Stereo-seq V2: Spatial mapping of total RNA on FFPE sections with high resolution

Cell. 2025 Nov 13;188(23):6554-6571.e21. doi: 10.1016/j.cell.2025.08.008. Epub 2025 Aug 28.

Abstract

Performing total RNA profiling on formalin-fixed, paraffin-embedded (FFPE) samples, the predominant sample conservation method in clinical practice, remains challenging for current spatial transcriptomics techniques. Here, we introduce Stereo-seq V2, which employs random primers to capture and sequence RNAs in situ on FFPE sections and provides single-cell resolution. The random-priming-based strategy offers unbiased transcript capturing and uniform gene body coverage, which increase the sensitivity to marker genes, the efficiency of non-polyadenylation (poly(A)) RNA profiling, and immune repertoire coverage. We demonstrated the robust performance of Stereo-seq V2 on clinical FFPE samples using triple-negative breast cancer (TNBC) sections and identified tumor-specific alternative splicing events. In a Mycobacterium tuberculosis (Mtb)-infected mouse model, we monitored gene expression dynamics of host and pathogen transcriptomes simultaneously by utilizing Stereo-seq V2. We also assembled immune repertoires and identified Mtb-specific BCR clones, which could also be observed in human tuberculous lung samples. These results highlight Stereo-seq V2's potential in biomedical research and personalized medicine.

Keywords: clinical FFPE tisues; full-length gene body coverage; random primer; spatial immune repertoire; spatial transcriptomics; total RNA; tuberculosis.

MeSH terms

  • Alternative Splicing
  • Animals
  • Female
  • Formaldehyde / chemistry
  • Gene Expression Profiling* / methods
  • Humans
  • Mice
  • Mycobacterium tuberculosis
  • Paraffin Embedding / methods
  • RNA* / analysis
  • RNA* / genetics
  • Sequence Analysis, RNA* / methods
  • Tissue Fixation
  • Transcriptome / genetics
  • Triple Negative Breast Neoplasms / genetics
  • Triple Negative Breast Neoplasms / pathology
  • Tuberculosis / genetics
  • Tuberculosis / microbiology

Substances

  • Formaldehyde
  • RNA