Ependymocytes control cerebrospinal fluid flow to the peripheral organs through periaxonal pathway

Mechanisms controlling movement of the CSF through the central canal towards the peripheral nerves are poorly characterized. We found that fluorescent dyes injected into cisterna magna are carried with cerebrospinal fluid (CSF) through the central canal and peripheral nerves to the peripheral organs such as liver, and pancreas. We also found close connection between spinal axons and ependymocytes, suggesting synaptic interactions. Serotonin, acting through the 5-HT2B receptors abundantly expressed in ependymal cells, trigger Ca2+ signal that induces polymerization of cytoskeleton protein F-actin, consequently reducing the volume of ependymocytes. Shrinkage of the latter opens one-way route to facilitate CSF outflow from the central canal into the spinal cord parenchyma and peripheral nerves. In liver, CSF is received by stellate cells. Ependymal control over transfer of the CSF from central canal to peripheral organs by the periaxonal space (PAS) represents a novel mechanism dynamically connecting the CNS with the periphery. In brief Ependymocytes control CSF flow from CNS to peripheral organs by periaxonal pathway, and serotonin evokes the ependymal shrinkage by the aggregation of F-actin. Highlights Ependymocytes control CSF flow from central canal to peripheral organs; CSF flows through the peripheral periaxonal space to reach the peripheral organs; Serotonin makes ependymocytes shrunk by 5-HT2B receptor-mediated Ca2+ signaling and F-actin polymerization; The hepatic stellate cells are potential collectors of CSF in the liver. ### Competing Interest Statement The authors have declared no competing interest.