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Tertiary lymphoid structures and B-cell infiltration are IPF features with functional consequences
Elisabetta Cocconcelli1, Elisabetta Balestro1, Graziella Turato1
1Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy.
Frontiers in Immunology
|October 28, 2024
Summary
Tertiary lymphoid structures (TLS) and B cells are present in idiopathic pulmonary fibrosis (IPF) from the disease's onset. TLS activity correlates with disease progression, indicating their role in IPF mechanisms.
Area of Science:
- Immunology
- Pulmonology
- Pathology
Background:
- Idiopathic pulmonary fibrosis (IPF) literature suggests B cell and autoantibody presence, implying tertiary lymphoid structures (TLS) formation.
- However, TLS are not traditionally recognized as a histological feature of IPF.
Purpose of the Study:
- To quantify TLS presence, size, and activation in early and late-stage IPF lungs.
- To correlate TLS characteristics with clinical course, disease progression, and lung inflammation in IPF patients.
Main Methods:
- Immunohistochemistry was used to analyze B cells and inflammatory cells (CD4, CD8, CD45) in lung tissue from IPF patients and controls.
- TLS activation was assessed via CD40 expression.
- Patients were categorized as slow or rapid progressors based on spirometry over follow-up.
Main Results:
- B cells and inflammatory cells were significantly higher in IPF patients compared to controls.
- TLS were found in all IPF patients (early and end-stage) and 50% of controls.
- TLS area and activation were greater in end-stage IPF than early IPF and controls.
- TLS activation score correlated with forced vital capacity (FVC) decline in rapid progressors.
Conclusions:
- B cell infiltration and TLS are integral to IPF from its early stages.
- TLS activity is linked to disease progression, specifically FVC decline in rapid progressors.
- TLS likely play a significant role in IPF pathogenesis and advancement.
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