Tertiary lymphoid structures support the development of allergen-specific progenitor CD4+ T cells

Tissue-resident memory CD4+ T cells (TRM) are key sentinels of the adaptive immune response that provide a rapid, robust inflammatory response upon reactivation in non-lymphoid tissues. While CD4+ TRM are highly protective during reinfections or tumor growth, they are also critical mediators of autoimmunity and allergic disease. Using transcriptional analysis and flow cytometry we profiled the heterogeneity of allergen-specific CD4+ TRM in the lungs following house dust mite exposure and observe two distinct populations of cells: a proinflammatory Th2 lineage and a progenitor TCF1+ lineage that can repopulate the Th2 branch. Confocal microscopy revealed that these two subsets occupied distinct anatomical niches in the inflamed lungs, with Th2 cells localized to the airways while TCF1+ cells localized within pulmonary tertiary lymphoid structures (TLS). Spatial transcriptomics affirmed the TLS as a tissue progenitor niche and highlight the transcriptional progression from progenitor to Th2 cell reflected in the TLS:airway axis. Manipulations to promote or ablate TLS development resulted in increased or decreased TCF1 expression among allergen-specific T cells, respectively. Finally, we identify the PD1 pathway as a critical signal localized to the TLS core and demonstrate that TCF1+ cells in the TLS are responsive to anti-PD1 treatment. Together, these data shape our understanding of tissue CD4+ T cell responses across space and time and highlight TLS as a critical therapeutic target that promotes the propagation of chronic inflammatory diseases.