The formation and function of tertiary lymphoid follicles in chronic pulmonary inflammation

Immunology. 2016 Nov;149(3):262-269. doi: 10.1111/imm.12649. Epub 2016 Aug 16.


Tertiary lymphoid follicles (TLFs) can develop in the respiratory tract in response to infections or chronic inflammation. However, their functional relevance remains unclear because they are implicated in both protective and pathological responses. In contrast to homeostatic conditions, external antigens and damage to the lung tissue may drive TLF formation in inflamed lungs, and once established, the presence of pulmonary TLFs may signal the progression of chronic lung disease. This novel concept will be discussed in light of recent work in chronic obstructive pulmonary disease and how changes in the pulmonary microbiota may drive and direct TLF formation and function. We will also discuss the cellularity of TLFs at the pulmonary mucosa, with emphasis on the potential roles of lymphoid tissue inducer cells, and B- and T-cell aggregates, and will examine the function of key chemokines and cytokines including CXCL13 and interleukin-17, in the formation and maintenance of pulmonary TLFs.

Keywords: B cells; inflammation; lung; lymphoid follicles.

Publication types

  • Review

MeSH terms

  • Animals
  • B-Lymphocytes / immunology*
  • Chemokine CXCL13 / metabolism
  • Chronic Disease
  • Humans
  • Interleukin-17 / metabolism
  • Microbiota / immunology*
  • Pneumonia / immunology*
  • Pulmonary Disease, Chronic Obstructive / immunology*
  • Respiratory Mucosa / immunology*
  • Respiratory Mucosa / microbiology
  • T-Lymphocytes / immunology*
  • Tertiary Lymphoid Structures / immunology*
  • Tertiary Lymphoid Structures / microbiology


  • Chemokine CXCL13
  • Interleukin-17