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Posttransplant Tertiary Lymphoid Organs.

Nancy H Ruddle1

  • 1Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT.

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Summary
This summary is machine-generated.

Tertiary lymphoid organs (TLOs) form during chronic inflammation and are key in organ transplant rejection and tolerance. This review details their characteristics, induction, and therapeutic potential.

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Area of Science:

  • Immunology
  • Transplantation Biology
  • Pathology

Background:

  • Tertiary lymphoid organs (TLOs), or ectopic lymphoid structures, are immune cell aggregates forming outside canonical lymphoid organs during chronic inflammation.
  • They arise via lymphoid neogenesis in conditions including autoimmunity, infection, cancer, aging, and transplantation.
  • This review focuses on TLOs in the context of organ transplantation, termed posttransplant TLOs (PT-TLOs).

Purpose of the Study:

  • To compare lymph nodes and TLOs regarding cellularity, organization, vasculature, and signaling.
  • To describe PT-TLO characteristics across various organs and species.
  • To explore the role of PT-TLOs in transplant rejection, tolerance, and cancer.

Main Methods:

  • Comparative analysis of lymphoid structures.
  • Review of existing literature on PT-TLOs in diverse organs (heart, kidney, lung, etc.) and species (human, mouse, etc.).
  • Examination of factors influencing TLO induction and maintenance.

Main Results:

  • PT-TLOs share organizational and cellular features with lymph nodes but arise ectopically.
  • Induction requires sustained antigen exposure (allo-, auto-, tumor-), ischemia, or aging.
  • PT-TLOs are primarily linked to organ rejection but can promote tolerance; their role in cancer and lymphoma development is also noted.

Conclusions:

  • PT-TLOs are dynamic structures with complex roles in transplantation, influencing both rejection and tolerance.
  • Understanding PT-TLOs offers therapeutic opportunities to modulate transplant outcomes.
  • Further research is needed for standardized staging, imaging, and therapeutic targeting of PT-TLOs.