Identification and characterisation of tertiary lymphoid organs in human type 1 diabetes – published online 29/04/2021

Éva Korpos, Nadir Kadri, Sophie Loismann, Clais R. Findeisen, Frank Arfuso, George W. Burke III, Sarah J. Richardson, Noel G. Morgan, Marika Bogdani, Alberto Pugliese, Lydia Sorokin

Tertiary lymphoid organs (TLOs) show structural and functional similarities to secondary lymphoid organs. They form in non-lymphoid tissues to generate local immune responses during chronic infection, autoimmunity and cancer. In this issue, Korpos et al (https://doi.org/10.1007/s00125-021-05453-z) show the presence of TLOs in the pancreas of individuals with ongoing islet autoimmunity in three distinct clinical settings of type 1 diabetes: (1) at risk of diabetes (autoantibody positive); (2) at/after diagnosis; and (3) in the transplanted pancreas with recurrent diabetes. The authors report that pancreatic TLOs in humans with type 1 diabetes and mouse models of type 1 diabetes are structurally and molecularly similar, exhibiting high endothelial venule formation, a biochemically similar reticular fibre network, fibroblastic reticular cells and T and B cells. TLOs were mostly associated with insulin-positive islets containing immune cell aggregates. Based on these findings, the authors suggest that TLOs are potential sites of autoreactive effector T cell generation in islet autoimmunity and may contribute to the progression of disease.

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