Spatial Transcriptomics Reveals Injured Cells, Signature Genes, and Communication Patterns in the Cyst Microenvironment of Polycystic Kidney Disease.

BACKGROUND Changes in the cyst microenvironment in Polycystic Kidney Disease (PKD) may drive progressive cyst formation. Bulk- and single-cell RNA sequencing have advanced our understanding of altered signaling; however, the lack of spatial information has limited our insights into local gene expression and cellular communication near cysts. METHODS We used wild-type and Pkd1-deficient mouse kidneys to generate 10x Genomics Visium Spatial Gene Expression datasets. Utilizing our single-cell mouse kidney atlas and single cell sequencing data for spot deconvolution, we enhanced resolution and estimated enriched cell types. We analyzed spatial gene expression patterns and used a cyst-centered analysis to identify cyst-associated gene signature. Cell communication near cysts was investigated, identifying key ligand-receptors. Prioritized key factors were validated in tissues. RESULTS We observed enrichment of fibroblasts, injury-repair-related cell types, and diverse immune populations in PKD. Injury-repair-related cells were exclusively observed in PKD, predominantly localized within immune cell-dense regions near cysts. These cells collectively contributed to the altered gene expression profile in PKD, including cyst-associated signature genes related to inflammatory processes. Analysis of cellular communication in less-inflamed regions around cysts revealed the involvement of multiple cell types. Key ligand-receptor interactions were associated with cytokine signaling, fibrosis, cellular development, and repair. These included Angpt2, C3, Csf1, Cxcl12, Il34, Gas6, Il16, Mdk, Mif, Ptn, Sfrp2, Spp1, Sdc1, Tnc, Tnfsf12, Wnt5a. In addition, ECM proteins implicated in immune response, ECM remodeling, cell adhesion, and cell signaling were identified, such as Adam9, Adam10, Col1a1, Col3a1, Col4a2, Lamb2, Lamc1, Efnb1, Efnb2, Thbs1, Thbs2, and Vcam1. IHC confirmed expression of Syndecan-1-Collagen IV, Midkine-Integrin β1, CSF-1, Pleiotrophin, and Tenascin-C in cystic kidneys. CONCLUSIONS Spatial transcriptomics in PKD revealed enrichment of (myo)fibroblasts, immune, and injury-repair-related cells near cysts, creating a (pro)inflammatory and (pro)fibrotic niche. Key ligand-receptor and ECM interactions were identified and validated.