This review systematically examines the structural and functional foundations of TLSs and dissects the mechanisms driving their formation in both autoimmune disorders and cancers, highlighting their potential as novel biomarkers and therapeutic targets and advancing the understanding of disease mechanisms and treatment approaches.
Abstract
Tertiary lymphoid structures (TLSs) are ectopic, organized immune aggregates forming in non‐lymphoid tissues during chronic inflammation. Resembling secondary lymphoid organs (SLOs) architecturally and functionally, TLSs feature specialized stromal networks and compartmentalized immune cell zones. In autoimmunity, TLSs can perpetuate local immune activation, autoantibody production, and tissue damage, correlating with disease severity and progression. In the tumor microenvironment, TLSs are generally associated with enhanced anti‐tumor immunity, improved patient survival, and better responses to immunotherapy, although their functional impact can vary across cancer types. This review systematically examines the structural and functional foundations of TLSs and dissects the mechanisms driving their formation in both autoimmune disorders and cancers. We critically evaluate the clinical correlations of TLSs with disease activity, progression, and patient outcomes. Furthermore, we summarize current methodologies for TLS detection and assess their diagnostic and prognostic utility in disease monitoring. Finally, we discuss emerging therapeutic strategies aimed at modulating TLSs formation or function. By synthesizing current knowledge, this review provides crucial insights into TLSs biology within autoimmunity and cancer, highlighting their potential as novel biomarkers and therapeutic targets, thereby advancing our understanding of disease mechanisms and treatment approaches.
Tertiary lymphoid structures (TLS) are ectopic lymphoid aggregates formed under chronic inflammatory tumor microenvironments. Clinical cohorts across solid cancers demonstrate that mature TLS with intact germinal centers serve as independent favorable prognostic biomarkers and predict superior responses to immune check...
Zhi-Chao Dou, Yu-Chao Shi, Kun Meng et al.· Molecular Biomedicine· 0 citations
The promise of non-immune components as rational targets for combination strategies to enhance TLS function and immunotherapy efficacy is discussed, suggesting that these structures function as emergent tissue ecosystems rather than as immune aggregates alone.
Owen K. Challen, Evelyn Fitzsimons, W. Anderson et al.· Frontiers in Immunology· 0 citations
Hepatocellular carcinoma (HCC) remains a leading cause of cancer-related mortality globally, with many patients presenting with advanced disease that does not respond to standard treatments. While immune checkpoint inhibitors (ICIs) have improved outcomes, their effectiveness is limited in immunologically "cold" tumors...
Mehriban Bazar, Ye Tian, Hai-Jing Luan et al.· Cancer Letters· 0 citations
Tertiary lymphoid structures (TLSs) are transient ectopic lymphoid-like structures potentiating the adaptive anti-tumor immunotherapy efficiency. They have been observed across diverse malignancies since they were initially found to correlate with favorable prognosis in non-small cell lung cancer. Importantly, TLSs cou...
Lin Yu, Hua-Long Liu, Xin-Yue Zha et al.· Biochimica et biophysica act...· 0 citations
Pancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal solid tumors and is largely refractory to current immunotherapy. Tertiary lymphoid structures (TLS), ectopic immune cell aggregates within the tumor microenvironment, have emerged as candidate biomarkers and therapeutic targets in this setting. This...
Tertiary lymphoid structures (TLSs) are associated with antitumor immunity and have prompted efforts to induce lymphoid organization within tumors. The central interpretive problem is whether the resulting tissue changes contribute to treatment benefit or accompany effects mediated by other cells. Building on establish...
Li Xiao, Hong-Bo Qiu, Hong-Li Luo· Frontiers in Immunology· 0 citations
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