Evidence map›Paper›PMID 41494243›Full record

ArticleEBioMedicine2026

Paediatric cerebrospinal fluid immune profiling distinguishes paediatric-onset multiple sclerosis from other paediatric-onset acute neurological disorders.

Diego A Espinoza, Tobias Zrzavy, Gautier Breville, Simon Thebault, Amaar Marefi, Ina Mexhitaj, Luana D Yamashita, Mengyuan Kan, Micky Bacchus, Jessica Legaspi and 18 more

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Article in EBioMedicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

28 authors.

Diego A EspinozaCenter for Neuroinflammation and Experimental Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Colton Center for Autoimmunity, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Tobias ZrzavyCenter for Neuroinflammation and Experimental Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Neurology, Medical University of Vienna, Vienna, Austria.
Gautier BrevilleCenter for Neuroinflammation and Experimental Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Simon ThebaultCenter for Neuroinflammation and Experimental Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, Canada.
Amaar MarefiDepartment of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Division of Child Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Ina MexhitajCenter for Neuroinflammation and Experimental Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Luana D YamashitaCenter for Neuroinflammation and Experimental Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Mengyuan KanColton Center for Autoimmunity, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Micky BacchusDivision of Child Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Jessica LegaspiDivision of Child Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Samantha FernandezDivision of Child Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Anna MelamedDivision of Child Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Mallory StubblebineDivision of Child Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Angela WintersDivision of Child Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Alister VirklerDivision of Child Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Ingo HelbigDivision of Child Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Yeseul KimCenter for Neuroinflammation and Experimental Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Zachary MartinezDivision of Oncology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Caroline DiorioDivision of Oncology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Andreas Schulte-MecklenbeckDepartment of Neurology with Institute of Translational Neurology, University Hospital of Münster, University of Münster, Münster, Germany.
Heinz WiendlClinic for Neurology and Neurophysiology, University Medical Center Freiburg, Freiburg, Germany; Brain and Mind Centre, University of Sydney, Camperdown, New South Wales, Australia.
Ayman RezkCenter for Neuroinflammation and Experimental Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Rui LiCenter for Neuroinflammation and Experimental Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Colton Center for Autoimmunity, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Neurology of the First Affiliated Hospital, Institute of Neuroscience, Fujian Medical University, Fujian, China.
Sona NarulaDepartment of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Division of Child Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Amy T WaldmanDepartment of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Division of Child Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Sarah E HopkinsDepartment of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Division of Child Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Brenda BanwellDepartment of Pediatrics, Johns Hopkins Children's Center, Baltimore, MD, USA. Electronic address: bbanwel2@jh.edu.
Amit Bar-OrCenter for Neuroinflammation and Experimental Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Colton Center for Autoimmunity, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Division of Child Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Electronic address: amitbar@pennmedicine.upenn.edu.

Funding

A computational phenotyping approach to characterize neurogenetic disordersR01NS131512 · NINDS · CHILDREN'S HOSP OF PHILADELPHIA · PI Ingo Helbig · 2023 to 2026
$2.8M
NINDS NIH HHS R01 NS131512
6 · The paper itself

Abstract

backgroundThe cerebrospinal fluid (CSF) provides a unique glimpse into the central nervous system (CNS) compartment and offers insights into immune processes associated with both healthy immune surveillance as well as inflammatory disorders of the CNS. The latter include demyelinating disorders, such as multiple sclerosis (MS) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), that warrant different therapeutic approaches yet are not always straightforward to distinguish on clinical and imaging grounds alone.

methodsWe established a comprehensive phenotypic landscape of the paediatric CSF immune compartment across a range of non-inflammatory and inflammatory neurological disorders, with a focus on better elucidating CNS-associated immune mechanisms potentially involved in, and discriminating between, paediatric-onset MS (MS) and other paediatric-onset suspected neuroimmune disorders, including MOGAD.

findingsCSF from paediatric patients with non-inflammatory neurological disorders is primarily composed of non-activated CD4+ T cells, with few if any B cells present. CSF from paediatric patients with acquired inflammatory demyelinating disorders is characterised by increased numbers of B cells compared to CSF of both patients with other inflammatory or non-inflammatory conditions. Certain features, including particular increased frequencies of antibody-secreting cells (ASCs) and decreased frequencies of CD14+ myeloid cells, distinguish MS from MOGAD and other acquired demyelinating syndromes.

interpretationIncreased CSF ASC frequencies and decreased CSF CD14+ myeloid cell frequencies help distinguish paediatric-onset MS from paediatric-onset MOGAD and other acquired demyelinating syndromes. Our findings provide insight into CNS-associated immune mechanisms that may be present early in the clinical course of MS.

fundingStated in acknowledgements section of manuscript.

Indexed as

Multiple SclerosisNervous System DiseasesAdolescentAge of OnsetBiomarkersChildChild, PreschoolDiagnosis, DifferentialFemaleHumansMaleMyelin-Oligodendrocyte GlycoproteinBiomarkersMyelin-Oligodendrocyte GlycoproteinAntibody-secreting cellsPaediatric cerebrospinal fluidPaediatric-onset MOGADPaediatric-onset multiple sclerosis

Identifiers

PMID41494243
PMCPMC12809754

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