Researchers find link between the immune system and acquired hydrocephalus

Researchers at the Yale School of Medicine have discovered an important link between the immune system and the development of two types of acquired hydrocephalus. The study, published in the journal Cell, may lead to new treatment options for managing hydrocephalus in the future.

Acquired hydrocephalus often develops either after an infection, or a bleed in the brain (intracranial haemorrhage). Cerebrospinal fluid (CSF), produced by the choroid plexus in the brain, accumulates in the ventricles and causes pressure damage to the surrounding tissue. Treatment then requires invasive neurosurgery to drain the CSF and relieve the pressure on the brain, typically this is achieved by fitting a ventriculoperitoneal shunt.

The Yale researchers, led by Kristopher Kahle MD PhD, used rat models to study how the choroid plexus responded to infection and to blood. They discovered that infection or a bleed within the ventricles activated markedly similar immune responses in the choroid plexus. They found that this immune response drove the choroid plexus to overproduce CSF, which then accumulated in the ventricles, causing hydrocephalus. When the researchers then suppressed the immune system in the rats using a drug called rapamycin, they showed that hydrocephalus did not develop after a bleed or infection. The findings suggest that targeting the immune system may be a way of preventing/treating acquired hydrocephalus in the future.

It will be a long time before further research leads to changes in clinical management of hydrocephalus, but it’s big leap forward in our understanding of the condition and exciting step towards future treatments.

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