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 Vol 55: Virchow-Robin space and aquaporin-4: new insights on an old friend.


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This article is from Croatian Medical Journal, volume 55.AbstractRecent studies have strongly indicated that the classic circulation model of cerebrospinal fluid CSF is no longer valid. The production of CSF is not only dependent on the choroid plexus but also on water flux in the peri-capillary Virchow Robin space. Historically, CSF flow through the Virchow Robin space is known as interstitial flow, the physiological significance of which is now fully understood. This article briefly reviews the modern concept of CSF physiology and the Virchow-Robin space, in particular its functionalities critical for central nervous system neural activities. Water influx into the Virchow Robin space and, hence, interstitial flow is regulated by aquaporin-4 AQP-4 localized in the endfeet of astrocytes, connecting the intracellular cytosolic fluid space of astrocytes and the Virchow Robin space. Interstitial flow has a functionality equivalent to systemic lymphatics, on which clearance of β-amyloid is strongly dependent. Autoregulation of brain blood flow serves to maintain a constant inner capillary fluid pressure, allowing fluid pressure of the Virchow Robin space to regulate regional cerebral blood flow rCBF based on AQP-4 gating. Excess heat produced by neural activities is effectively removed from the area of activation by increased rCBF by closing AQP-4 channels. This neural flow coupling NFC is likely mediated by heat generated proton channels.



Author: Nakada, Tsutomu

Source: https://archive.org/



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