We thank Dr. Evan Jellison and Ms. Li Zhu in the flow cytometry core at UConn Health for their assistance with flow cytometry, Dr. Lynn Puddington in the Department of Immunology at UConn Health for her support of the instruments, Ms. Slawa Gajewska and Dr. Paul Appleton in the clinical research core at UConn Health for their help in obtaining blood samples. We acknowledge Dr. Christopher &#34;Kit&#34; Bonin and Dr. Geneva Hargis from UConn School of Medicine for their help with scientific writing and editing of this manuscript. This research was supported by grants from the National Institutes of Health, National Heart, Lung, and Blood Institute (R01HL145454), National Institute of General Medical Sciences (P20GM121176), USA, a Career Development Award from the American Heart Association (18CDA34110426), and a startup fund from UConn Health. Figure 1 was created with BioRender.com.

Heparinized whole-blood samples were obtained from de-identified healthy human donors after obtaining informed consent, as approved by the Institutional Review Board of UConn Health, following the principles of the Declaration of Helsinki. Informed consent was obtained from all donors. The inclusion/exclusion criteria for this study were carefully developed to ensure the suitability of participants and to minimize potential risks. Eligible participants were aged between 18 and 65 years, of any ethnicity, fluent in Englis...

Screening of ?2 Integrin Activation Inhibitors in Human Neutrophils

<ol>
	<li>Herrero-Cervera, A., Soehnlein, O., Kenne, E. Neutrophils in chronic inflammatory diseases. Cellular &#38; Molecular Immunology. 19 (2), 177-191 (2022).</li>
	<li>Sadik, C. D., Kim, N. D., Luster, A. D. Neutrophils cascading their way to inflammation. Trends in immunology. 32 (10), 452-460 (2011).</li>
	<li>Mitroulis, I. et al. Leukocyte integrins: Role in leukocyte recruitment and as therapeutic targets in inflammatory disease. Pharmacology &#38; Therapeutics. 147, 123-135 (2015).</li>
	<li>Slack, R. J., Macdonald, S. J. F., Roper, J. A., Jenkins, R. G., Hatley, R. J. D. Emerging therapeutic opportunities for integrin inhibitors. Nature Reviews Drug Discovery. 21 (1), 60-78 (2022).</li>
	<li>Frampton, J. E., Plosker, G. L. Efalizumab. American Journal of Clinical Dermatology. 10 (1), 51-72 (2009).</li>
	<li>Talamonti, M. et al. Efalizumab. Expert Opinion on Drug Safety. 10 (2), 239-251 (2011).</li>
	<li>Sariba&#351;, A. S., &#214;zdemir, A., Lam, C., Safak, M. JC virus-induced progressive multifocal leukoencephalopathy. Future Virology. 5 (3), 313-323 (2010).</li>
	<li>Chames, P., Van Regenmortel, M., Weiss, E., Baty, D. Therapeutic antibodies: successes, limitations and hopes for the future. British Journal of Pharmacology. 157 (2), 220-233 (2009).</li>
	<li>Mancuso, R. V., Casper, J., Schmidt, A. G., Kr&#228;henb&#252;hl, S., Weitz-Schmidt, G. Anti-&#945;L&#946;2 antibodies reveal novel endocytotic cross-modulatory functionality. British Journal of Pharmacology. 177 (12), 2696-2711 (2020).</li>
	<li>Anderson, J. M., Li, J., Springer, T. A. Regulation of integrin &#945;5&#946;1 conformational states and intrinsic affinities by metal ions and the ADMIDAS. Molecular Biology of the Cell. 33 (6), ar56 (2022).</li>
	<li>Jensen, R. K. et al. Complement receptor 3 forms a compact high-affinity complex with iC3b. The Journal of Immunology. 206 (12), 3032-3042 (2021).</li>
	<li>Li, J., Yan, J., Springer, T. A. Low affinity integrin states have faster ligand binding kinetics than the high affinity state. Elife. 10, e73359 (2021).</li>
	<li>Luo, B. H., Carman, C. V., Springer, T. A. Structural basis of integrin regulation and signaling. Annual Review of Immunology. 25, 619-647 (2007).</li>
	<li>Fan, Z. et al. Neutrophil recruitment limited by high-affinity bent &#946;2 integrin binding ligand in cis. Nature communications. 7 (1), 1-14 (2016).</li>
	<li>Fan, Z. et al. High-affinity bent &#946;2-integrin molecules in arresting neutrophils face each other through binding to ICAMs in cis. Cell reports. 26 (1), 119-130 (2019).</li>
	<li>Gupta, V. et al. The &#946;-tail domain (&#946;TD) regulates physiologic ligand binding to integrin CD11b/CD18. Blood. 109 (8), 3513-3520 (2006).</li>
	<li>Sen, M., Yuki, K., Springer, T. A. An internal ligand-bound, metastable state of a leukocyte integrin, &#945;X&#946;2. Journal of Cell Biology. 203 (4), 629-642 (2013).</li>
	<li>Sun, H., Hu, L., Fan, Z. &#946;2 integrin activation and signal transduction in leukocyte recruitment. American Journal of Physiology-Cell Physiology. 321 (2), C308-C316 (2021).</li>
	<li>Sun, H., Zhi, K., Hu, L., Fan, Z. The activation and regulation of &#946;2 integrins in phagocytes. Frontiers in Immunology. 12, 978 (2021).</li>
	<li>Kamata, T. et al. The role of the CPNKEKEC sequence in the &#946;2 subunit I domain in regulation of integrin &#945;L&#946;2 (LFA-1). The Journal of Immunology. 168 (5), 2296-2301 (2002).</li>
	<li>Lu, C., Shimaoka, M., Zang, Q., Takagi, J., Springer, T. A. Locking in alternate conformations of the integrin &#945;L&#946;2 I domain with disulfide bonds reveals functional relationships among integrin domains. Proceedings of the National Academy of Sciences. 98 (5), 2393-2398 (2001).</li>
	<li>Yang, W., Shimaoka, M., Chen, J., Springer, T. A. Activation of integrin &#946;-subunit I-like domains by one-turn C-terminal &#945;-helix deletions. Proceedings of the National Academy of Sciences. 101 (8), 2333-2338 (2004).</li>
	<li>Dransfield, I., Hogg, N. Regulated expression of Mg2+ binding epitope on leukocyte integrin alpha subunits. The EMBO Journal. 8 (12), 3759-3765 (1989).</li>
	<li>Torres, M., Hall, F., O&#39;neill, K. Stimulation of human neutrophils with formyl-methionyl-leucyl-phenylalanine induces tyrosine phosphorylation and activation of two distinct mitogen-activated protein-kinases. The Journal of Immunology. 150 (4), 1563-1577 (1993).</li>
	<li>Dorward, D. A. et al. The role of formylated peptides and formyl peptide receptor 1 in governing neutrophil function during acute inflammation. The American Journal of Pathology. 185 (5), 1172-1184 (2015).</li>
	<li>Lin, F. Y. et al. A general chemical principle for creating closure-stabilizing integrin inhibitors. Cell. 185 (19), 3533-3550 (2022).</li>
	<li>Lizcano, A. et al. Erythrocyte sialoglycoproteins engage Siglec-9 on neutrophils to suppress activation. Blood, The Journal of the American Society of Hematology. 129 (23), 3100-3110 (2017).</li>
	<li>Tadema, H., Abdulahad, W. H., Stegeman, C. A., Kallenberg, C. G., Heeringa, P. Increased expression of Toll-like receptors by monocytes and natural killer cells in ANCA-associated vasculitis. PloS One. 6 (9), e24315 (2011).</li>
	<li>Nagelkerke, S. Q., aan de Kerk, D. J., Jansen, M. H., van den Berg, T. K., Kuijpers, T. W. Failure to detect functional neutrophil B helper cells in the human spleen. PloS one. 9 (2), e88377 (2014).</li>
	<li>Blanco-Camarillo, C., Alem&#225;n, O. R., Rosales, C. Low-density neutrophils in healthy individuals display a mature primed phenotype. Frontiers in Immunology. 12, 672520 (2021).</li>
	<li>Zhang, J. H., Chung, T. D., Oldenburg, K. R. A simple statistical parameter for use in evaluation and validation of high throughput screening assays. Journal of biomolecular screening. 4 (2), 67-73 (1999).</li>
	<li>Shimaoka, M., Salas, A., Yang, W., Weitz-Schmidt, G., Springer, T.A. Small molecule integrin antagonists that bind to the &#946;2 subunit I-like domain and activate signals in one direction and block them in the other. Immunity. 19 (3), 391-402 (2003).</li>
	<li>Liu, W. et al. Nexinhib20 Inhibits neutrophil adhesion and &#946;2 integrin activation by antagonizing Rac-1-Guanosine 5&#8242;-Triphosphate interaction. The Journal of Immunology. 209 (8), 1574-1585 (2022).</li>
	<li>Robinson, M. et al. Antibody against the Leu-CAM beta-chain (CD18) promotes both LFA-1-and CR3-dependent adhesion events. The Journal of Immunology. 148 (4), 1080-1085 (1992).</li>
	<li>Lu, C., Ferzly, M., Takagi, J., Springer, T. A. Epitope mapping of antibodies to the C-terminal region of the integrin &#946;2 subunit reveals regions that become exposed upon receptor activation. The Journal of Immunology. 166 (9), 5629-5637 (2001).</li>
	<li>Mauler, M. et al. Platelet serotonin aggravates myocardial ischemia/reperfusion injury via neutrophil degranulation. circulation. 139 (7), 918-931 (2019).</li>
	<li>Shen, X. F., Cao, K., Jiang, J., Guan, W. X., Du, J. F. Neutrophil dysregulation during sepsis: an overview and update. Journal of Cellular and Molecular Medicine. 21 (9), 1687-1697 (2017).</li>
	<li>Chiang, C. C., Cheng, W. J., Korinek, M., Lin, C. Y., Hwang, T. L. Neutrophils in Psoriasis. Frontiers in Immunology. 10, 02376 (2019).</li>
	<li>Lood, C. et al. Neutrophil extracellular traps enriched in oxidized mitochondrial DNA are interferogenic and contribute to lupus-like disease. Nature medicine. 22 (2), 146-153 (2016).</li>
	<li>Bazzoni, G., Shih, D. T., Buck, C. A., Hemler, M. E. Monoclonal antibody 9EG7 defines a novel &#946;1 integrin epitope induced by soluble ligand and manganese, but inhibited by calcium. Journal of Biological Chemistry. 270 (43), 25570-25577 (1995).</li>
	<li>Luque, A. et al. Activated conformations of very late activation integrins detected by a group of antibodies (HUTS) specific for a novel regulatory region(355-425) of the common &#946;1 chain. Journal of Biological Chemistry. 271 (19), 11067-11075 (1996).</li>
	<li>Mould, A. P., Akiyama, S. K., Humphries, M. J. The inhibitory Anti-&#946;1 integrin monoclonal antibody 13 recognizes an epitope that is attenuated by ligand occupancy: evidence for allosteric inhibition of integrin function. Journal of Biological Chemistry. 271 (34), 20365-20374 (1996).</li>
	<li>Spiess, M. et al. Active and inactive &#946;1 integrins segregate into distinct nanoclusters in focal adhesions. Journal of Cell Biology. 217 (6), 1929-1940 (2018).</li>
	<li>Yang, S. et al. Relating conformation to function in integrin &#945;5&#946;1. Proceedings of the National Academy of Sciences. 113 (27), E3872-E3881 (2016).</li>
	<li>Shattil, S. J., Hoxie, J. A., Cunningham, M., Brass, L. F. Changes in the platelet membrane glycoprotein IIb.IIIa complex during platelet activation. Journal of Biological Chemistry. 260 (20), 11107-11114 (1985).</li>
	<li>Shattil, S. J., Motulsky, H. J , Insel, P. A., Flaherty, L., Brass, L. F. Expression of fibrinogen receptors during activation and subsequent desensitization of human platelets by epinephrine. Blood. 68 (6), 1224-1231 (1986).</li>
	<li>Carre&#241;o, R. et al. 2E8 binds to the high affinity i-domain in a metal ion-dependent manner: a second generation monoclonal antibody selectively targeting activated LFA-1. Journal of Biological Chemistry. 285 (43), 32860-32868 (2010).</li>
	<li>Keizer, G. D., Visser, W., Vliem, M., Figdor, C. G. A monoclonal antibody (NKI-L16) directed against a unique epitope on the alpha-chain of human leukocyte function-associated antigen 1 induces homotypic cell-cell interactions. The Journal of Immunology. 140 (5), 1393-1400 (1988).</li>
	<li>Lefort, C. T. et al. Distinct roles for talin-1 and kindlin-3 in LFA-1 extension and affinity regulation. Blood. 119 (18), 4275-4282 (2012).</li>
	<li>van Kooyk, Y. et al. Activation of LFA-1 through a Ca2(+)-dependent epitope stimulates lymphocyte adhesion. Journal of Cell Biology. 112 (2), 345-354 (1991).</li>
	<li>Mould, A. P. et al. Conformational changes in the integrin a domain provide a mechanism for signal transduction via hybrid domain movement. Journal of Biological Chemistry. 278 (19), 17028-17035 (2003).</li>
	<li>Chigaev, A. et al. Real-time analysis of conformation-sensitive antibody binding provides new insights into integrin conformational regulation. Journal of Biological Chemistry. 284 (21), 14337-14346 (2009).</li>
	<li>Njus, B. H. et al. Conformational mAb as a tool for integrin ligand discovery. Assay and Drug Development Technologies. 7 (5), 507-515 (2009).</li>
	<li>Chigaev, A., Wu, Y., Williams, D. B., Smagley, Y., Sklar, L. A. Discovery of very late antigen-4 (VLA-4, &#945;4&#946;1 integrin) allosteric antagonists. Journal of Biological Chemistry. 286 (7), 5455-5463 (2011).</li>
	<li>Ghigo, A., De Santi, C., Hart, M., Mitash, N., Swiatecka-Urban, A. Cell signaling and regulation of CFTR expression in cystic fibrosis cells in the era of high efficiency modulator therapy. Journal of Cystic Fibrosis. 22, S12-S16 (2023).</li>
	<li>Van Goor, F., Yu, H., Burton, B., Hoffman, B.J. Effect of ivacaftor on CFTR forms with missense mutations associated with defects in protein processing or function. Journal of Cystic Fibrosis. 13 (1), 29-36 (2014).</li>
</ol>

The initiation and termination of neutrophil stimulation and staining are determined by the addition of neutrophils and the fixative PFA. Therefore, ensuring the same time interval between pipetting neutrophils or PFA into each column is critical. This ensures that the stimulation and staining time of neutrophils from each well remains consistent. Due to the short lifespan of neutrophils, the entire experiment, from collecting blood from donors to completing flow cytometry, must be carried out on the same day. Neutrophil...

Many inflammatory diseases are characterized by the infiltration of neutrophils at the site of swelling or injury1. To infiltrate these tissues, neutrophils must complete the neutrophil recruitment cascade, which involves arrest to the endothelium, extravasation across the vessel wall, and recruitment into the tissue2. Circulating neutrophils need &#946;2 integrin activation to complete this cascade, especially for the arrest phase. Thus, integrin-inhibiting drugs that reduce neutrophil adhesion, extravasation, and recruitment may effectively treat inflammatory diseases3,4.
&#946;2 integrins have been targeted for inflammatory diseases before. Efalizumab, a monoclonal antibody directly targeting integrin &#945;L&#946;2, was developed to treat psoriasis5. However, efalizumab was withdrawn due to its lethal side effect - progressive multifocal leukoencephalopathy resulting from JC virus reactivation6,7. New anti-inflammatory integrin-based therapies should consider maintaining the anti-infection functions of leukocytes to minimize side effects. The side effects of efalizumab might be due to the prolonged circulation of monoclonal antibodies in the bloodstream, which could inhibit immune functions in the long term8. A recent study shows that efalizumab mediates &#945;L&#946;2 crosslinking and the unwanted internalization of &#945;4 integrins, providing an alternative explanation for the side effects9. Thus, short-lived, small-molecule antagonists might avoid this problem.
A high-throughput method to screen small-molecule &#946;2 integrin antagonists using human neutrophils is presented here. &#946;2 integrin activation requires conformational changes of the integrin ectodomain to gain access to and increase its binding affinity to its ligand. In the canonical switchblade model, the bent-closed integrin ectodomain first extends to an extended-closed conformation and then opens its headpiece to a fully activated extended-open conformation10,11,12,13. There is also an alternative pathway that starts from the bent-closed to bent-open and extended-open, eventually14,15,16,17,18,19. The conformation-specific antibody mAb24 binds to an epitope in the human &#946;2-I-like domain when the headpiece of the ectodomain is open20,21,22,23.
Here, mAb24-APC is used to determine whether the &#946;2 integrins are activated. To activate neutrophils and integrin, N-formylmethionyl-leucyl-phenylalanine (fMLP), a bacterial-derived short chemotactic peptide that can activate neutrophil &#946;2 integrins24, is used as a stimulus in this protocol. When fMLP binds to the Fpr1 on neutrophils, downstream signaling cascades involving G-proteins, phospholipase C&#946;, and phosphoinositide 3-kinase &#947; are activated. These signaling events ultimately result in integrin activation via the inside-out signaling pathway18,25. Besides small molecule antagonists that directly bind to &#946;2 integrins and prevent conformational changes of integrin activation26, compounds that can inhibit components in the &#946;2 integrin inside-out activation signaling pathway would also be detected with this method. Automated flow cytometers enable high-throughput screening. Identifying new antagonists may not only deepen our understanding of integrin physiology but also provide translational insight into integrin-based anti-inflammation therapy.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>16-channel pipettes</td>
			<td>Thermo</td>
			<td>4661090N</td>
			<td>Instrument</td>
		</tr>
		<tr>
			<td>384-well plate</td>
			<td>Greiner</td>
			<td>784201</td>
			<td>Materials</td>
		</tr>
		<tr>
			<td>APC anti-human CD11a/CD18 (LFA-1) Antibody Clone: m24</td>
			<td>BioLegend</td>
			<td>363410</td>
			<td>Reagents</td>
		</tr>
		<tr>
			<td>Bravo&#160;Automated Liquid Handling Platform&#160;</td>
			<td>Agilent</td>
			<td>16050-102</td>
			<td>384 multi-channel liquid handler</td>
		</tr>
		<tr>
			<td>Centrifuge</td>
			<td>Eppendorf</td>
			<td>Model 5810R</td>
			<td>Instrument</td>
		</tr>
		<tr>
			<td>FlowJo</td>
			<td>Becton, Dickinson &#38; Company</td>
			<td>NA</td>
			<td>Software</td>
		</tr>
		<tr>
			<td>Human Serum Albumin Solution (25%)</td>
			<td>GeminiBio</td>
			<td>800-120</td>
			<td>Reagents</td>
		</tr>
		<tr>
			<td>Lifitegrast</td>
			<td>Thermofisher</td>
			<td>&#160;50-208-2121</td>
			<td>Reagents</td>
		</tr>
		<tr>
			<td>Nexinhib20</td>
			<td>Tocris</td>
			<td>6089</td>
			<td>Reagents</td>
		</tr>
		<tr>
			<td>N-Formyl-Met-Leu-Phe (fMLP)</td>
			<td>Sigma</td>
			<td>F3506</td>
			<td>Reagents</td>
		</tr>
		<tr>
			<td>Paraformaldehyde 16% solution</td>
			<td>Electron Microscopy Sciences</td>
			<td>15710</td>
			<td>Reagents</td>
		</tr>
		<tr>
			<td>Plate buckets</td>
			<td>Eppendorf</td>
			<td>UL155</td>
			<td>Accessory</td>
		</tr>
		<tr>
			<td>Plate shaker&#160;</td>
			<td>Fisher</td>
			<td>88-861-023</td>
			<td>Instrument</td>
		</tr>
		<tr>
			<td>PolymorphPrep</td>
			<td>PROGEN</td>
			<td>1895 (previous 1114683)</td>
			<td>Reagents</td>
		</tr>
		<tr>
			<td>Prestwick Chemical Library Compound Plates (10 mM)</td>
			<td>Prestwick Chemical Libraries</td>
			<td>Ver19_384</td>
			<td>1520 small molecules, 98% marketed approved drugs (FDA, EMA, JAN, and other agencies approved)</td>
		</tr>
		<tr>
			<td>RPMI 1640 Medium, no phenol red</td>
			<td>Gibco</td>
			<td>11-835-030</td>
			<td>Reagents</td>
		</tr>
		<tr>
			<td>Swing-bucket rotor&#160;</td>
			<td>Eppendorf</td>
			<td>A-4-62</td>
			<td>Rotor</td>
		</tr>
		<tr>
			<td>ZE5 Cell Analyzer</td>
			<td>Bio-Rad Laboratories</td>
			<td>Model ZE5</td>
			<td>Instrument</td>
		</tr>
	</tbody>
</table>

a flow cytometry-based high-throughput technique for screening integrin-inhibitory drugs

This protocol aims to establish a method for identifying small molecular antagonists of &#946;2 integrin activation, utilizing conformational-change-reporting antibodies and high-throughput flow cytometry. The method can also serve as a guide for other antibody-based high-throughput screening methods. &#946;2 integrins are leukocyte-specific adhesion molecules that are crucial in immune responses. Neutrophils rely on integrin activation to exit the bloodstream, not only to fight infections but also to be involved in multiple inflammatory diseases. Controlling &#946;2 integrin activation presents a viable approach for treating neutrophil-associated inflammatory diseases. In this protocol, a monoclonal antibody, mAb24, which specifically binds to the high-affinity headpiece of &#946;2 integrins, is utilized to quantify &#946;2 integrin activation on isolated primary human neutrophils. N-formylmethionyl-leucyl-phenylalanine (fMLP) is used as a stimulus to activate neutrophil &#946;2 integrins. A high-throughput flow cytometer capable of automatically running 384-well plate samples was used in this study. The effects of 320 chemicals on &#946;2 integrin inhibition are assessed within 3 h. Molecules that directly target &#946;2 integrins or target molecules in the G protein-coupled receptor-initiated integrin inside-out activation signaling pathway can be identified through this approach.

Author Spotlight: Development of a Method for Identifying Small Molecular Antagonists of &amp;#946;2 Integrin Activation 

A Flow Cytometry-Based High-Throughput Technique for Screening Integrin-Inhibitory Drugs

Our research is focused on neutrophil integrin, and in this study we aim to establish a method to find small molecular antagonists of Beta-2 integrin activation. We believe with this method we can find new antagonists that may deepen our understanding in integrin physiology, and also provide translational insight into integrin-based anti-inflammatory therapy. In the future, we will focus on discovering new anti-inflammatory drugs and dissecting their mechanisms of action.

Data from a representative 384-well plate screening (Figure 4) revealed that negative controls had an MFI of mAb24-APC of 3236 &#177; 110, while positive controls had an MFI of mAb24-APC of 7588 &#177; 858. The Z&#39; factor for this plate is approximately 0.33, which is within an acceptable range31. However, Z&#39; requires further validation in secondary assays.
To normalize the data, all values were scaled to assign a maximum value of 1 ...

Watch this Scientific Journal Video about Development of a Method for Identifying Small Molecular Antagonists of β2 Integrin Activation at JoVE.com

This protocol describes a flow cytometry-based, high-throughput screening method to identify small-molecule drugs that inhibit &#946;2 integrin activation on human neutrophils.

This protocol aims to establish a method for identifying small molecular antagonists of &#946;2 integrin activation, utilizing ...

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Research

JoVE Journal

Immunology and Infection

High-Throughput Screening of Compounds Using Neutrophils Isolated from Human Blood in a 384-Well Plate Format

Neutrophils Screening Assay Using Flow Cytometry

988 Views.  UConn Health.  This protocol describes a flow cytometry-based, high-throughput screening method to identify small-molecule drugs that inhibit β2 integrin activation on human neutrophils.

Screening of ?2 Integrin Activation Inhibitors in Human Neutrophils

Summary