Highly Multiplexed Immunofluorescence of the Human Kidney using Co-Detection by Indexing (CODEX)

The human kidney is composed of many cell types that vary in their abundance and distribution from organ to organ. As these cell types perform unique and essential functions, it is important to confidently label each within a single tissue to more accurately assess tissue architecture. Towards this goal, we demonstrate the use of co-detection by indexing (CODEX) multiplexed immunofluorescence for visualizing 23 antigens within the human kidney. Using CODEX, all the major cell types and substructures, such as collecting ducts, glomeruli, and thick ascending limb, were visualized within a single tissue section. Of these antibodies, 19 were conjugated in-house, demonstrating the flexibility and utility of this approach for studying the human kidney using traditional antibody markers. We performed a pilot study showing that the studied tissues had on average 84 {+/-} 11 cells per mm2 with the most variance seen within the cells containing vimentin and aquaporin 1, while cells containing -smooth muscle actin and CD31 possessed a high degree of uniformity between the samples. These precursory data show the power of CODEX multiplexed IF for surveying the cellular diversity of the human kidney and have potential applications within pathology, histology, and building anatomical atlases.