A tissue multiplexing approach to maximize spatial omics output from pathology specimens

Spatial profiling technologies are revolutionising traditional research by enabling whole transcriptome and high-plex protein in situ analysis at scale. Profiling tissue microarrays permits multiple specimens to be analysed at once, but depending upon your research question, these are not widely applicable. Since diagnostic specimens retrieved from pathology laboratories cannot be altered (aside from sectioning) for ethico-legal reasons, this method introduces an approach in which multiple patient specimens, sectioned from individual tissue blocks, are combined to enable measurement of several tissues within a single capture array. This strategy provides a cost-effective means to increase sample size, permitting statistically robust data outputs, and fast-tracks clinical implementation. Importantly, our tissue multiplexing method is compatible with the standard protocols of multiple spatial platforms, including Visium CytAssist (and HD), Xenium in situ , GeoMx, CosMx, PhenoCycler-Fusion, and MERSCOPE. We have used skin biopsies in this study as this is our primary area of research, but this method can be extended to any tissue of interest.