Ependymal cells: roles in central nervous system infections and therapeutic application

Ependymal cells are arranged along the inner surfaces of the ventricles and the central canal of the spinal cord, providing anatomical, physiological and immunological barriers that maintain cerebrospinal fluid (CSF) homeostasis. Based on this, studies have found that alterations in gene expression, cell junctions, cytokine secretion and metabolic disturbances can lead to dysfunction of ependymal cells, thereby participating in the onset and progression of central nervous system (CNS) infections. Additionally, ependymal cells can exhibit proliferative and regenerative potential as well as secretory functions during CNS injury, contributing to neuroprotection and post-injury recovery. Currently, studies on ependymal cell primarily focus on the basic investigations of their morphology, function and gene expression; however, there is a notable lack of clinical translational studies examining the molecular mechanisms by which ependymal cells are involved in disease onset and progression. This limits our understanding of ependymal cells in CNS infections and the development of therapeutic applications. Therefore, this review will discuss the molecular mechanism underlying the involvement of ependymal cells in CNS infections, and explore their potential for application in clinical treatment modalities. Ependymal cells play an important role in the maintenance of CSF homeostasis and CNS health by forming physical and immune barriers against pathogen invasion. PPRs signaling pathways, cilia and intercellular junctions, cytokine secretion or senescence of ependymal cells can lead to dysfunction, which in turn is involved in the onset and progression of CNS infection. We propose potential therapeutic applications including gene transfer and novel biomarkers. Studies of ependymal cells have provided new ideas for pathophysiology and treatment, but further research is needed to fully understand their role in CNS infection and evaluate therapeutic effect.