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CXCL13

CXCL13, also known as C-X-C motif chemokine ligand 13 (BCA-1 or B lymphocyte chemoattractant), is a small secreted cytokine belonging to the CXC subfamily of chemokines.^[1] Encoded by the CXCL13 gene located on human chromosome 4q21.1 (positions 77,511,753-77,611,834), it produces a precursor protein of 109 amino acids that matures into an 87-amino-acid polypeptide with a molecular weight of approximately 10.3 kDa.^[1]^[2]^[3] The protein features a conserved CXC motif with four cysteine residues forming two disulfide bonds, contributing to its characteristic chemokine fold as revealed by X-ray crystallography at 1.88 Å resolution.^[4] CXCL13 functions primarily as a chemoattractant for B lymphocytes by selectively binding to the G protein-coupled receptor CXCR5 (also known as BLR1), thereby directing B cell homing to lymphoid follicles.^[1]^[2] This interaction is essential for orchestrating the structural organization and functional maturation of secondary lymphoid organs, such as lymph nodes and spleen, where CXCL13 is highly expressed.^[1]^[5] In the broader context of immunity, CXCL13 is constitutively produced by stromal cells in lymphoid tissues and follicular dendritic cells, promoting the recruitment and positioning of CXCR5-expressing cells, including B cells and T follicular helper (Tfh) cells, to facilitate germinal center formation and high-affinity antibody production.^[6]^[7] Beyond homeostasis, dysregulated CXCL13 expression contributes to pathological conditions; for instance, elevated plasma levels serve as a biomarker for disease activity in chronic lymphocytic leukemia and are implicated in the pathogenesis of autoimmune disorders like rheumatoid arthritis and Sjögren's syndrome through lymphoid neogenesis.^[1]^[7] In cancer, the CXCL13/CXCR5 axis drives the formation of tertiary lymphoid structures within tumors, which can enhance anti-tumor immune responses by attracting B cells and Tfh cells, though it may also support tumor progression in certain contexts such as multiple myeloma osteolytic lesions.^[8]^[9]^[10] Additionally, CXCL13 influences responses to infections and vaccinations by modulating B cell migration and germinal center reactions, underscoring its central role in adaptive immunity.^[6]

Discovery and nomenclature

Discovery

CXCL13 was initially identified in 1998 as a novel B-cell chemoattractant through the screening of expressed sequence tag (EST) DNA sequences derived from a cDNA library of the human Burkitt's lymphoma cell line Namalwa, which originates from lymphoid tissue.^[11] This approach led to the discovery of a previously unknown chemokine gene, subsequently cloned and sequenced, encoding a 109-amino-acid precursor protein with a 22-residue signal peptide and a characteristic CXC motif typical of the CXC chemokine subfamily.^[11] The mature protein, termed B cell-attracting chemokine 1 (BCA-1), exhibited 23–34% amino acid identity with other known human CXC chemokines, distinguishing it as a unique member with potential homeostatic functions in lymphoid organs.^[11] Early characterization involved chemical synthesis of the BCA-1 protein to perform functional assays, which demonstrated its potent chemotactic activity specifically toward human B lymphocytes expressing the receptor BLR1 (later designated CXCR5).^[11] In transwell migration assays, BCA-1 induced robust migration of primary human B cells at concentrations as low as 1 nM, while showing no chemoattractant effect on T lymphocytes, monocytes, or neutrophils, even at higher doses up to 1 μM.^[11] These assays also confirmed selectivity, as BCA-1 did not elicit responses in cells responsive to other CXC or CC chemokines, and it triggered calcium mobilization in BLR1-transfected pre-B cells, underscoring its targeted action on B-cell subsets.^[11] Concurrently, a murine homolog termed B lymphocyte chemoattractant (BLC) was identified in 1998 through similar EST screening from mouse lymphoid tissues, revealing high sequence conservation and analogous B-cell specificity via the orthologous receptor. The human BCA-1/CXCL13 discovery, detailed in the seminal work by Legler et al., established its role as a selective B-cell attractant and laid the foundation for understanding lymphoid homing mechanisms.^[11]

Nomenclature

CXCL13 is officially designated as chemokine (C-X-C motif) ligand 13 by the International Union of Basic and Clinical Pharmacology (IUPHAR).^[12] This systematic name reflects its position within the CXC subfamily of chemokines, characterized by a single amino acid separating the first two cysteine residues in their conserved motif.^[13] Following its initial identification as B cell-attracting chemokine 1 (BCA-1) in 1998, CXCL13 has been known by several synonyms, including B-lymphocyte chemoattractant (BLC) and small-inducible cytokine B13 (SCYB13).^[14]^[2] In the early 2000s, a nomenclature subcommittee under the International Union of Immunological Societies (IUIS) and World Health Organization (WHO) standardized chemokine naming to address inconsistencies in prior functional or species-specific designations, adopting CXCL13 as the preferred term while retaining historical synonyms in parentheses for reference.^[15] As a homeostatic CXC chemokine, CXCL13 is distinguished from inflammatory counterparts like CXCL8 by its constitutive expression in lymphoid tissues rather than inducible production during acute immune responses.^[16] This classification underscores its role in baseline immune organization, separate from the ELR motif-bearing inflammatory CXC chemokines that primarily attract neutrophils.^[17]

Structure

Gene

The CXCL13 gene is located on the long arm of human chromosome 4 at the cytogenetic band 4q21.1, within a genomic cluster that includes several other CXC chemokine genes such as CXCL1, CXCL2, CXCL3, CXCL5, CXCL6, and CXCL8.^[18] This positioning reflects the evolutionary organization of the CXC subfamily, where most members are clustered on chromosome 4. The gene spans approximately 100 kb of genomic DNA and is organized into four exons in its canonical transcript, with the majority of the coding sequence contained within exon 4.^[2]^[19] The structure supports the production of a 109-amino-acid preprotein, including a signal peptide.^[18] The promoter region upstream of the CXCL13 transcription start site features binding sites for NF-κB transcription factors, enabling inducible expression in response to inflammatory signals via both canonical and non-canonical pathways.^[20]^[21] CXCL13 has orthologs in other mammals, including the mouse gene Cxcl13 on chromosome 5, which exhibits high sequence conservation; the human and mouse proteins share 64% amino acid identity.^[18] This degree of homology underscores the functional preservation of CXCL13 across species.

Protein

CXCL13 is synthesized as a precursor protein of 109 amino acids, which undergoes cleavage of a 22-amino-acid signal peptide to yield the mature protein consisting of 87 amino acids with a molecular weight of approximately 10 kDa.^[13]^[2] The mature form is non-glycosylated, consistent with the typical properties of many CXC chemokines produced in prokaryotic systems or observed in structural studies.^[22] The protein exhibits a conserved CXC motif, defined by four cysteine residues that form two intramolecular disulfide bonds essential for structural integrity: one between cysteine 11 and cysteine 34, and another between cysteine 13 and cysteine 50 (using mature protein numbering).^[13]^[23] In 2020, the crystal structure of human CXCL13 was determined at 1.88 Å resolution (PDB ID: 7JNY), revealing a monomeric conformation with a canonical chemokine fold. This includes an N-terminal region leading into three antiparallel β-strands forming a Greek key motif, overlaid by a C-terminal α-helix positioned above the β-sheet. The core domain displays rigidity, while the N- and C-termini remain highly flexible.^[23]^[4] Post-translational modifications of CXCL13 are minimal and primarily limited to the formation of the aforementioned disulfide bridges, which stabilize the tertiary structure without additional glycosylation or other major alterations reported in the mature protein.^[13]^[23]

Expression and regulation

Sites of expression

CXCL13 is constitutively expressed at high levels in the B-cell follicles of secondary lymphoid organs, including lymph nodes, spleen, and Peyer's patches, where it guides the organization of lymphoid structures.^[21]^[24] This expression is primarily driven by stromal cells, such as mesenchymal lymphoid tissue organizer (mLTo) cells and follicular dendritic cells (FDCs), which maintain the chemoattractant gradient essential for B-cell homing.^[5]^[24] In humans, follicular helper T (Tfh) cells within germinal centers also contribute to this production, enhancing the localization of CXCR5-expressing lymphocytes.^[5] Under inflammatory conditions, CXCL13 expression becomes inducible in additional cell types, including macrophages and endothelial cells, which respond to stimuli like cytokines and promote leukocyte recruitment.^[5]^[24] Basal expression remains low in non-lymphoid tissues such as the liver and gut mucosa during homeostasis, but it is markedly upregulated in ectopic lymphoid structures, for instance, in the inflamed synovium of patients with rheumatoid arthritis, where it supports the formation of tertiary lymphoid organs.^[21]^[24] During embryogenesis, CXCL13 plays a critical role in lymph node initiation, with expression initiated in stromal organizer cells around embryonic day 12.5–14.5 to attract lymphoid tissue inducer (LTi) cells and facilitate early clustering.^[25] This retinoic acid-dependent process is essential for the development of secondary lymphoid architecture.^[25]

Regulatory mechanisms

The expression of the CXCL13 gene is primarily regulated at the transcriptional level by proinflammatory cytokines and signaling pathways critical for lymphoid organogenesis and inflammation. Tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β) induce CXCL13 transcription in macrophages and stromal cells by activating the canonical NF-κB pathway, which binds to specific promoter elements to drive gene expression.^[5]^[26] Similarly, lymphotoxin signaling through the lymphotoxin beta receptor (LTβR) engages both canonical and non-canonical NF-κB pathways, leading to robust CXCL13 upregulation in lymphoid stromal cells essential for B cell follicle formation.^[27]^[28] Additionally, interleukin-10 (IL-10) enhances CXCL13 expression via the JAK/STAT signaling cascade, cooperating with proinflammatory cytokines to optimize gene expression in immune cells.^[29] Epigenetic modifications, particularly DNA methylation, play a key role in restricting CXCL13 expression to lymphoid tissues under homeostatic conditions. Hypermethylation of the CXCL13 promoter region suppresses transcription in non-lymphoid cells, such as epithelial or tumor-derived lines, preventing ectopic expression and maintaining tissue-specificity.^[30] This methylation pattern is dynamically altered during inflammation or oncogenesis, allowing inducible derepression in response to environmental cues.^[31] Post-transcriptional regulation further controls CXCL13 levels through microRNA-mediated mRNA destabilization. For instance, miR-125b targets the 3' untranslated region (UTR) of CXCL13 mRNA, promoting its degradation and thereby reducing protein output in immune and non-immune cells.^[32] This mechanism contributes to fine-tuning CXCL13 availability during immune responses. A positive feedback loop involving CXCR5 signaling reinforces CXCL13 production in stromal compartments. B cells, upon binding CXCL13 via CXCR5, upregulate lymphotoxin α1β2 expression, which in turn signals back to stromal cells to sustain CXCL13 secretion, thereby amplifying B cell recruitment and lymphoid structure maintenance.^[33]

Function

Receptor binding

CXCL13 primarily binds to CXCR5, a seven-transmembrane G-protein-coupled receptor expressed on various immune cells. This interaction occurs with high affinity, characterized by a dissociation constant (Kd) of approximately 50 nM for CXCL13 binding to CXCR5 alone.^[34] The binding is highly specific, as CXCL13 acts exclusively as a chemotactic agent for CXCR5 and shows no significant affinity for other chemokine receptors, such as those in the CXC or CC families.^[21] The binding mechanism involves a two-site recognition paradigm typical of chemokine-receptor interactions, where the structured core domain of CXCL13, featuring the characteristic CXC motif, engages the N-terminus and extracellular loops of CXCR5 to initiate docking.^[35] Subsequently, the flexible N-terminal domain of CXCL13 inserts into the receptor's orthosteric pocket, triggering conformational changes that activate Gαi-mediated signaling, including inhibition of adenylyl cyclase but without significant mobilization of intracellular calcium stores in B lymphocytes.^[23]^[36] This selective engagement directs CXCL13's activity toward cells expressing CXCR5, such as naive B cells and follicular helper T (Tfh) cells, facilitating targeted immune responses without off-target effects on other leukocyte subsets.^[37] At high concentrations, CXCL13 can undergo dimerization, which modulates its ability to activate CXCR5 by altering ligand availability and potentially reducing signaling efficiency, although the precise structural basis for this effect remains under investigation.^[21] This concentration-dependent behavior underscores the regulatory nuances in CXCL13's receptor interactions within physiological microenvironments.

Physiological roles

CXCL13 plays a central role in guiding the trafficking of CXCR5-expressing B cells to lymphoid follicles, facilitating their organization into distinct zones within secondary lymphoid organs. By binding to CXCR5 on naive and activated B cells, CXCL13 directs these cells from high endothelial venules into the B cell follicles, where they cluster to support germinal center formation during immune responses. This chemotactic activity ensures proper compartmentalization, allowing B cells to interact effectively with follicular dendritic cells and other stromal elements essential for antigen presentation and selection. In lymphoid organogenesis, CXCL13 is indispensable for the embryonic development of lymph nodes and the architectural organization of the spleen. Cxcl13 knockout mice exhibit a profound defect, lacking several peripheral lymph nodes such as inguinal, axillary, and brachial nodes, while displaying disorganized splenic white pulp with absent B cell follicles and germinal centers. This phenotype underscores CXCL13's function in recruiting lymphoid cells to nascent anlagen during development, establishing the foundational structure for adaptive immunity through a positive feedback loop involving B cell-derived lymphotoxin that further amplifies CXCL13 production by stromal cells. CXCL13 also supports the recruitment of T follicular helper (Tfh) cells to B cell follicles, promoting critical T-B cell interactions necessary for humoral immunity. Through CXCR5-mediated signaling, CXCL13 attracts activated CD4+ T cells expressing high levels of the receptor to the T-B cell border and into follicles, where they provide help for B cell proliferation, differentiation, and antibody affinity maturation in germinal centers. This positioning is vital for coordinating cognate interactions that drive the germinal center reaction without inducing inflammation. Beyond development, CXCL13 contributes to the homeostatic maintenance of B cell zones in adult lymphoid tissues, sustaining follicle integrity and B cell positioning in the absence of antigenic stimulation. In steady-state conditions, constitutive CXCL13 expression by follicular stromal cells preserves the segregation of B cells from T cell areas, ensuring readiness for rapid immune responses while preventing ectopic lymphoid clustering. Disruptions in this homeostatic role, as observed in Cxcl13-deficient models, lead to diffuse B cell distribution and impaired follicle maintenance.

Clinical significance

Autoimmune diseases

In autoimmune diseases, CXCL13 contributes to pathology by promoting the formation of ectopic lymphoid structures (ELS), which facilitate aberrant B-cell homing, activation, and autoantibody production beyond normal lymphoid tissues. This dysregulation amplifies chronic inflammation and tissue damage, contrasting with its physiological role in directing B cells to secondary lymphoid organs. Elevated CXCL13 levels in affected tissues and fluids serve as biomarkers of disease activity and B-cell involvement across multiple conditions.^[38] In rheumatoid arthritis (RA), CXCL13 is markedly elevated in synovial fluid and tissue, where it drives B-cell infiltration into the synovium and supports the development of germinal center-like structures within ELS. This process enhances local autoantibody production, such as rheumatoid factor and anti-citrullinated protein antibodies, exacerbating joint inflammation and erosion. Studies indicate that synovial CD4+ T cells produce CXCL13, attracting CXCR5-expressing B cells and follicular helper T cells to perpetuate the inflammatory cycle. High CXCL13 concentrations in early RA predict disease activity and radiographic progression, highlighting its prognostic value.^[39]^[40]^[41]^[42] Sjögren's syndrome features high serum CXCL13 levels that correlate with the extent of B-cell infiltration and lymphoid neogenesis in salivary glands, forming ELS that mimic secondary lymphoid organs. This chemokine's expression in glandular epithelium and stromal cells recruits B cells, promoting chronic inflammation and glandular dysfunction. Clinical data show that elevated CXCL13 associates with higher disease severity scores, such as ESSDAI, and histological focus scores, positioning it as a marker for local pathology and potential progression to lymphoma.^[43]^[44]^[45]^[46] In multiple sclerosis (MS), cerebrospinal fluid (CSF) CXCL13 levels are elevated during active disease, serving as a biomarker of intrathecal B-cell activity and inflammation in central nervous system lesions. It attracts B cells to the CSF and brain parenchyma, contributing to ELS formation in the meninges and perivascular spaces, which sustains humoral autoimmunity against myelin antigens. CSF CXCL13 correlates with B-cell counts and oligoclonal bands, predicting disease activity and response to B-cell depleting therapies in relapsing-remitting MS.^[47]^[48]^[49] Systemic lupus erythematosus (SLE), particularly with renal involvement, involves CXCL13 driving T follicular helper (Tfh) cell expansion and germinal center formation within kidney tertiary lymphoid structures. This leads to local B-cell activation and autoantibody deposition, worsening lupus nephritis through tubulointerstitial damage. Renal biopsies reveal high CXCL13 expression in cortical interstitium, correlating with disease activity indices like SLEDAI and anti-dsDNA levels, while supporting autoreactive B-cell survival in ectopic sites.^[50]^[51]^[52]^[53]

Cancer

CXCL13 exhibits a dual role in cancer, promoting tumor progression through immune suppression in certain malignancies while fostering anti-tumor immunity via the formation of tertiary lymphoid structures (TLS) in others. In the tumor microenvironment, CXCL13 binds to CXCR5 on immune cells, facilitating their recruitment and influencing the balance between pro- and anti-tumor responses. This chemokine's expression is often upregulated by tumor cells or stromal components, contributing to both oncogenesis and potential therapeutic vulnerabilities. As of 2025, high CXCL13 expression has been associated with improved responses to immune checkpoint inhibitors in lung adenocarcinoma by promoting TLS formation.^[54]^[55]^[56] In lymphomas, CXCL13 overexpression sustains malignant B-cell niches, particularly in follicular lymphoma (FL) and mucosa-associated lymphoid tissue (MALT) lymphoma. In FL, malignant B cells produce CXCL13, which attracts CXCR5-expressing B cells and T follicular helper cells, thereby maintaining ectopic germinal center-like structures that support tumor survival and proliferation.^[57] Similarly, in MALT lymphoma, especially Helicobacter pylori-associated gastric cases, transformed B blasts are the primary source of CXCL13, promoting lymphoid aggregate formation and B-cell recruitment to perpetuate the neoplastic niche.^[58]^[59] In solid tumors, CXCL13 often drives immunosuppressive environments by recruiting regulatory T cells (Tregs). In breast cancer, tumor-derived CXCL13 attracts CXCR5+ Tregs, which suppress cytotoxic T-cell activity and correlate with poor outcomes in certain subtypes.^[54]^[60] In prostate cancer, CXCL13 facilitates B-cell infiltration that indirectly supports Treg expansion via lymphotoxin signaling, enhancing castration-resistant progression.^[58] Additionally, elevated CXCL13 expression serves as a prognostic marker in lung adenocarcinoma, where high levels are associated with advanced disease and variable immunotherapy responses, reflecting its role in modulating the tumor immune landscape.^[54] The dual function of CXCL13 is exemplified by its promotion of TLS, which can enhance anti-tumor immunity in contexts like melanoma. In melanoma, CXCL13 expression by tumor-associated fibroblasts and immune cells drives TLS formation, recruiting effector T cells and B cells to bolster local anti-tumor responses and improve survival.^[61] This contrasts with its pro-tumor effects in other settings, highlighting context-dependent signaling via the CXCL13/CXCR5 axis.^[55] Serum CXCL13 levels are elevated in non-Hodgkin lymphoma (NHL) and correlate with disease stage and prognosis. Higher circulating CXCL13 is observed in advanced NHL, including diffuse large B-cell lymphoma, where it reflects tumor burden and predicts poorer overall survival, independent of other prognostic scores.^[62]^[54]

Other conditions

CXCL13 is upregulated in chronic infections such as HIV, where plasma levels increase with disease progression and correlate with B-cell activation, enhancing immune responses through recruitment of B cells to lymphoid tissues.^[63] In Lyme disease, particularly neuroborreliosis, cerebrospinal fluid (CSF) CXCL13 levels are markedly elevated during acute infection, serving as a sensitive biomarker for diagnosis with high specificity for active disease.^[64] This elevation supports B-cell aggregation and antibody production in response to Borrelia burgdorferi, aiding in the containment of persistent infection.^[65] In neurological disorders, CXCL13 concentrations are raised in the CSF of patients with multiple sclerosis, reflecting B-cell involvement in central nervous system inflammation, though this overlaps with autoimmune processes.^[47] Beyond autoimmune contexts, CSF CXCL13 is significantly higher in neuromyelitis optica spectrum disorder, where levels correlate with disease activity and relapse rates, indicating its role in driving pathogenic B-cell responses.^[66] In amyotrophic lateral sclerosis, CXCL13 and its receptor CXCR5 are upregulated in motor neurons, exerting a protective effect by attenuating neuroinflammation and preserving neuronal integrity through autocrine signaling.^[67] Emerging therapeutic applications target the CXCL13-CXCR5 axis, with CXCR5 antagonists like PF-06835375, which completed phase 1 trials for autoimmune conditions including rheumatoid arthritis and systemic lupus erythematosus, currently under investigation in phase 2 clinical trials for primary immune thrombocytopenia (ITP) as of 2025, aiming to deplete CXCR5-positive B and follicular helper T cells to reduce ectopic lymphoid structures.^[68]^[69] Additionally, CXCL13 has shown promise as a vaccine adjuvant, enhancing germinal center formation and broad humoral immunity by recruiting B cells and T follicular helper cells, as demonstrated in preclinical models of rabies and other pathogens.^[70] As a biomarker, plasma CXCL13 levels in idiopathic multicentric Castleman disease predict germinal center hyperactivity and response to siltuximab therapy, with elevated concentrations indicating immune dysregulation and poorer prognosis if untreated.^[71]

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CXCL13 and Its Receptor CXCR5 in Cancer: Inflammation, Immune ...
Chemokines can be grouped into four classes based on the positioning of their N-terminal cysteine residues: CC, CXC, XC, and CX3C (8–11). The different ...
[57]
CXCL13, CCL21, and CXCL12 expression in salivary ... - PubMed
Apr 1, 2008 · Our findings suggest that in salivary gland MALT lymphoma the lymphoid CKs CXCL13 and CCL21 are directly implicated in the organization of ...
[58]
CXCL13-producing T FH cells link immune suppression ... - JCI Insight
Jun 2, 2017 · Ectopic CXCL13 expression is sufficient for recruiting B cells and inducing TLS formation in nonlymphoid tissues (13), while inhibiting ...Missing: promoter methylation
[59]
Role of Tertiary Lymphoid Structures (TLS) in Anti-Tumor Immunity
In IR+ tumors, expression of transcription factors such as the interferon regulatory factors (IRFs), NF-κB and STAT molecules regulate TLS-inducing cytokines ...1. Introduction · 1.3. A Role For Tls In... · 1.3. 1. Breast Cancer
[60]
The serum CXCL13 level is associated with the Glasgow Prognostic ...
May 14, 2015 · (A, B) High CXCL13 levels are associated with lower overall survival among patients with non-detectable EBV titers and stage I/II disease.
[61]
CXCL13 as a Biomarker of Immune Activation During Early and ...
Feb 21, 2019 · Conclusion: Plasma CXCL13 levels increased with HIV disease progression. Early initiation of ART reduces plasma CXCL13 and B cell activation ...
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CXCL13: a biomarker for acute Lyme neuroborreliosis - PubMed
The level of CXCL13 is a cerebrospinal fluid (CSF) biomarker for acute Lyme neuroborreliosis (LNB) with a high sensitivity.
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Cerebrospinal fluid CXCL13 as a diagnostic marker of ...
Aug 31, 2017 · In the literature, CSF CXCL13 elevation was also demonstrated for other diseases such as chronic infections (HIV, neurosyphilis) and autoimmune ...
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Cerebrospinal fluid levels of CXCL13 are elevated in neuromyelitis ...
Dec 15, 2011 · CSF CXCL13 levels in NMO were notable higher than MS (p=0.015) and CTLs (p<0.001), and were related to the NMO disease activity indicated by relapse rate.
[65]
CXCL13/CXCR5 signalling is pivotal to preserve motor neurons in ...
We hypothesise that MNs activate CXCL13 signalling to attenuate CNS inflammation and prevent the neuromuscular denervation.
[66]
ab0511 a phase 1, randomised, double-blind, placebo-controlled ...
PF-06835375 is in development for autoimmune diseases through depletion of CXCR5-positive B and Tfh cells and antagonism of C-X-C motif chemokine ligand 13- ...
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CXCL13 promotes broad immune responses induced by circular ...
Oct 22, 2024 · This study demonstrates that CXCL13 based on the circRNA-tLNPs can provide broad immune stimulation in vaccines against multiple pathogens.Cxcl13 Induces Robust And... · Cxcl13 Enhances Protection... · Cxcl13 Enhances Both The...
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CXCL13 is a predictive biomarker in idiopathic multicentric ... - Nature
Nov 24, 2022 · Increased circulating levels of CXCL13 may indicate increased germinal center activity and/or immune dysregulation, but the clinical ...