Global research landscape and emerging trends of tertiary lymphoid structures in autoimmune diseases: a bibliometric analysis.

Background: Tertiary lymphoid structures (TLSs) are increasingly regarded as important local immune niches in chronic inflammation and autoimmunity. However, a focused bibliometric overview of TLS research in autoimmune diseases is still lacking. Methods: Publications on TLSs in autoimmune diseases published between 2006 and 2025 were retrieved from the Web of Science Core Collection and Scopus databases. After screening and deduplication, the eligible records were analyzed using Bibliometrix/Biblioshiny, VOSviewer, and CiteSpace to assess publication trends, collaboration patterns, co-citation networks, keyword clustering, and thematic evolution. Results: A total of 479 publications were included. Annual output showed an overall upward trend, indicating sustained interest in this field. The United States occupied a central position in the international collaboration network, while several European countries also made important contributions. Rheumatoid arthritis, Sjögren's syndrome, systemic lupus erythematosus/lupus nephritis, and myasthenia gravis emerged as the major disease contexts of TLS research. The field evolved from early attention to lymphoid neogenesis, chemokine-mediated tissue organization, and ectopic germinal center-like responses toward local B-cell hyperactivity, disease-specific immune microenvironments, and clinical heterogeneity. Recent frontiers include T follicular helper/peripheral helper T-cell axes, stromal remodeling, fibroblast-associated immune organization, disease subsets, and single-cell/spatial omics approaches. Conclusion: TLS research in autoimmune diseases has evolved from structural recognition toward functional interpretation, disease stratification, and translational exploration. Further studies integrating mechanistic investigation with clinical stratification are needed to clarify the translational relevance of TLSs in precision medicine.