B cells and tertiary lymphoid organs in renal inflammation

B lymphocytes are part of the inflammatory cells recruited to the human kidney in various disease settings. B cell infiltrates have been described in renal allografts, in acute and chronic interstitial nephritis, and the most common glomerular diseases like immunoglobulin A (IgA) and membranous nephropathy. These cells are almost exclusively recruited to the tubulointerstitium, but not the glomerular tuft. In addition to diffuse tubulointerstitial infiltrates, B cells together with T cells and dendritic cells form organized nodular aggregates surrounded by neo-lymphatic vessels. The functional significance of these tertiary lymphoid organs remains to be fully defined. Intrarenal B cells may be part of a local system to enhance the immunological response by functioning as antigen presenting cells, and as a source for cytokines promoting T-cell proliferation and lymphatic neoangiogenesis. In this way, they could enhance the local immune response to persisting autoantigens in the tubulointerstitium.