OBSERVATIONS ON THE TRANSPORT OF PROTEINS BY THE ISOLATED CHOROID PLEXUS

Targeting the Choroid Plexuses for Protein Drug Delivery

Delivery of therapeutic agents to the central nervous system is challenged by the barriers in place to regulate brain homeostasis. This is especially true for protein therapeutics. Targeting the barrier formed by the choroid plexuses at the interfaces of the systemic circulation and ventricular system may be a surrogate brain delivery strategy to circumvent the blood-brain barrier. Heterogenous cell populations located at the choroid plexuses provide diverse functions in regulating the exchange of material within the ventricular space. Receptor-mediated transcytosis may be a promising mechanism to deliver protein therapeutics across the tight junctions formed by choroid plexus epithelial cells. However, cerebrospinal fluid flow and other barriers formed by ependymal cells and perivascular spaces should also be considered for evaluation of protein therapeutic disposition. Various preclinical methods have been applied to delineate protein transport across the choroid plexuses, including imaging strategies, ventriculocisternal perfusions, and primary choroid plexus epithelial cell models. When used in combination with simultaneous measures of cerebrospinal fluid dynamics, they can yield important insight into pharmacokinetic properties within the brain. This review aims to provide an overview of the choroid plexuses and ventricular system to address their function as a barrier to pharmaceutical interventions and relevance for central nervous system drug delivery of protein therapeutics. Protein therapeutics targeting the ventricular system may provide new approaches in treating central nervous system diseases.

Physiology of blood-brain interfaces in relation to brain disposition of small compounds and macromolecules

The brain develops and functions within a strictly controlled environment resulting from the coordinated action of different cellular interfaces located between the blood and the extracellular fluids of the brain, which include the interstitial fluid and the cerebrospinal fluid (CSF). As a correlate, the delivery of pharmacologically active molecules and especially macromolecules to the brain is challenged by the barrier properties of these interfaces. Blood-brain interfaces comprise both the blood-brain barrier located at the endothelium of the brain microvessels and the blood-CSF barrier located at the epithelium of the choroid plexuses. Although both barriers develop extensive surface areas of exchange between the blood and the neuropil or the CSF, the molecular fluxes across these interfaces are tightly regulated. Cerebral microvessels acquire a barrier phenotype early during cerebral vasculogenesis under the influence of the Wnt/β-catenin pathway, and of recruited pericytes. Later in development, astrocytes also play a role in blood-brain barrier maintenance. The tight choroid plexus epithelium develops very early during embryogenesis. It is specified by various signaling molecules from the embryonic dorsal midline, such as bone morphogenic proteins, and grows under the influence of Sonic hedgehog protein. Tight junctions at each barrier comprise a distinctive set of claudins from the pore-forming and tightening categories that determine their respective paracellular barrier characteristics. Vesicular traffic is limited in the cerebral endothelium and abundant in the choroidal epithelium, yet without evidence of active fluid phase transcytosis. Inorganic ion transport is highly regulated across the barriers. Small organic compounds such as nutrients, micronutrients and hormones are transported into the brain by specific solute carriers. Other bioactive metabolites, lipophilic toxic xenobiotics or pharmacological agents are restrained from accumulating in the brain by several ATP-binding cassette efflux transporters, multispecific solute carriers, and detoxifying enzymes. These various molecular effectors differently distribute between the two barriers. Receptor-mediated endocytotic and transcytotic mechanisms are active in the barriers. They enable brain penetration of selected polypeptides and proteins, or inversely macromolecule efflux as it is the case for immnoglobulins G. An additional mechanism specific to the BCSFB mediates the transport of selected plasma proteins from blood into CSF in the developing brain. All these mechanisms could be explored and manipulated to improve macromolecule delivery to the brain.

Ontogenesis of transthyretin gene expression in chicken choroid plexus and liver

1. Chicken liver transthyretin cDNA hybridizes strongly with choroid plexus transthyretin mRNA from chickens, pigeons, quails and ducks. 2. In the chicken at hatching the choroid plexus has reached 70%, total brain 30%, and liver 5.8% of their organ masses in adults. 3. The proportion of transthyretin mRNA in total RNA is 0.45-times the adult value in the choroid plexus of the chicken at hatching. 4. In the liver at hatching, the proportion of transthyretin mRNA in total RNA is 1.1-times the value in adult chickens. 5. The pattern of maturation of transthyretin gene expression in chicken liver is comparable to that in precocial, but differs from that in altricial mammals.

Regional surface changes during the development of the telencephalic choroid plexus in the chick. A scanning-electron microscopic study

The surface morphology of the developing chick telencephalic choroid plexus (TCP) was examined by scanning electron and light microscopy. A blunt evagination develops rostro-cranially to the foramen of Monro on the medial telencephalic septum. The pseudostratified TCP epithelium differs in its surface morphology from that of the surrounding ependyma. Subsequently the TCP becomes elongated and branches. On the 9th embryonic day (ED) the pseudostratified epithelium progressively becomes high columnar epithelium in a distal to proximal direction along the branches of the TCP. The apical poles of the high columnar epithelial cells protrude into the ventricular lumen. Later, additional branches sprout at the base of the TCP, which then resembles a tree with a bush growing at its roots. Before the time of hatching, the high columnar epithelium changes to low columnar epithelium again in a distal to proximal direction. The surface of the TCP becomes flatter, in the process of which the number of cilia per unit surface area is reduced. On the developing TCP the epiplexus cells vary in shape, depending upon their functional state. It is proposed that not only the morphological but also the functional differentiation of the TCP proceeds in a distal to proximal direction along the branches of the choroid plexus. The surface differentiation of the TCP has a more regular character than that of the diencephalic CP (DCP), described previously, which seems to be influenced in its development by other anatomical structures.

The development of the diencephalic choroid plexus in the chick. A scanning electron-microscopic study

The surface morphology of the diencephalic choroid plexus (Pl. ch. v. III) was investigated by light microscopy and scanning electron microscopy in chicks from the 7th embryonic day (ED) to the 8th week after hatching. Pl. ch. v. III develops on the anterior ventricular roof from a sagittally oriented fold and a few posteriorly located transverse folds. On the 7th ED no significant differences in the cell surface morphology between Pl. ch. v. III and the surrounding ependyma are observed: both are covered with cilia. During the next four days, long cell prolongations (one per cell) covered with microvilli develop first on the surface of the posterior ventricular roof and then on the posterior part of Pl. ch. v. III. These structures are transitory. On the 11th ED, round cell prolongations (one per cell) appear progressively on the entire plexus, also replacing the long ones. Now the plexus surface is distinct from the surface of the surrounding ependyma. During the last week before hatching and also after hatching, the round cell prolongations become less prominent. Simultaneously, the number of cilia per unit surface area diminishes. With consideration of earlier reports, this study suggests that the following factors are involved in the increase of the surface area of Pl. ch. v. III: (1) The pseudostratified epithelium changes into columnar epithelium. (2) Ependymal elements of the posterior roof of the 3rd ventricle contribute to the anlage of Pl. ch. v. III. In later stages, however, Pl. ch. v. III grows only by mitoses.

Vesicular transport of cationized ferritin by the epithelium of the rat choroid plexus

We have studied the transport of ferritin that was internalized by coated micropinocytic vesicles at the apical surface of the choroid plexus epithelium in situ. After ventriculocisternal perfusion of native ferritin (NF) or cationized ferritin (CF), three routes followed by the tracers are revealed: (a) to lysosomes, (b) to cisternal compartments, and (c) to the basolateral cell surface. (a) NF is micropinocytosed to a very limited degree and appears in a few lysosomal elements whereas CF is taken up in large amounts and can be followed, via endocytic vacuoles and light multivesicular bodies, to dark multivesicular bodies and dense bodies. (b) Occasionally, CF particles are found in cisterns that may represent GERL or trans-Golgi elements, whereas stacked Golgi cisterns never contain CF. (c) Transepithelial vesicular transport of CF is distinctly revealed. The intercellular spaces of the epithelium, below the apical tight junctions, contain numerous clusters of CF particles, often associated with surface-connected, coated vesicles. Vesicles in the process of exocytosis of CF are also present at the basal epithelial surface, whereas connective tissue elements below the epithelium are unlabeled. Our conclusion is that fluid and solutes removed from the cerebrospinal fluid by endocytosis either become sequestered in the lysosomal apparatus of the choroidal epithelium or are transported to the basolateral surface. However, our results do not indicate any significant recycling via Golgi complexes of internalized apical cell membrane.

Acquired hydrocephalus. III. A pathophysiological study correlated with neuropathological findings and clinical manifestations

On the basis of the laws of Pascal and Laplace, it is shown that the ventricular dilatation in acquired hydrocephalus is due to a primary increase in the intraventricular pressure (IVP), and that a new steady state can be reached, whether the IVP is increased or normal. The pressure increase is due to a disproportion between the production and reabsorption of cerebrospinal fluid (CSF). As water and salts pass freely across the ependyma and the choroid plexus in hydrocephalus, the pressure increase is caused by an increased protein concentration in the ventricular CSF, leading to increased fluid contents according to the Gibbs-Donnan equilibrium. During the ventricular dilatation, the ependyma is destroyed, and the protein molecules penetrate into the subependymal part of the white matter. This results in a reduction in the colloid osmotic pressure of the ventricular CSF, and a new steady state can be reached, with a normal protein concentration in an increased volume. The attendant microscopic changes in the ventricular wall were demonstrated in a patient with acquired hydrocephalus, and the observations made were in conformity with the results of a number of animal experiments. The symptomatology of acquired hydrocephalus is in agreement with a primary affection of the axons running in the juxtaventricular part of the white matter.

Fcgamma receptors in human choroid plexus

Crysotat sections of human choroid plexus adsorbed erythrocytes sensitized with IgG antibodies of human and rabbit origin. No adsorption occurred when the erythrocytes were sensitized with F(ab')2 or Facb fragments. The reaction was strongly inhibited by intact IgG and by Fc fragments and not inhibited by Facb and F(ab')2 or albumin. These properties are similar to those of corresponding receptors in human placenta. The presence of an Fcgamma receptor in choroid plexus may be of significance for the transfer of IgG from blood to cerebrospinal fluid.

The uptake of delta9-tetrahydrocannabinol in choroid plexus and brain cortex in vitro and in vivo

[3H]delta9 Tetrahydrocannabinol (delta9-THC) was actively transported by the choroid plexus and cerebral cortical slices of the rabbit when incubated as a BSA-microsuspension in artificial rabbit CSF. The transport system for delta9-THC in choroid plexus had a V max of 174 nmoles/mg tissue/h, approximately 9-fold greater than that observed for cortical slices. In vivo experiments demonstrated a preferential distribution of delta9-THC in choroid plexus at 1 h after intravenous injection. These results indicate that delta9-THC is actively accumulated by choroidal epithelium and may also be transported across the epithelial stroma into the capillary circulation. This suggests that the choroid plexus participates in the regulation of delta9-THC concentration in CSF and indirectly in brain by means of the "sink" function of the CSF.

Quantitative development of choroid plexuses in chick embryo cerebral ventricles

Quantitative development of choroid plexuses in cerebral ventricles of chick embryos was investigated by means of the planary projection of the choroid plexuses from the time the plexuses reached a consistent flattened structure. Choroid plexuses in the lateral cerbral ventricles were studied from day 6, the plexus in the third cerebral ventricle from day 8, and the plexus in the fourth cerebral ventricle from day 11 of incubation. Regardless of the microscopic origin of these choroid plexuses, their development reached a growth maximum on day 15 of incubation, after which there was a slight regression. The regression was gradual in the plexus of the third cerebral ventricle but a transient enlargement of plexuses in the laternal and in the fourth cerebral ventricle was observed between days 18 and 19. The enlargement of choroid plexuses in the lateral cerebral ventricles was caused by a flattening of the villi, whereas that of the plexus in the fourth cerebral ventricle was caused by thinning and yawning of the villi. The area of choroid plexuses in the lateral cerebral ventricles was six or seven times larger than the sum of the areas of the remaining choroid plexuses.

The choroid plexus in experimental hydrocephalus. A light and electron microscopic study in normal, hydrocephalic, and shunted hydrocephalic dogs

✓ Experimental hydrocephalus was created in dogs by injection of kaolin into the cisterna magna. One month after the kaolin injection, ventriculojugular shunts were performed on certain of the hydrocephalic dogs. Shunted hydrocephalic dogs were killed 1 day or 1 week after placement of the shunt. Cerebrospinal fluid (CSF) pressures were measured prior to the kaolin administration and/or 1 month post-kaolin injection and/or after the shunting procedure. Choroid plexuses from control, hydrocephalic, and shunted hydrocephalic dogs were examined by light and electron microscopy. The hydrocephalic dogs had choroid plexuses with a flattened epithelium, compacted cytoplasm, and multiple large vacuoles usually containing small, rounded membrane-bound structures; it was postulated that these vacuolar structures were dilated multivesicular bodies possibly related to CSF resorption. Choroid plexuses from hydrocephalic dogs examined 1 day post-shunt closely resembled choroid plexuses from the control dogs. Intracytoplasmic, apical lipoid inclusions, 1.0 to 6.0 µ in diameter, were noted within many choroidal epithelial cells of dogs shunted for 1 week. This change was probably related to the trauma of shunt insertion. It was concluded that the morphology of the canine choroid plexus returned to normal 1 day after the ventriculojugular shunt.

Human choroid plexus: a light and electron microscopic study

✓ Specimens of human choroid plexus, obtained during craniotomy, were examined by light and electron microscopy. Inclusions were observed within the cytoplasm of the choroidal epithelial cells, and could be classified into three types on the basis of morphological characteristics. Each inclusion type predominated in a particular age group. In choroid plexuses of older humans, filaments from 60 to 150 Å in diameter, with no apparent periodicity, were noted circumjacent to the intracytoplasmic inclusions.

The active transport of 5-hydroxyindol-3-ylacetic acid and 3-methoxy-4-hydroxyphenylacetic acid from a recirculatory perfusion system of the cerebral ventricles of the unanaesthetized dog

1. An operation on dogs for the implantation of guide tubes to the lateral ventricle and cisterna magna and a method whereby the ventricular space can be repeatedly perfused in conscious and unrestrained animals are described.2. The characteristics of a recirculatory perfusion system were examined and the bulk formation and absorption of cerebrospinal fluid and the volume of the ventricular space perfused were derived from the concentrations achieved during the infusion of inulin into the system.3. 5-hydroxyindol-3-ylacetic acid (5-HIAA), the acid metabolite of 5-hydroxytryptamine, and 3-methoxy-4-hydroxyphenylacetic acid (HVA), the main acid metabolite of dopamine, were demonstrated to be mainly removed from cerebrospinal fluid (c.s.f.) by an active transport system localized in the region of the fourth ventricle.4. It was possible to inhibit the active transport of these acids from cerebrospinal fluid by pre-treating the dogs with probenecid.

Ultrastructural organization of cilia and basal bodies of the epithelium of the choroid plexus in the chick embryo

Ultrastructural studies were performed on normal and abnormal cilia and basal bodies associated with the choroidal epithelium of the chick embryo. Tissues were prepared in each of several fixatives including: 1% osmium tetroxide, in both phosphate and veronal acetate buffers; 2% glutaraldehyde, followed by postfixation in osmium tetroxide; 1% potassium permanganate in veronal acetate buffer. Normal cilia display the typical pattern of 9 peripheral doublets and 2 central fibers, as well as a system of 9 secondary fibers. The latter show distinct interconnections between peripheral and central fibers. Supernumerary fibers were found to occur in certain abnormal cilia. The basal body is complex, bearing 9 transitional fibers at the distal end and numerous cross-striated rootlets at the proximal end. The distal end of the basal body is delimited by a basal plate of moderate density. The tubular cylinder consists of 9 triple fibers. The C subfibers end at the basal plate, whereas subfibers A and B continue into the shaft of the cilium. The 9 transitional fibers radiate out from the distal end of the basal body, ending in bulblike terminal enlargements which are closely associated with the cell membrane in the area of the basal cup. One or 2 prominent basal feet project laterally from the basal body. These structures characteristically show several dense cross-bands and, on occasion, are found associated with microtubules.