The Stereo-seq protocol is highly detailed and involves several critical steps that require precision, timing, and a clean environment to ensure success especially with microbiome or non-host profiling that may require specific precautions.
The use of nuclease free water during all steps is required, and the capture chip must not be touched with anything other than the sample and reagents. Exercise extreme caution when using the cassette assembly, taking time to utilize practice chips. A scratch on the tissue area will ruin tissue spatial resolution, and a scratch on the track lines can likely prevent the spatial resolution or the sample from being automatically aligned. Further, for high RNase/DNase tissues such as pancreatic or liver, changes of water during sectioning are recommended. Additionally, to maintain RNA quality it is suggested to store FFPE tissue blocks with a small amount of wax-seal on the face, at 4 °C, and in a desiccator to prevent degradation. If stored this way, the samples will still need to be rehydrated on the surface and equilibrated to cutting room temperature before using25,26,27. The cutting room should be at 22 to 25 °C. Furthermore, the samples best suited for Stereo-seq are ones with a DV200 score of higher than 50, but scores with DV200 over 30 may also be sequenced with limited results. If microbiome is of interest, it is best practice to not reuse any materials and only use fresh reagents, wear masks, and keep areas clean if not sterile for the whole process.
For single-cell resolution and cellular binning (cellbin), imaging of the cell nuclei with ssDNA dye is required. However, the concentration of this dye is camera-specific, and dependent on the dynamic range that can be imaged by the system. This requires titration and testing of dye concentrations for each new device, typically a 1:2 to 1:10 dilution of the ssDNA dye from manufacturer recommendations. During imaging, it is recommended to manually focus on 3-5 areas without tissue and 4-6 areas with tissue; however, most consistent results occurred using a 13-point setup to ensure quality control with clear cellular focus, as both the track lines and tissue must be found in the focal depth.
Certain reagents are more sensitive to timing than others. Specifically, the permeabilization reagent must be resuspended in a 0.01 N HCl solution (pH 2.0 +/- 0.1). Store the aliquoted 10x PR solution to avoid degradation from freeze-thaw cycles. Timing varies by tissue type, with thicker sections requiring between 15 and 30 min when embedded in soft paraffin. Handle chips carefully post-permeabilization to avoid damage, diffusion, and artifacts from disturbing the chip/tissue surface. The sequencing strategy for the library barcode mix is a very important pooling strategy for sequencing and multiplexing. If sequencing a single sample on a single lane, it is easiest to just use a barcode set (BC1-4, BC5-8, BC9-12, or BC13-16). Other strategies are detailed in the manufacturer's handbook.
The addition of a ceramic resin sealant around the chip can help prevent xylene's penetration of the adhesive that seals the chip to the slide (Figure 2A-C). In addition, the use of poly-L-Lysine is recommended for high fatty tissues and fragile tissues, but may lead to issues with capture due to residues from the PLL drying processes (Figure 2D-E). As such, it is not recommended for all tissues. To reduce reagents, utilize a silicone chamber (Figure 2F-H), which decreases the volume from 30 mL to 500 µL of reagent needed, specifically for microbiome work, which requires fresh reagents for each slide. It is recommended to do additional filtration of reagents when trying to capture microbiome data. Further, utilizing sealed ethanol that is only accessed via a needle/syringe will provide cleaner reactions than ethanol that is open to the air. SPRI beads concentration can be modified by decreasing the concentration to select longer fragments, but this will reduce the overall yield. This protocol was modified on the SPRI bead steps to have a more consistent yield by warming the beads to (~30 °C) and using double elution to increase yield consistency.
Stereo-seq is currently one of the highest resolutions with the largest capture areas for sequencing-based spatial transcriptomics (SST) methods. It offers nanoscale resolution (200 nm nanoball spot size with center-to-center distance of 500 nm), species-agnostic capture, and a large field of view (up to 13 cm x 13 cm). By comparison, Slide-seq V2 achieves ~10 µm resolution with high sensitivity (~50% RNA capture efficiency) but is limited by smaller capture areas with bead-based barcoding24. Similarly, probe based whole transcriptome capture methods and spatial transcriptomics A'tailling capture method provided robust whole mRNA transcriptome profiling using A-tailing capture, but at a much lower resolution (55 µm spot size with center-to-center distance of 100 µm), requiring computational methods to deconvolute the cell mixtures per spot. The newer whole genome probe-based capture methods have improved resolution of 2 µm tiles (recommending 8 µm x 8 µm) and rely on species-specific probe panels mostly focused on protein coding genes; however, the method tends to be more robust and less finicky. Another SST method, DBiT-seq, uses microfluidics-based spatial barcoding to achieve ~10 µm near single-cell resolution with flexibility in experimental design, but lacks the nanoscale precision and scalability of Stereo-seq28. Other cellular-level resolution SST platforms with cellular dissociation are the easiest to combine with single-cell sequencing data, but this method has many of the disadvantages of single-cell sequencing due to its methodology of disaggregation, filtering, and profiling using single-cell RNA methods. Lastly, Slide-tag (10 µm resolution) is more cost-effective but currently does not match Stereo-seq's nanoscale capabilities28.
Aside from SST methods, probe-based methods excel in targeted transcript detection with high sensitivity but are limited to predefined probes, although some have expanded to up to 5,000 probes panels29,30,31. Still, Stereo-seq provides unbiased whole-transcriptome analysis limited to SST methods28,32. Imaging-based methods33,34 achieve single-molecule or single-cell resolution but are constrained by multiplexing limits and imaging throughput. Overall, Stereo-seq is a labor-intensive process, including multiple time-sensitive steps that are extremely influenced by the hands of the operator for the duration of the multiday protocol. The protocol capture rate for each individual space will not be as sensitive as target probe-based methods or imaging methods, but offers unparalleled resolution and unbiased capture in untargeted spatial transcriptomics, as highlighted by its species-agnostic capture ability. The protocol involves a multi-day workflow with numerous steps critical steps, including tissue preparation for sectioning and adhesion, deparaffination, rehydration and staining of the tissue before time-sensitive fluorescent imaging, followed time and pH sensitive by tissue permeabilization, RNA capture, in situ RNA amplification, cDNA release, clean up and amplification, and lastly by library preparation. All of which require meticulous attention, and unique technical skills often best performed by different people, each with detail and precise timing to ensure high-quality results. Many of these steps are highly time-sensitive, particularly tissue permeabilization, RNA capture and enzymatic reactions, where delays or deviations can lead to RNA degradation or loss of spatial resolution. In addition, after permeabilization, there is an increased chance of diffusion the more the slide is moved. Lastly, while library preparation itself does not demand extensive or specialized equipment, relying primarily on standard laboratory tools such as thermocyclers, pipettes, and magnetic racks for bead purification, it still requires an experienced operator to prevent RNA loss, PCR bubbles, or drying during amplification, and understanding of the issues such as uneven amplification, tissue sectioning artifacts, or contamination. This reliance on skilled personnel adds to the complexity of the protocol.