Pilot spatial transcriptomics of dental pulpitis suggests immune-fibroblast profiling linked to reversibility

Area of Science:

• Dental research
• Molecular biology
• Immunology

Background:

• Current endodontic diagnostics rely on subjective assessments, potentially misclassifying pulpitis (reversible vs. irreversible).
• This can lead to overtreatment, missing opportunities for conservative, pulp-preserving therapies.
• Spatial transcriptomics offers a novel approach to analyze pulp tissue heterogeneity.

Purpose of the Study:

• To investigate spatial transcriptomic variations in healthy, reversible pulpitis (RP), and irreversible pulpitis (IP) dental pulp.
• To identify immune and fibroblast markers distinguishing RP-like from IP-like molecular profiles.

Main Methods:

• Spatial transcriptomics (Visium-CytAssist-V2) was applied to four human dental pulp samples.
• Cell deconvolution, differential gene expression, and pathway analysis characterized gene-expression patterns.
• Focus was placed on coronal regions near carious lesions.

Main Results:

• One IP sample showed RP-like transcriptomic features, including immune-to-fibroblast ratio and pathway activation.
• IP samples displayed differential expression of genes in immune signaling, cell migration, and remodeling.
• Candidate markers for RP-like profiles included increased PTN and CXCL14, with decreased ENG, SELE, COL4A1, CXCL1, and CXCL13.

Conclusions:

• Spatial transcriptomics reveals significant molecular heterogeneity in clinically diagnosed pulpitis.
• Clinical diagnoses may not consistently reflect the underlying transcriptomic state.
• Further validation of identified immune-fibroblast features could improve pulpitis classification and support pulp-preserving strategies.