The movers and shapers in immune privilege of the CNS
Abstract
Discoveries leading to an improved understanding of immune surveillance of the central nervous system (CNS) have repeatedly provoked dismissal of the existence of immune privilege of the CNS. Recent rediscoveries of lymphatic vessels within the dura mater surrounding the brain, made possible by modern live-cell imaging technologies, have revived this discussion. This review emphasizes the fact that understanding immune privilege of the CNS requires intimate knowledge of its unique anatomy. Endothelial, epithelial and glial brain barriers establish compartments in the CNS that differ strikingly with regard to their accessibility to immune-cell subsets. There is a unique system of lymphatic drainage from the CNS to the peripheral lymph nodes. We summarize current knowledge on the cellular and molecular mechanisms involved in immune-cell trafficking and lymphatic drainage from the CNS, and we take into account differences in rodent and human CNS anatomy.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The perivascular compartment of human cortex is merely a potential space for movement of solutes.
“It has been proposed that the perivascular compartment of human cortex is merely a potential space for movement of solutes (32-36), a view that recently was maintained based on observations made in fixed tissue specimens (37).”
From Brain-wide glymphatic enhancement and clearance in humans assessed with MRI. (2018) · cites this paper as [37]
More recent studies in mice using fluorescent solutes have shown that the brain has its own lymphatic vascular system in the dura mater, which drains interstitial fluid and macromolecules into the deep cervical lymph nodes.
“More recent studies in mice using fluorescent solutes have shown that brain has its own lymphatic vascular system in the dura matter, which drains ISF and macromolecules into the deep cervical lymph nodes (32, 160, 162, 376).”
From Blood-Brain Barrier: From Physiology to Disease and Back (2019) · cites this paper as [162]
CNS immune responses differ based on anatomical location, with a clear distinction between responses that develop in fluid spaces and membranous lining (meninges) relative to the parenchyma.
“CNS immune responses differ based on anatomical location, and a clear distinction exists between responses that develop in the fluid spaces and membranous lining (or meninges) relative to the parenchyma (1).”
From The anatomy and immunology of vasculature in the central nervous system (2019) · cites this paper as [1]
Cites
Iliff, J. J., Wang, M., Liao, Y., Plogg, B. A., Peng, W., Gundersen, G. A., Benveniste, H., Vates, G. E., Deane, R., Goldman, S. A., et al. (2012) · Science Translational Medicine · doi:10.1126/scitranslmed.3003748 · Cited by 5,824 · see citing works
Structural and functional features of central nervous system lymphatic vessels
Louveau, A., Smirnov, I., Keyes, T. J., Eccles, J. D., Rouhani, S. J., Peske, J. D., Derecki, N. C., Castle, D., Mandell, J. W., Lee, K. S., et al. (2015) · Nature · doi:10.1038/nature14432 · Cited by 4,413 · see citing works
A dural lymphatic vascular system that drains brain interstitial fluid and macromolecules
Aspelund, A., Antila, S., Proulx, S. T., Karlsen, T. V., Karaman, S., Detmar, M., Wiig, H., & Alitalo, K. (2015) · Journal of Experimental Medicine · doi:10.1084/jem.20142290 · Cited by 2,198 · see citing works
Commensal microbiota and myelin autoantigen cooperate to trigger autoimmune demyelination
Berer, K., Mues, M., Koutrolos, M., Rasbi, Z. A., Boziki, M., Johner, C., Wekerle, H., & Krishnamoorthy, G. (2011) · Nature · doi:10.1038/nature10554 · Cited by 1,251 · see citing works
Origin, fate and dynamics of macrophages at central nervous system interfaces
Goldmann, T., Wieghofer, P., Jordão, M. J. C., Prutek, F., Hagemeyer, N., Frenzel, K., Amann, L., Staszewski, O., Kierdorf, K., Krueger, M., et al. (2016) · Nature Immunology · doi:10.1038/ni.3423 · Cited by 1,209 · see citing works
Reboldi, A., Coisne, C., Baumjohann, D., Benvenuto, F., Bottinelli, D., Lira, S., Uccelli, A., Lanzavecchia, A., Engelhardt, B., & Sallusto, F. (2009) · Nature Immunology · doi:10.1038/ni.1716 · Cited by 1,206 · see citing works
Self-citationThe T lymphocyte in experimental allergic encephalomyelitis.
Zamvil, S., & Steinman, L. (1990) · Annual Review of Immunology · doi:10.1146/annurev.iy.08.040190.003051 · Cited by 1,091 · see citing works
Medawar, P. B. (1948) · PubMed · Cited by 1,084 · see citing works
Dendritic cells permit immune invasion of the CNS in an animal model of multiple sclerosis
Greter, M., Heppner, F. L., Lemos, M. P., Odermatt, B. M., Goebels, N., Laufer, T., Noelle, R. J., & Becher, B. (2005) · Nature Medicine · doi:10.1038/nm1197 · Cited by 862 · see citing works
CNS immune privilege: hiding in plain sight
Carson, M. J., Doose, J. M., Melchior, B., Schmid, C. D., & Ploix, C. C. (2006) · Immunological Reviews · doi:10.1111/j.1600-065x.2006.00441.x · Cited by 797 · see citing works
What is immune privilege (not)?
Galea, I., Bechmann, I., & Perry, V. H. (2007) · Trends in Immunology · doi:10.1016/j.it.2006.11.004 · Cited by 768 · see citing works
Rennels, M. L., Gregory, T. F., Blaumanis, O. R., Fujimoto, K., & Grady, P. A. (1985) · Brain Research · doi:10.1016/0006-8993(85)91383-6 · Cited by 752 · see citing works
Capture, crawl, cross: the T cell code to breach the blood–brain barriers
Engelhardt, B., & Ransohoff, R. M. (2012) · Trends in Immunology · doi:10.1016/j.it.2012.07.004 · Cited by 686 · see citing works
Self-citationEffector T cell interactions with meningeal vascular structures in nascent autoimmune CNS lesions.
Bartholomäus, I., Kawakami, N., Odoardi, F., Schläger, C., Miljkovic, D., Ellwart, J. W., Klinkert, W. E. F., Flügel-Koch, C., Issekutz, T. B., Wekerle, H., et al. (2009) · Nature · doi:10.1038/nature08478 · Cited by 685 · see citing works
Shechter, R., Miller, O., Yovel, G., Rosenzweig, N., London, A., Ruckh, J., Kim, K.-W., Klein, E., Kalchenko, V., Bendel, P., et al. (2013) · Immunity · doi:10.1016/j.immuni.2013.02.012 · Cited by 683 · see citing works
Weller, R. O., Subash, M., Preston, S., Mazanti, I., & Carare, R. O. (2008) · Brain Pathology · doi:10.1111/j.1750-3639.2008.00133.x · Cited by 682 · see citing works
Self-citationHeterogeneity of CNS myeloid cells and their roles in neurodegeneration
Prinz, M., Priller, J., Sisodia, S. S., & Ransohoff, R. M. (2011) · Nature Neuroscience · doi:10.1038/nn.2923 · Cited by 674 · see citing works
Carare, R. O., Bernardes‐Silva, M., Newman, T. A., Page, A. M., Nicoll, J. A. R., Perry, V. H., & Weller, R. O. (2008) · Neuropathology and Applied Neurobiology · doi:10.1111/j.1365-2990.2007.00926.x · Cited by 665 · see citing works
Self-citationCervical lymphatics, the blood-brain barrier and the immunoreactivity of the brain: a new view
Cserr, H. F., & Knopf, P. M. (1992) · Immunology Today · doi:10.1016/0167-5699(92)90027-5 · Cited by 648 · see citing works
Mechanisms of fluid movement into, through and out of the brain: evaluation of the evidence
Hladky, S. B., & Barrand, M. A. (2014) · Fluids and Barriers of the CNS · doi:10.1186/2045-8118-11-26 · Cited by 633 · see citing works
The cortical angiome: an interconnected vascular network with noncolumnar patterns of blood flow
Blinder, P., Tsai, P. S., Kaufhold, J. P., Knutsen, P. M., Suhl, H., & Kleinfeld, D. (2013) · Nature Neuroscience · doi:10.1038/nn.3426 · Cited by 573 · see citing works
Agrawal, S., Anderson, P., Durbeej, M., van Rooijen, N., Ivars, F., Opdenakker, G., & Sorokin, L. M. (2006) · The Journal of Experimental Medicine · doi:10.1084/jem.20051342 · Cited by 559 · see citing works
Brain barriers: Crosstalk between complex tight junctions and adherens junctions
Tietz, S., & Engelhardt, B. (2015) · Journal of Cell Biology · doi:10.1083/jcb.201412147 · Cited by 551 · see citing works
Self-citationKivisäkk, P., Mahad, D., Callahan, M. K., Trebst, C., Tucky, B. H., Wei, T., Wu, L., Bækkevold, E. S., Lassmann, H., Staugaitis, S. M., et al. (2003) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1433000100 · Cited by 546 · see citing works
Kida, S., Pantazis, A., & Weller, R. O. (1993) · Neuropathology and Applied Neurobiology · doi:10.1111/j.1365-2990.1993.tb00476.x · Cited by 520 · see citing works
Self-citation(1990) · Europe PMC (PubMed Central) · Cited by 463 · see citing works
Cserr, H. F., Harling‐Berg, C. J., & Knopf, P. M. (1992) · Brain Pathology · doi:10.1111/j.1750-3639.1992.tb00703.x · Cited by 450 · see citing works
A balanced view of the cerebrospinal fluid composition and functions: Focus on adult humans
Spector, R., Snodgrass, S. R., & Johanson, C. E. (2015) · Experimental Neurology · doi:10.1016/j.expneurol.2015.07.027 · Cited by 445 · see citing works
T cells become licensed in the lung to enter the central nervous system
Odoardi, F., Sie, C., Streyl, K., Ulaganathan, V. K., Schläger, C., Lodygin, D., Heckelsmiller, K., Nietfeld, W., Ellwart, J. W., Klinkert, W. E. F., et al. (2012) · Nature · doi:10.1038/nature11337 · Cited by 440 · see citing works
Vascular, glial, and lymphatic immune gateways of the central nervous system
Engelhardt, B., Carare, R. O., Bechmann, I., Flügel, A., Laman, J. D., & Weller, R. O. (2016) · Acta Neuropathologica · doi:10.1007/s00401-016-1606-5 · Cited by 362 · see citing works
Self-citationHawkes, C. A., Härtig, W., Kacza, J., Schliebs, R., Weller, R. O., Nicoll, J. A. R., & Carare, R. O. (2011) · Acta Neuropathologica · doi:10.1007/s00401-011-0801-7 · Cited by 359 · see citing works
Self-citationVajkoczy, P., Laschinger, M., & Engelhardt, B. (2001) · Journal of Clinical Investigation · doi:10.1172/jci12440 · Cited by 357 · see citing works
Self-citationDrainage of interstitial fluid from different regions of rat brain
Szentistvanyi, I., Patlak, C. S., Ellis, R. A., & Cserr, H. F. (1984) · American Journal of Physiology-Renal Physiology · doi:10.1152/ajprenal.1984.246.6.f835 · Cited by 355 · see citing works
Perivascular Spaces and the Two Steps to Neuroinflammation
Owens, T., Bechmann, I., & Engelhardt, B. (2008) · Journal of Neuropathology & Experimental Neurology · doi:10.1097/nen.0b013e31818f9ca8 · Cited by 352 · see citing works
Self-citationEnvironmental cues, dendritic cells and the programming of tissue-selective lymphocyte trafficking
Sigmundsdóttir, H., & Butcher, E. C. (2008) · Nature Immunology · doi:10.1038/ni.f.208 · Cited by 330 · see citing works
Andersson, P.-B., Perry, V. H., & Gordon†, S. (1992) · Neuroscience · doi:10.1016/0306-4522(92)90347-5 · Cited by 324 · see citing works
Mechanisms to explain the reverse perivascular transport of solutes out of the brain
Schley, D., Carare-Nnadi, R., Please, C. P., Perry, V. H., & Weller, R. O. (2006) · Journal of Theoretical Biology · doi:10.1016/j.jtbi.2005.07.005 · Cited by 293 · see citing works
Self-citationVascular basement membranes as pathways for the passage of fluid into and out of the brain
Morris, A. W. J., Sharp, M. M., Albargothy, N. J., Fernandes, R., Hawkes, C. A., Verma, A., Weller, R. O., & Carare, R. O. (2016) · Acta Neuropathologica · doi:10.1007/s00401-016-1555-z · Cited by 289 · see citing works
Self-citationMason, D., Charlton, H. M., Jones, A. J., et al. (1986) · Neuroscience · doi:10.1016/0306-4522(86)90292-7 · Cited by 286 · see citing works
Glymphatic solute transport does not require bulk flow
Asgari, M., de Zélicourt, D., & Kurtcuoglu, V. (2016) · Scientific Reports · doi:10.1038/srep38635 · Cited by 280 · see citing works
Interstitial fluid drainage is impaired in ischemic stroke and Alzheimer’s disease mouse models
Arbel‐Ornath, M., Hudry, E., Eikermann‐Haerter, K., Hou, S. S., Gregory, J. L., Zhao, L., Betensky, R. A., Frosch, M. P., Greenberg, S. M., & Bacskai, B. J. (2013) · Acta Neuropathologica · doi:10.1007/s00401-013-1145-2 · Cited by 256 · see citing works
The Cranial Arachnoid and Pia Mater in Man: Anatomical and Ultrastructural Observations
Alcolado, R., Weller, R. O., Parrish, E. P., & Garrod, D. R. (1988) · Neuropathology and Applied Neurobiology · doi:10.1111/j.1365-2990.1988.tb00862.x · Cited by 251 · see citing works
Self-citationKawakami, N., Nägerl, U. V., Odoardi, F., Bonhoeffer, T., Wekerle, H., & Flügel, A. (2005) · The Journal of Experimental Medicine · doi:10.1084/jem.20050011 · Cited by 248 · see citing works
McCandless, E. E., Wang, Q., Woerner, B. M., Harper, J. M., & Klein, R. S. (2006) · The Journal of Immunology · doi:10.4049/jimmunol.177.11.8053 · Cited by 247 · see citing works
Lopes Pinheiro, M. A., Kooij, G., Mizee, M. R., Kamermans, A., Enzmann, G., Lyck, R., Schwaninger, M., Engelhardt, B., & de Vries, H. E. (2016) · Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease · doi:10.1016/j.bbadis.2015.10.018 · Cited by 247 · see citing works
Self-citationSteffen, B. J., Breier, G., Butcher, E. C., Schulz, M., & Engelhardt, B. (1996) · Europe PMC (PubMed Central) · Cited by 245 · see citing works
Self-citationPreston, S., Steart, P. V., Wilkinson, A., Nicoll, J. A. R., & Weller, R. O. (2003) · Neuropathology and Applied Neurobiology · doi:10.1046/j.1365-2990.2003.00424.x · Cited by 238 · see citing works
Self-citationInfectious immunity in the central nervous system and brain function
Klein, R. S., Garber, C., & Howard, N. (2017) · Nature Immunology · doi:10.1038/ni.3656 · Cited by 235 · see citing works
Anatomical relationships of the pia mater to cerebral blood vessels in man
Hutchings, M., & Weller, R. O. (1986) · Journal of Neurosurgery · doi:10.3171/jns.1986.65.3.0316 · Cited by 233 · see citing works
Self-citationPerivascular spaces in the basal ganglia of the human brain: their relationship to lacunes
POLLOCK, H., HUTCHINGS, M., WELLER, R. O., & ZHANG, E. (1997) · Journal of Anatomy · doi:10.1046/j.1469-7580.1997.19130337.x · Cited by 220 · see citing works
Self-citationSong, J., Wu, C., Korpos, É., Zhang, X., Agrawal, S. M., Wang, Y., Faber, C., Schäfers, M. A., Körner, H., Opdenakker, G., et al. (2015) · Cell Reports · doi:10.1016/j.celrep.2015.01.037 · Cited by 218 · see citing works
Kerfoot, S. M., & Kubes, P. (2002) · The Journal of Immunology · doi:10.4049/jimmunol.169.2.1000 · Cited by 210 · see citing works
Carare, R. O., Hawkes, C. A., Jeffrey, M., Kalaria, R. N., & Weller, R. O. (2013) · Neuropathology and Applied Neurobiology · doi:10.1111/nan.12042 · Cited by 207 · see citing works
Self-citationZhang, E. T., Richards, H. K., Kida, S., & Weller, R. O. (1992) · Acta Neuropathologica · doi:10.1007/bf00296784 · Cited by 205 · see citing works
Self-citationCNS-specific T cells shape brain function via the choroid plexus
Baruch, K., & Schwartz, M. (2013) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2013.04.002 · Cited by 195 · see citing works
Oligodendrocyte death results in immune-mediated CNS demyelination
Traka, M., Podojil, J. R., McCarthy, D. P., Miller, S. D., & Popko, B. (2016) · Nature Neuroscience · doi:10.1038/nn.4193 · Cited by 195 · see citing works
Schebesch, K.-M., Proescholdt, M. A., Höhne, J., et al. (2013) · Acta Neurochirurgica · doi:10.1007/s00701-013-1643-y · Cited by 194 · see citing works
Knopf, P. M., Harling‐Berg, C. J., Cserr, H. F., Basu, D., Sirulnick, E. J., Nolan, S. C., Park, J. T., Keir, G., Thompson, E. J., & Hickey, W. F. (1998) · The Journal of Immunology · doi:10.4049/jimmunol.161.2.692 · Cited by 193 · see citing works
Kawakami, N., Laßmann, S., Li, Z., Odoardi, F., Ritter, T., Ziemssen, T., Klinkert, W. E. F., Ellwart, J. W., Bradl, M., Krivacic, K. A., et al. (2004) · The Journal of Experimental Medicine · doi:10.1084/jem.20031064 · Cited by 189 · see citing works
T cells traffic from brain to cervical lymph nodes via the cribroid plate and the nasal mucosa
Goldmann, J., Kwidzinski, E., Brandt, C., Mahlo, J., Richter, D., & Bechmann, I. (2006) · Journal of Leukocyte Biology · doi:10.1189/jlb.0306176 · Cited by 188 · see citing works
How Do Meningeal Lymphatic Vessels Drain the CNS?
Raper, D. M. S., Louveau, A., & Kipnis, J. (2016) · Trends in Neurosciences · doi:10.1016/j.tins.2016.07.001 · Cited by 181 · see citing works
The fine anatomy of the human spinal meninges
Nicholas, D. S., & Weller, R. O. (1988) · Journal of neurosurgery · doi:10.3171/jns.1988.69.2.0276 · Cited by 180 · see citing works
Self-citationMicroscopic morphology and histology of the human meninges
Weller, R. O. (2005) · Morphologie · doi:10.1016/s1286-0115(05)83235-7 · Cited by 176 · see citing works
Self-citationStudies on the problem of corneal homografts
Billingham, R. E., & Boswell, T. (1953) · Proceedings of the Royal Society B Biological Sciences · doi:10.1098/rspb.1953.0049 · Cited by 175 · see citing works
The morphology of cerebrospinal fluid drainage pathways in human arachnoid granulations
Upton, M. L., & Weller, R. O. (1985) · Journal of neurosurgery · doi:10.3171/jns.1985.63.6.0867 · Cited by 175 · see citing works
Self-citationGiant tumefactive perivascular spaces.
Salzman, K. L., Osborn, A. G., House, P. A., Jinkins, J. R., Ditchfield, A., Cooper, J. A., & Weller, R. O. (2005) · PubMed Central · Cited by 170 · see citing works
Self-citationUltrastructure of the human spinal arachnoid mater and dura mater.
Vandenabeele, F., Creemers, J., & Lambrichts, I. (1996) · PubMed · Cited by 167 · see citing works
Mechanism of Cerebral β-Amyloid Angiopathy: Murine and Cellular Models
Herzig, M. C., Nostrand, W. E. V., & Jucker, M. (2006) · Brain Pathology · doi:10.1111/j.1750-3639.2006.tb00560.x · Cited by 167 · see citing works
Hatterer, E., Davoust, N., Didier‐Bazès, M., Vuaillat, C., Malcus, C., Belin, M., & Nataf, S. (2005) · Blood · doi:10.1182/blood-2005-01-0154 · Cited by 163 · see citing works
Rejection of fetal neocortical neural transplants by H-2 incompatible mice.
Nicholas, M. K., Antel, J. P., Stefánsson, K., et al. (1987) · The Journal of Immunology · doi:10.4049/jimmunol.139.7.2275 · Cited by 152 · see citing works
van Zwam, M., Huizinga, R., Heijmans, N., van Meurs, M., Wierenga‐Wolf, A. F., Melief, M., Hintzen, R. Q., Hart, B. A. ‘., Amor, S., Boven, L. A., et al. (2008) · The Journal of Pathology · doi:10.1002/path.2476 · Cited by 151 · see citing works
Lodygin, D., Odoardi, F., Schläger, C., Körner, H., Kitz, A., Nosov, M., van den Brandt, J., Reichardt, H. M., Haberl, M., & Flügel, A. (2013) · Nature Medicine · doi:10.1038/nm.3182 · Cited by 144 · see citing works
Primary oligodendrocyte death does not elicit anti-CNS immunity
Locatelli, G., Wörtge, S., Buch, T., Ingold, B., Frommer, F., Sobottka, B., Krüger, M., Karram, K., Bühlmann, C., Bechmann, I., et al. (2012) · Nature Neuroscience · doi:10.1038/nn.3062 · Cited by 132 · see citing works
Drug transporters on arachnoid barrier cells contribute to the blood-cerebrospinal fluid barrier
Yasuda, K., Cline, C., Vogel, P., Onciu, M., Fatima, S., Sorrentino, B. P., Thirumaran, R. K., Ekins, S., Urade, Y., Fujimori, K., et al. (2013) · Drug Metabolism and Disposition · doi:10.1124/dmd.112.050344 · Cited by 128 · see citing works
Shinkai, Y., Yoshimura, M., Ito, Y., Odaka, A., Suzuki, N., Yanagisawa, K., & Ihara, Y. (1995) · Annals of Neurology · doi:10.1002/ana.410380312 · Cited by 127 · see citing works
Atangana, E. N., Schneider, U. C., Blecharz, K., et al. (2016) · Translational Stroke Research · doi:10.1007/s12975-016-0485-3 · Cited by 110 · see citing works
Howell, O. W., Schulz‐Trieglaff, E. K., Carassiti, D., Gentleman, S. M., Nicholas, R. S., Roncaroli, F., & Reynolds, R. (2014) · Neuropathology and Applied Neurobiology · doi:10.1111/nan.12199 · Cited by 107 · see citing works
Afferent and efferent immunological pathways of the brain. Anatomy, Function and Failure
Carare, R. O., Hawkes, C. A., & Weller, R. O. (2013) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2013.10.012 · Cited by 100 · see citing works
Self-citationThe Choroid Plexus in Health and Disease
Netsky, M. G., & Shuangshotĭ, S. (2013) · Cited by 98 · see citing works
Ultrastructural localization of adhesion molecules in the healthy
Wolburg‐Buchholz, K., Gerhardt, H., Schulz, M., Wolburg, H., & Engelhardt, B. (1999) · Cell and Tissue Research · doi:10.1007/s004410051287 · Cited by 87 · see citing works
Self-citationMigration of monocytes after intracerebral injection at entorhinal cortex lesion site
Kaminski, M., Bechmann, I., Pohland, M., Kiwit, J. C. W., Nitsch, R., & Glumm, J. (2012) · Journal of Leukocyte Biology · doi:10.1189/jlb.0511241 · Cited by 85 · see citing works
Woitzik, J., Peña-Tapia, P. G., Schneider, U. C., et al. (2006) · Stroke · doi:10.1161/01.str.0000221671.94521.51 · Cited by 75 · see citing works
Cholinergic deafferentation of the rabbit cortex: a new animal model of Aβ deposition
Beach, T. G., Potter, P. E., Kuo, Y., Emmerling, M. R., Durham, R. A., Webster, S. D., Walker, D. G., Sue, L. I., Scott, S., Layne, K. J., et al. (2000) · Neuroscience Letters · doi:10.1016/s0304-3940(00)00916-2 · Cited by 69 · see citing works
Evidence for lymphatic Aβ clearance in Alzheimer's transgenic mice
Pappolla, M., Sambamurti, K., Vidal, R., Pacheco-Quinto, J., Poeggeler, B., & Matsubara, E. (2014) · Neurobiology of Disease · doi:10.1016/j.nbd.2014.07.012 · Cited by 69 · see citing works
The Choroid Plexus in Health and Disease
(1975) · Elsevier eBooks · doi:10.1016/c2013-0-06439-0 · Cited by 69 · see citing works
Lane, B., Bohnstedt, B. N., & Cohen‐Gadol, A. (2014) · Journal of neurosurgery · doi:10.3171/2014.10.jns132766 · Cited by 65 · see citing works
Engels, K., Fox, S. B., Whitehouse, R. M., Gatter, K. C., & Harris, A. L. (1997) · The Journal of Pathology · doi:10.1002/(sici)1096-9896(199708)182:4 · Cited by 60 · see citing works
Bayerl, S., Niesner, R. A., Cseresnyés, Z., Radbruch, H., Pohlan, J., Brandenburg, S., Czabanka, M., & Vajkoczy, P. (2016) · Glia · doi:10.1002/glia.22994 · Cited by 58 · see citing works
Self-citationZhang, X., Wu, C., Song, J., Götte, M., & Sorokin, L. M. (2013) · The Journal of Immunology · doi:10.4049/jimmunol.1300931 · Cited by 56 · see citing works
Carare, R. O., Teeling, J. L., Hawkes, C. A., Püntener, U., Weller, R. O., Nicoll, J. A. R., & Perry, V. H. (2013) · Acta Neuropathologica Communications · doi:10.1186/2051-5960-1-48 · Cited by 50 · see citing works
Self-citationZekonyte, J., Sakai, K., Nicoll, J. A. R., Weller, R. O., & Carare, R. O. (2015) · Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease · doi:10.1016/j.bbadis.2015.08.025 · Cited by 40 · see citing works
Self-citationSharp, M. K., Diem, A. K., Weller, R. O., & Carare, R. O. (2015) · Annals of Biomedical Engineering · doi:10.1007/s10439-015-1457-6 · Cited by 37 · see citing works
Self-citationWeller, R. O., Hawkes, C. A., Carare, R. O., & Hardy, J. (2015) · Acta Neuropathologica · doi:10.1007/s00401-015-1416-1 · Cited by 36 · see citing works
Self-citationBarua, N. U., Bienemann, A. S., Hesketh, S. A., Wyatt, M. J., Castrique, E. S., Love, S., & Gill, S. S. (2012) · Fluids and Barriers of the CNS · doi:10.1186/2045-8118-9-2 · Cited by 35 · see citing works
Clinical Implications of Cortical Microvasculature in Adult Moyamoya Disease
Czabanka, M., Peña-Tapia, P. G., Schubert, G. A., et al. (2009) · Journal of Cerebral Blood Flow & Metabolism · doi:10.1038/jcbfm.2009.69 · Cited by 28 · see citing works
Forgotten findings of brain lymphatics
Mezey, É., & Palkovits, M. (2015) · Nature · doi:10.1038/524415b · Cited by 27 · see citing works
Clapham, R., O’Sullivan, E. P., Weller, R. O., & Carare, R. O. (2009) · Clinical Anatomy · doi:10.1002/ca.20887 · Cited by 27 · see citing works
Self-citationSAPSFORD, I., BUONTEMPO, J. M., & Weller, R. O. (1983) · Neuropathology and Applied Neurobiology · doi:10.1111/j.1365-2990.1983.tb00106.x · Cited by 19 · see citing works
Self-citationEngelhardt, B., Vajkoczy, P., & Laschinger, M. (2003) · Humana Press eBooks · doi:10.1385/1-59259-419-0:83 · Cited by 14 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Blood–brain barrier breakdown in Alzheimer disease and other neurodegenerative disorders
Sweeney, M. D., Sagare, A. P., & Zlokovic, B. V. (2018) · Nature Reviews Neurology · doi:10.1038/nrneurol.2017.188 · Cited by 3,076 · see citing works
Blood-Brain Barrier: From Physiology to Disease and Back
Sweeney, M. D., Zhao, Z., Montagne, A., Nelson, A. R., & Zlokovic, B. V. (2019) · Physiological Reviews · doi:10.1152/physrev.00050.2017 · Cited by 2,294 · see citing works
Van Hove, H., Martens, L., Scheyltjens, I., De Vlaminck, K., Pombo Antunes, A. R., De Prijck, S., Vandamme, N., De Schepper, S., Van Isterdael, G., Scott, C. L., et al. (2019) · Nature Neuroscience · doi:10.1038/s41593-019-0393-4 · Cited by 1,160 · see citing works
Neuroinflammation and depression: A review
Troubat, R., Barone, P., Leman, S., Desmidt, T., Cressant, A., Atanasova, B., Brizard, B., El Hage, W., Surget, A., Belzung, C., et al. (2021) · European Journal of Neuroscience · doi:10.1111/ejn.14720 · Cited by 1,107 · see citing works
Mrdjen, D., Pavlovic, A., Hartmann, F. J., Schreiner, B., Utz, S. G., Leung, B. P., Lelios, I., Heppner, F. L., Kipnis, J., Merkler, D., et al. (2018) · Immunity · doi:10.1016/j.immuni.2018.01.011 · Cited by 1,010 · see citing works
CNS lymphatic drainage and neuroinflammation are regulated by meningeal lymphatic vasculature.
Louveau, A., Herz, J., Alme, M. N., Salvador, A. F., Dong, M. Q., Viar, K. E., Herod, S. G., Knopp, J., Setliff, J. C., Lupi, A. L., et al. (2018) · Nature Neuroscience · doi:10.1038/s41593-018-0227-9 · Cited by 956 · see citing works
Immune responses to stroke: mechanisms, modulation, and therapeutic potential.
Iadecola, C., Buckwalter, M. S., & Anrather, J. (2020) · Journal of Clinical Investigation · doi:10.1172/jci135530 · Cited by 853 · see citing works
Alzheimer’s disease: A matter of blood–brain barrier dysfunction?
Montagne, A., Zhao, Z., & Zlokovic, B. V. (2017) · Journal of Experimental Medicine · doi:10.1084/jem.20171406 · Cited by 672 · see citing works
Understanding the functions and relationships of the glymphatic system and meningeal lymphatics
Louveau, A., Plog, B. A., Antila, S., Alitalo, K., Nedergaard, M., & Kipnis, J. (2017) · Journal of Clinical Investigation · doi:10.1172/jci90603 · Cited by 640 · see citing works
The role of brain barriers in fluid movement in the CNS: is there a ‘glymphatic’ system?
Abbott, N. J., Pizzo, M. E., Preston, J. E., Janigro, D., & Thorne, R. G. (2018) · Acta Neuropathologica · doi:10.1007/s00401-018-1812-4 · Cited by 593 · see citing works
Brain-wide glymphatic enhancement and clearance in humans assessed with MRI.
Ringstad, G., Valnes, L. M., Dale, A. M., Pripp, A. H., Vatnehol, S.-A. S., Emblem, K. E., Mardal, K.-A., & Eide, P. K. (2018) · JCI Insight · doi:10.1172/jci.insight.121537 · Cited by 533 · see citing works
Microglia in Central Nervous System Inflammation and Multiple Sclerosis Pathology
Voet, S., Prinz, M., & van Loo, G. (2019) · Trends in Molecular Medicine · doi:10.1016/j.molmed.2018.11.005 · Cited by 503 · see citing works
Heterogeneity of meningeal B cells reveals a lymphopoietic niche at the CNS borders
Brioschi, S., Wang, W.-L., Peng, V., Wang, M., Shchukina, I., Greenberg, Z. J., Bando, J. K., Jaeger, N., Czepielewski, R. S., Swain, A., et al. (2021) · Science · doi:10.1126/science.abf9277 · Cited by 472 · see citing works
Yousef, H., Czupalla, C. J., Lee, D., Chen, M. B., Burke, A. N., Zera, K. A., Zandstra, J., Berber, E., Lehallier, B., Mathur, V., et al. (2019) · Nature Medicine · doi:10.1038/s41591-019-0440-4 · Cited by 442 · see citing works
Peripheral and central immune system crosstalk in Alzheimer disease — a research prospectus
Bettcher, B. M., Tansey, M. G., Dorothée, G., & Heneka, M. T. (2021) · Nature Reviews Neurology · doi:10.1038/s41582-021-00549-x · Cited by 427 · see citing works
Mou, Y., Du, Y., Zhou, L., Yue, J., Hu, X., Liu, Y., Chen, S., Lin, X., Zhang, G., Xiao, H., et al. (2022) · Frontiers in Immunology · doi:10.3389/fimmu.2022.796288 · Cited by 432 · see citing works
Ghersi-Egea, J.-F., Strazielle, N., Catala, M., Silva-Vargas, V., Doetsch, F., & Engelhardt, B. (2018) · Acta Neuropathologica · doi:10.1007/s00401-018-1807-1 · Cited by 436 · see citing works
Self-citationTau and neuroinflammation: what impact for Alzheimer's disease and tauopathies?
Laurent, C., Buée, L., & Blum, D. (2018) · Biomedical Journal · doi:10.1016/j.bj.2018.01.003 · Cited by 348 · see citing works
Alves de Lima, K., Rustenhoven, J., & Kipnis, J. (2020) · Annual Review of Immunology · doi:10.1146/annurev-immunol-102319-103410 · Cited by 348 · see citing works
CNS Infection and Immune Privilege
Forrester, J. V., McMenamin, P. G., & Dando, S. J. (2018) · Nature Reviews Neuroscience · doi:10.1038/s41583-018-0070-8 · Cited by 313 · see citing works
The anatomy and immunology of vasculature in the central nervous system
Mastorakos, P., & McGavern, D. (2019) · Science Immunology · doi:10.1126/sciimmunol.aav0492 · Cited by 333 · see citing works
Marchetti, L., & Engelhardt, B. (2020) · Vascular Biology · doi:10.1530/vb-19-0033 · Cited by 304 · see citing works
Stress-Induced Metabolic Disorder in Peripheral CD4+ T Cells Leads to Anxiety-like Behavior
Fan, K.-Q., Li, Y.-Y., Wang, H.-L., Mao, X.-T., Guo, J.-X., Wang, F., Huang, L.-J., Li, Y.-N., Ma, X.-Y., Gao, Z.-J., et al. (2019) · Cell · doi:10.1016/j.cell.2019.10.001 · Cited by 312 · see citing works
Emerging roles of innate and adaptive immunity in Alzheimer’s disease
Chen, X., & Holtzman, D. M. (2022) · Immunity · doi:10.1016/j.immuni.2022.10.016 · Cited by 297 · see citing works
De Schepper, S., Ge, J. Z., Sierksma, A., Crowley, G., Ferreira, L. S. S., Garceau, D., Toomey, C. E., Sokolova, D., Rueda-Carrasco, J., Shin, S.-H., et al. (2023) · Nature Neuroscience · doi:10.1038/s41593-023-01257-z · Cited by 295 · see citing works
Infectious immunity in the central nervous system and brain function
Klein, R. S., Garber, C., & Howard, N. (2017) · Nature Immunology · doi:10.1038/ni.3656 · Cited by 235 · see citing works
Mundt, S., Mrdjen, D., Utz, S. G., Greter, M., Schreiner, B., & Becher, B. (2019) · Science Immunology · doi:10.1126/sciimmunol.aau8380 · Cited by 235 · see citing works
Weller, R. O., Sharp, M. M., Christodoulides, M., Carare, R. O., & Møllgård, K. (2018) · Acta Neuropathologica · doi:10.1007/s00401-018-1809-z · Cited by 222 · see citing works
“Although veins in the SAS are coated by a layer of leptomeningeal cells, the main barrier to entry of inflammatory cells from the blood into the CSF in the SAS is the vascular endothelium lining veins in the SAS and subpial spaces [30, 31].”
BackgroundBrain perivascular macrophages: characterization and functional roles in health and disease
Faraco, G., Park, L., Anrather, J., & Iadecola, C. (2017) · Journal of Molecular Medicine · doi:10.1007/s00109-017-1573-x · Cited by 206 · see citing works
A Binary Cre Transgenic Approach Dissects Microglia and CNS Border-Associated Macrophages
Kim, J.-S., Kolesnikov, M., Peled-Hajaj, S., Scheyltjens, I., Xia, Y., Trzebanski, S., Haimon, Z., Shemer, A., Lubart, A., Van Hove, H., et al. (2021) · Immunity · doi:10.1016/j.immuni.2020.11.007 · Cited by 176 · see citing works
Neuropathobiology of COVID-19: The Role for Glia
Tremblay, M.-E., Madore, C., Bordeleau, M., Tian, L., & Verkhratsky, A. (2020) · Frontiers in Cellular Neuroscience · doi:10.3389/fncel.2020.592214 · Cited by 159 · see citing works
Russo, M. V., Latour, L. L., & McGavern, D. B. (2018) · Nature Immunology · doi:10.1038/s41590-018-0086-2 · Cited by 149 · see citing works
Clearance of cerebrospinal fluid from the sacral spine through lymphatic vessels
Ma, Q., Decker, Y., Müller, A., Ineichen, B. V., & Proulx, S. T. (2019) · Journal of Experimental Medicine · doi:10.1084/jem.20190351 · Cited by 136 · see citing works
The Emerging Role of Central and Peripheral Immune Systems in Neurodegenerative Diseases
Zang, X., Chen, S., Zhu, J., Ma, J., & Zhai, Y. (2022) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2022.872134 · Cited by 139 · see citing works
Kaushik, D. K., Bhattacharya, A., Mirzaei, R., Rawji, K. S., Ahn, Y., Rho, J. M., & Yong, V. W. (2019) · Journal of Clinical Investigation · doi:10.1172/jci124012 · Cited by 136 · see citing works
Inflammation of the Embryonic Choroid Plexus Barrier following Maternal Immune Activation
Cui, J., Shipley, F. B., Shannon, M. L., Alturkistani, O., Dani, N., Webb, M. D., Sugden, A. U., Andermann, M. L., & Lehtinen, M. K. (2020) · Developmental Cell · doi:10.1016/j.devcel.2020.09.020 · Cited by 128 · see citing works
Coles, J. A., Myburgh, E., Brewer, J. M., & McMenamin, P. G. (2017) · Progress in Neurobiology · doi:10.1016/j.pneurobio.2017.05.002 · Cited by 123 · see citing works
Enzmann, G., Kargaran, S., & Engelhardt, B. (2018) · Therapeutic Advances in Neurological Disorders · doi:10.1177/1756286418794184 · Cited by 119 · see citing works
Self-citationRole of Macrophages in Brain Tumor Growth and Progression
Guadagno, E., Presta, I., Maisano, D., Donato, A., Pirrone, C., Cardillo, G., Corrado, S., Mignogna, C., Mancuso, T., Donato, G., et al. (2018) · International Journal of Molecular Sciences · doi:10.3390/ijms19041005 · Cited by 118 · see citing works
Frieser, D., Pignata, A., Khajavi, L., Shlesinger, D., Gonzalez-Fierro, C., Nguyen, X.-H., Yermanos, A., Merkler, D., Höftberger, R., Desestret, V., et al. (2022) · Science Translational Medicine · doi:10.1126/scitranslmed.abl6157 · Cited by 102 · see citing works
Emerging role of non-coding RNAs in neuroinflammation mediated by microglia and astrocytes
Yang, R., Yang, B., Liu, W., Tan, C., Chen, H., & Wang, X. (2023) · Journal of Neuroinflammation · doi:10.1186/s12974-023-02856-0 · Cited by 91 · see citing works
Moffett, J. R., Arun, P., Puthillathu, N., Vengilote, R., Ives, J. A., Badawy, A. A.-B., & Namboodiri, A. M. (2020) · Frontiers in Immunology · doi:10.3389/fimmu.2020.00031 · Cited by 89 · see citing works
“The brain is an immune-privileged organ, with heightened barriers to peripheral immune cell trafficking, and therefore, it does not respond to immune challenges to the same degree as many peripheral organ systems [reviewed in (66)].”
BackgroundThe Gut Microbiome as a Regulator of the Neuroimmune Landscape
Yu, L. W., Agirman, G., & Hsiao, E. Y. (2022) · Annual Review of Immunology · doi:10.1146/annurev-immunol-101320-014237 · Cited by 75 · see citing works
Basal lamina changes in neurodegenerative disorders
Nguyen, B., Bix, G., & Yao, Y. (2021) · Molecular Neurodegeneration · doi:10.1186/s13024-021-00502-y · Cited by 75 · see citing works
Mechanisms of myeloid cell entry to the healthy and diseased central nervous system
Amann, L., Masuda, T., & Prinz, M. (2023) · Nature Immunology · doi:10.1038/s41590-022-01415-8 · Cited by 50 · see citing works
Guo, Y., Chen, J., Ji, W., Xu, L., Xie, Y., He, S., Lai, C., Hou, K., Li, Z., Chen, G., et al. (2023) · Molecular Therapy Methods & Clinical Development · doi:10.1016/j.omtm.2023.08.021 · Cited by 47 · see citing works
Reiter, R. J., Sharma, R., Rosales-Corral, S., de Mange, J., Phillips, W. T., Tan, D. X., & Bitar, R. D. (2022) · Biochemical and Biophysical Research Communications · doi:10.1016/j.bbrc.2022.03.025 · Cited by 31 · see citing works
Wostyn, P., & De Deyn, P. P. (2018) · Medical Hypotheses · doi:10.1016/j.mehy.2018.07.007 · Cited by 27 · see citing works
The role of the adaptive immune system in the initiation and persistence of multiple sclerosis
Afzali, A. M., & Korn, T. (2025) · Seminars in Immunology · doi:10.1016/j.smim.2025.101947 · Cited by 25 · see citing works
T-cell Receptor Therapy Targeting Mutant Capicua Transcriptional Repressor in Experimental Gliomas
Kilian, M., Friedrich, M., Sanghvi, K., Green, E., Pusch, S., Kawauchi, D., Löwer, M., Sonner, J. K., Krämer, C., Zaman, J., et al. (2022) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-21-1881 · Cited by 18 · see citing works
Use of the MicroSiM (µSiM) Barrier Tissue Platform for Modeling the Blood-Brain Barrier
McCloskey, M. C., Kasap, P., Trempel, M., Widom, L. P., Kuebel, J., Chen, K., Gaborski, T. R., Engelhardt, B., & McGrath, J. L. (2024) · Journal of Visualized Experiments · doi:10.3791/65258 · Cited by 8 · see citing works
Self-citationThe brain washing system in sepsis-associated encephalopathy
Chen, T., Hu, J., Liao, Y., Xie, S., & Zhang, L. (2025) · Journal of Neuroinflammation · doi:10.1186/s12974-025-03602-4 · Cited by 8 · see citing works
- Authors
- Engelhardt, B., Vajkoczy, P., & Weller, R. O.
- Affiliations
- University of Bern (CH)
- Stiftung Charité (DE)
- University Hospital Southampton NHS Foundation Trust (GB)
- Corresponding author
- Engelhardt, Britta
- Weller, Roy O
- Venue
- Nature Immunology
- Published
- 2017-01-16
- Volume
- 18
- Issue
- 2
- Pages
- 123-131
- ISSN
- 1529-2908 (ISSN-L)
- 1529-2916
- OpenAlex
- W2573339072
- Cited by
- 893
- References
- 99
- Citations by year
- 2026: 71 · 2025: 73 · 2024: 107 · 2023: 117 · 2022: 113 · 2021: 107 · 2020: 103 · 2019: 63 · 2018: 95 · 2017: 44
- FWCI
- 8.07
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Nature Immunology (publishedVersion)
- PubMed (publishedVersion)
- Bern Open Repository and Information System (University of Bern) (submittedVersion)
- Topics
- Life Sciences › Neuroscience › Neurology › Barrier Structure and Function Studies
- Life Sciences › Neuroscience › Neurology › Neuroinflammation and Neurodegeneration Mechanisms
- Health Sciences › Medicine › Oncology › Lymphatic System and Diseases
- Keywords
- immune privilege, central nervous system, blood-CSF barrier, blood-brain barrier, lymphatic drainage, immune surveillance, intravital microscopy
- MeSH terms
- Animals, Cell Movement, Central Nervous System, Dura Mater, Humans, Immune Tolerance, Immunologic Surveillance, Physiology, Comparative, Autoimmunity, Microglia, Mice, Rats
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review