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The cosmic ray (CR) spectrum detected at Earth is a non-trivial combination of the spectrum released by the sources and of the CR propagation and interaction with the interstellar medium (ISM). CRs in the ISM are scattered by the turbulent magnetic field, and, depending on their energy and species, they can incur in severe energy losses. In addition, CRs  can  themselves  excite  magnetic  turbulence  in  the background plasma and generate large scale flows like galactic winds, thus affecting  their own  transport.
In this talk I will discuss some  implications of the CR-ISM interaction, in particular  the formation of galactic winds,  the CR escape and propagation in the source proximity, the identification of the sources of TeV CR electrons and  the ionization of molecular clouds.