are rare.


Etymology

Choroid plexus translates from the Latin plexus chorioides,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 χοριοειδές πλέγμα. The word ''chorion'' was used by
Galen Aelius Galenus or Claudius Galenus ( el, Κλαύδιος Γαληνός; September 129 – c. AD 216), often Anglicized as Galen () or Galen of Pergamon, was a Greek physician, surgeon and philosopher in the Roman Empire. Considered to be one of ...
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 use ...
(now
Terminologia Anatomica ''Terminologia Anatomica'' is the international standard for human anatomical terminology. It is developed by the Federative International Programme on Anatomical Terminology, a program of the International Federation of Associations of Anatomis ...
) 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


See also

*
Choroid plexus papilloma Choroid plexus papilloma, also known as papilloma of the choroid plexus, is a rare benign neuroepithelial intraventricular WHO grade I lesion found in the choroid plexus. It leads to increased cerebrospinal fluid production, thus causing increa ...
*
Tela choroidea The tela choroidea (or tela chorioidea) is a region of meningeal pia mater that adheres to the underlying ependyma, and gives rise to the choroid plexus in each of the brain’s four ventricles. ''Tela'' is Latin for ''woven'' and is used to desc ...


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