A recent study has uncovered a crucial connection between the immune system and the development of acquired hydrocephalus. Hydrocephalus is a condition that occurs when cerebrospinal fluid (CSF) builds up in the brain’s ventricles, causing pressure that can lead to brain damage or even death.
Researchers at Yale School of Medicine have discovered the immune-mediated process that underlies two common types of acquired hydrocephalus. The findings highlight the interactions between the brain and peripheral immune system and suggest new avenues for non-surgical management of the disease.
The study identified that infection and haemorrhage trigger a similar immune response in the choroid plexus, which results in excessive cerebrospinal fluid production and accumulation in the brain. This research sheds new light on the condition and may lead to new treatments for patients with acquired hydrocephalus.
“The work is significant for two reasons,” says lead author Stephanie Robert, MD, Ph.D., a chief neurosurgery resident at Yale School of Medicine. “It demonstrates that post-hemorrhagic and post-infectious hydrocephaluses have a common underlying pathophysiology mediated by the choroid plexus. It identifies the peripheral immune response as an important key component of this pathobiological response.”
Excitingly, researchers found that the immunosuppressant drug rapamycin can prevent the development of hydrocephalus in both infectious and hemorrhagic hydrocephalus models.
Senior author Kristopher Kahle, MD, Ph.D., said, “The study sheds new light on the inflammatory mechanism that drives acquired hydrocephalus and demonstrates that targeting the peripheral immune system with systemic immunomodulation can decrease CSF hypersecretion and prevent hydrocephalus.”
These findings may lead to non-invasive treatments for certain forms of acquired hydrocephalus.
The study, conducted by a team of researchers, found that inflammation caused by the immune system can play a significant role in developing acquired hydrocephalus. The researchers discovered that specific immune cells, known as T cells, are activated in response to inflammation and can accumulate in the brain’s ventricles, contributing to the buildup of CSF and subsequent development of hydrocephalus.
The choroid plexus is a part of the brain that makes cerebrospinal fluid. Hydrocephalus is a condition with too much cerebrospinal fluid in the brain. Hydrocephalus, caused by infection or bleeding in the brain, does not have good treatments.
Researchers found that in both infection and bleeding cases, there is an immune response that causes too much cerebrospinal fluid to be made. They also found that a protein called SPAK is involved in this process. By using drugs to stop the immune response and SPAK, they prevented hydrocephalus from happening. This new information may lead to better treatments for hydrocephalus caused by infection or bleeding in the brain.
The study’s findings have important implications for the diagnosis and treatment of acquired hydrocephalus. By identifying the role of the immune system in developing the condition, doctors may be able to create new treatments that target the immune response and prevent the accumulation of CSF in the brain.
Moreover, the study’s results may pave the way for future research investigating the underlying mechanisms of acquired hydrocephalus and how they can be addressed using immune system-related interventions. Overall, this research represents a significant step forward in our understanding of acquired hydrocephalus and how it can be prevented or treated.
- Stephanie M. Robert, Benjamin C. Reeves, Emre Kiziltug. The choroid plexus links innate immunity to CSF dysregulation in hydrocephalus.j. Cell. DOI: 10.1016/j.cell.2023.01.017