A new study by Bernhard Dumoulin, Katalin Susztak and colleagues provides insights into the spatial organization of cells in diabetic kidney disease (DKD) and identifies a tertiary lymphoid structure (TLS)-like immune microenvironment that is associated with disease progression.

“The fundamental challenge driving our research is that DKD is both biologically and mechanistically heterogeneous,” explains Dumoulin. “Without knowing which cell types are doing what, and where, within kidney tissue, it is very difficult to design targeted therapies. Bulk RNA sequencing, single-nucleus RNA sequencing and traditional histopathology obscure cell-specific changes, strip away spatial context and lack molecular resolution, respectively. By contrast, next-generation single-cell spatial transcriptomics platforms make it possible to identify the type, state and neighbours of any given cell within intact tissue.”