Evidence map›Paper›PMID 34446066›Full record

ArticleFluids and barriers of the CNS2021

The CXCL13/CXCR5-chemokine axis in neuroinflammation: evidence of CXCR5+CD4 T cell recruitment to CSF.

Christine Harrer, Ferdinand Otto, Georg Pilz, Elisabeth Haschke-Becher, Eugen Trinka, Wolfgang Hitzl, Peter Wipfler, Andrea Harrer

Open access · goldAbstract read
In one paragraph

Article in Fluids and barriers of the CNS, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 1 pooled it
1.4field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.

  1. Pooled it
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  14. The utility of CXCL13 and circulating CXCR5Frontiers in immunology · 2025
    Article
  15. IL-7Rα on CD4Journal of neuroinflammation · 2024
    Article
  16. Review
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  19. Review
  20. Cerebrospinal Fluid CXCL13 as Candidate Biomarker of Intrathecal Immune Activation, IgG Synthesis and Neurocognitive Impairment in People with HIV.Journal of neuroimmune pharmacology : the official journal of the Society on NeuroImmune Pharmacology · 2023
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Christine HarrerDepartment of Neurology, Christian-Doppler-Klinik, Paracelsus Medical University, Ignaz-Harrer-Str 79, 5020, Salzburg, Austria.
Ferdinand OttoDepartment of Neurology, Christian-Doppler-Klinik, Paracelsus Medical University, Ignaz-Harrer-Str 79, 5020, Salzburg, Austria.
Georg PilzDepartment of Neurology, Christian-Doppler-Klinik, Paracelsus Medical University, Ignaz-Harrer-Str 79, 5020, Salzburg, Austria.
Elisabeth Haschke-BecherDepartment of Laboratory Medicine, Paracelsus Medical University, Landeskrankenhaus, Salzburg, Austria.
Eugen TrinkaDepartment of Neurology, Christian-Doppler-Klinik, Paracelsus Medical University, Ignaz-Harrer-Str 79, 5020, Salzburg, Austria.
Wolfgang HitzlResearch Office, Biostatistics, Paracelsus Medical University, Salzburg, Austria.
Peter Wipfler *Department of Neurology, Christian-Doppler-Klinik, Paracelsus Medical University, Ignaz-Harrer-Str 79, 5020, Salzburg, Austria.
Andrea Harrer *Department of Neurology, Christian-Doppler-Klinik, Paracelsus Medical University, Ignaz-Harrer-Str 79, 5020, Salzburg, Austria. a.harrer@salk.at.ORCID http://orcid.org/0000-0001-7717-6125
Paracelsus Medical University · AT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundC-X-C chemokine ligand 13 (CXCL13) is frequently elevated in cerebrospinal fluid (CSF) in a variety of inflammatory central nervous system (CNS) diseases, has been detected in meningeal B cell aggregates in brain tissues of multiple sclerosis patients, and proposedly recruits B cells into the inflamed CNS. Besides B cells also follicular helper T (Tfh) cells express the cognate receptor C-X-C chemokine receptor type 5 (CXCR5) and follow CXCL13 gradients in lymphoid tissues. These highly specialized B cell helper T cells are indispensable for B cell responses to infection and vaccination and involved in autoimmune diseases. Phenotypically and functionally related circulating CXCR5+CD4 T cells occur in blood. Their co-recruitment to the inflamed CSF is feasible but unresolved.

methodsWe approached this question with a retrospective study including data of all patients between 2017 and 2019 of whom immune phenotyping data of CXCR5 expression and CSF CXCL13 concentrations were available. Discharge diagnoses and CSF laboratory parameters were retrieved from records. Patients were categorized as pyogenic/aseptic meningoencephalitis (ME, n = 29), neuroimmunological diseases (NIMM, n = 22), and non-inflammatory neurological diseases (NIND, n = 6). ANOVA models and Spearman's Rank-Order correlation were used for group comparisons and associations of CXCL13 levels with immune phenotyping data.

resultsIn fact, intrathecal CXCL13 elevations strongly correlated with CXCR5+CD4 T cell frequencies in the total cohort (p < 0.0001, r = 0.59), and ME (p = 0.003, r = 0.54) and NIMM (p = 0.043, r = 0.44) patients. Moreover, the ratio of CSF-to-peripheral blood (CSF/PB) frequencies of CXCR5+CD4 T cells strongly correlated with CXCL13 levels both in the total cohort (p = 0.001, r = 0.45) and ME subgroup (p = 0.005, r = 0.50), indicating selective accumulation. ME, NIMM and NIND groups differed with regard to CSF cell counts, albumin quotient, intrathecal IgG, CXCL13 elevations and CXCR5+CD4 T cells, which were higher in inflammatory subgroups.

conclusionThe observed link between intrathecal CXCL13 elevations and CXCR5+CD4 T cell frequencies does not prove but suggests recruitment of possible professional B cell helpers to the inflamed CSF. This highlights CSF CXCR5+CD4 T cells a key target and potential missing link to the poorly understood phenomenon of intrathecal B cell and antibody responses with relevance for infection control, chronic inflammation and CNS autoimmunity.

Indexed as

AdultAgedAged, 80 and overCD4-Positive T-LymphocytesChemokine CXCL13FemaleHumansMaleMiddle AgedNeuroinflammatory DiseasesReceptors, CXCR5Retrospective StudiesYoung AdultChemokine CXCL13CXCL13 protein, humanCXCR5 protein, humanReceptors, CXCR5CNSCSFCXCL13CXCR5Flow cytometryNeuroinflammationTfh cells

Identifiers

PMID34446066
PMCPMC8390062
OpenAlexW3194572557

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.