Microfluidic Model of Necrotizing Enterocolitis Incorporating Human Neonatal Intestinal Enteroids and a Dysbiotic Microbiome

Summary

This protocol describes an in vitro model of necrotizing enterocolitis (NEC), which can be used for mechanistic studies into disease pathogenesis. It features a microfluidic chip seeded with intestinal enteroids derived from the human neonatal intestine, endothelial cells, and the intestinal microbiome of a neonate with severe NEC.

Abstract

Necrotizing enterocolitis (NEC) is a severe and potentially fatal intestinal disease that has been difficult to study due to its complex pathogenesis, which remains incompletely understood. The pathophysiology of NEC includes disruption of intestinal tight junctions, increased gut barrier permeability, epithelial cell death, microbial dysbiosis, and dysregulated inflammation. Traditional tools to study NEC include animal models, cell lines, and human or mouse intestinal organoids. While studies using those model systems have improved the field's understanding of disease pathophysiology, their ability to recapitulate the complexity of human NEC is limited. An improved in vitro model of NEC using microfluidic technology, named NEC-on-a-chip, has now been developed. The NEC-on-a-chip model consists of a microfluidic device seeded with intestinal enteroids derived from a preterm neonate, co-cultured with human endothelial cells and the microbiome from an infant with severe NEC. This model is a valuable tool for mechanistic studies into the pathophysiology of NEC and a new resource for drug discovery testing for neonatal intestinal diseases. In this manuscript, a detailed description of the NEC-on-a-chip model will be provided.

Introduction

Necrotizing enterocolitis (NEC) affects preterm infants, with an incidence of up to 10% in those born weighing < 1500 g¹. The pathophysiology of NEC is complex and includes damage to the intestinal epithelium, disruption of intestinal tight junctions, increased gut barrier permeability, immune dysregulation, and epithelial cell death^2,3. Our understanding of the mechanisms involved in the pathogenesis of NEC remains incomplete, and despite decades of research, there are still no effective targeted therapies.

A significant barrier to advancing NEC research....

Protocol

Enteroids were derived from small intestinal samples from premature infants (born at 22 to 36 weeks gestation) obtained at the time of surgery for NEC or other intestinal conditions with non-inflammatory etiologies. All specimen collection and processing was performed after informed consent and approval from the Institutional Review Boards at Washington University in St. Louis (IRB Protocol numbers 201706182 and 201804040) and the University of North Carolina at Chapel Hill (IRB protocol number 21-3134).

Discussion

This NEC-on-a-chip system is a powerful new tool that can be used to model the pathophysiology of NEC. This platform provides a complex microenvironment that more closely resembles the in vivo intestinal milieu than previous models by incorporating a co-culture system with continuous luminal flow and stretch. These conditions promote the development of 3D villus-like architecture lined by a highly polarized epithelium consisting of mature epithelial sub-types and tight junctions (Figure 2

Materials

Name	Company	Catalog Number	Comments
[Leu15]-Gastrin I human	Sigma-Aldrich	G9145
A 83-01	Sigma-Aldrich	SML0788
Advanced Dulbecco's Modified Eagle Medium/Ham's F-12	Gibco	12634010
B-27 Supplement, serum free (50x)	Gibco	17504044
Basic Bio-kit	Emulate	N/A
BioTek Synergy 2 Multi-Mode Microplate Reader	Agilent	7131000
BRAND Methacrylate (PMMA) Cuvettes, Semi-Micro	BrandTech	759085D
Cell Recovery Solution	Corning	354270
CFX Opus Real-Time PCR Systems	Bio-Rad	12011319
Chip Cradle	Emulate	N/A
Chip-S1 Stretchable Chip	Emulate	N/A
CHIR99021	Sigma-Aldrich	SML1046
Clear TC-treated Multiple Well Plates,  48 well	Corning	3548
Collagen from human placenta	Sigma-Aldrich	C5533
Collagenase, Type I, powder	Gibco	17018029
Complete Human Endothelial Cell Medium with Kit	Cell Biologics	H-1168
Conical Polypropylene Centrifuge Tubes, 15 mL	Fisher Scientific	05-539-12
Conical Polypropylene Centrifuge Tubes, 50mL	Fisher Scientific	05-539-8
Countess Cell Counting Chamber Slides	Invitrogen	C10283
Countess II automated cell counter	Invitrogen	AMQAX1000
DAPI (4',6-Diamidino-2-Phenylindole, Dilactate)	Invitrogen	D3571
DAPT	Sigma-Aldrich	D5942
Dextran, Cascade Blue, 3000 MW, Anionic, Lysine Fixable	Invitrogen	D7132	Permeability dye
Dimethyl sulfoxide (DMSO)	Sigma-Aldrich	D8418
Disposable PES Filter Units, 0.2um aPES membrane	Fisher Scientific	FB12566504
DMEM/F-12	Gibco	11320033
Donkey serum	Sigma-Aldrich	D9663
Dulbecco′s Modified Eagle′s Medium - high glucose	Sigma-Aldrich	D5796
Dulbecco′s Phosphate Buffered Saline (DPBS)	Gibco	14190-136
EDTA, 0.5 M,  pH 8.0	Corning	46-034-CI
ER-1 surface activation reagent	Emulate	ER-1	Chip Activation Reagent 1
ER-2 surface activation reagent	Emulate	ER-2	Chip Activation Reagent 2
Fibronectin Human Protein, Plasma	Gibco	33016015
Fisherbrand Petri Dishes with Clear Lid, 100mm	Fisher Scientific	FB0875713
Gelatin-Based Coating Solution	Cell Biologics	6950
Genie Temp-Shaker 300	Scientific Industries, Inc.	SI-G300
Gentamicin	Gibco	15750060
HEPES, Liquid 1M Solution (238.3 mg/ mL)	Corning	25-060-CI
Hoechst 33342, Trihydrochloride, Trihydrate	Invitrogen	H3570
Human Collagen Type I	Sigma-Aldrich	CC050
Human Primary Small Intestinal Microvascular Endothelial Cells	Cell Biologics	H-6054
Inverted Microscope	Fisher Scientific	03-000-013
Isotemp General Purpose Deluxe Water Baths	Fisher Scientific	FSGPD10
L-Glutamine	Gibco	25030-081
Luria Broth (LB) agar, Miller	Supelco	L3027
L-WRN Cells	American Type Culture Collection	CRL-3276
Matrigel Growth Factor Reduced Basement Membrane Matrix, LDEV-free	Corning	356231	Cell Culture Matrix
N-2 Supplement (100x)	Gibco	17502048
N-acetyl-L-cysteine	Sigma-Aldrich	1009005
NAILSTAR UV LAMP	NailStar	NS-01-US
NanoDrop OneC Microvolume UV-Vis Spectrophotometer	Thermo Scientific	840-274200
Nicotinamide	Sigma-Aldrich	72340
Orb-HM1 Hub Module	Emulate	N/A
Paraformaldehyde	ThermoFisher	047392.9L
Penicillin-Streptomycin	Gibco	15140122
Phosphate buffered saline (PBS)	Gibco	10010023
Pipet-Lite Multi Pipette L8-200XLS+	Rainin	17013805
Pipette Tips TR LTS 1000µL S 768A/8	Rainin	17014966
Pod Portable Module	Emulate	N/A
Premium Grade Fetal Bovine Serum (FBS)(Heat Inactivated)	Avantor Seradigm	1500-500
QuantiTect Reverse Transcription Kit	QIAGEN	205313
Recombinant Murine Epidermal Growth Factor (EGF)	PeproTech	315-09
SB 431542	Tocris	1614
Square BioAssay Dish with Handles, not TC-treated	Corning	431111
SsoAdvanced Universal SYBR Green Supermix	Bio-Rad	1725271
Steriflip-GV Sterile Centrifuge Tube Top Filter Unit	Millipore	SE1M179M6
Sterile Cell Strainers, 70um	Fisher Scientific	22-363-548
Sterile Syringes, 10mL	Fisher Scientific	14-955-453
Straight, fine, sharp point scissors	Miltex Instruments	MH5-300
Thermo Scientific Sorvall X4R Pro-MD Centrifuge	Thermo Scientific	75016052
Triton X-100	Sigma-Aldrich	T8787	Detergent
TRIzol Reagent	Invitrogen	15596026	RNA extraction reagent
Trypan Blue Solution, 0.4% (w/v) in PBS, pH 7.5 ± 0.5	Corning	25-900-CI
TrypLE Express Enzyme (1X), no phenol red	Gibco	12604013	Enzymatic Dissociation Reagent
Trypsin-EDTA solution	Sigma-Aldrich	T4174
VIOS 160i CO2 Incubator, 165 L	Thermo Scientific	13-998-252
Y-27632	Tocris	1254
Zoë-CM1 Culture Module	Emulate	N/A