Name: an immunohistopathologic study to profile the folate receptor beta macrophage and vascular immune microenvironment in giant cell arteritis
Uploaded: 2019-02-08T12:30:00
Description: Watch this Scientific Journal Video about An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis at JoVE.com

This work was made possible by the support&#160; of Dr. Douglas Stairs, Marianne Klinger , Ann Benko, the Division of Rheumatology/Department of Medicine and the Molecular and Histopathologic Core Laboratory, Penn State University College of Medicine, Hershey PA.

All methods described were approved by the Penn State Institutional Review Board.
1. Histopathological Preparation, and Processing After Obtaining Temporal Artery Biopsy
NOTE:&#160;The temporal artery biopsy (TAB) is performed under local anesthesia and sterile conditions by a certified surgeon. After surgically obtaining a 3 cm arterial section on the more affected side, the specimen is fixed in formalin immediately for 24 h, divided into 3 to 4 mm s...

<ol>
	<li>Klippel, J. H., Stone, J. H., White, P. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Primer on the rheumatic diseases. , (2008).</li><li>Weyand, C. M., Goronzy, J. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Immune+mechanisms+in+medium+and+large-vessel+vasculitis.">Immune mechanisms in medium and large-vessel vasculitis.</a> Nature Reviews Rheumatol. 9 (12), 731-740 (2013).</li><li>Weyand, C. M., Liao, Y. J., Goronzy, J. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+immunopathology+of+giant+cell+arteritis:+diagnostic+and+therapeutic+implications.">The immunopathology of giant cell arteritis: diagnostic and therapeutic implications.</a> Journal of Neuro-ophthalmology. 32 (3), 259-265 (2012).</li><li>Deng, J., Younge, B., Olshen, R., Goronzy, J., Weyand, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Th17+and+Th1+T-cell+responses+in+giant+cell+arteritis.">Th17 and Th1 T-cell responses in giant cell arteritis.</a> Circulation. 121, 906-915 (2010).</li><li>Mahr, A. D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Adjunctive+methotrexate+for+treatment+of+giant+cell+arteritis:+an+individual+patient+data+meta-analysis.">Adjunctive methotrexate for treatment of giant cell arteritis: an individual patient data meta-analysis.</a> Arthritis &amp; Rheumatology. 56 (8), 2789-2797 (2007).</li><li>Hoffman, G. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+multicenter,+randomized,+double-blind,+placebo-controlled+trial+of+adjuvant+methotrexate+treatment+for+giant+cell+arteritis.">A multicenter, randomized, double-blind, placebo-controlled trial of adjuvant methotrexate treatment for giant cell arteritis.</a> Arthritis &amp; Rheumatology. 46 (5), 1309-1318 (2002).</li><li>Stone, J. H., Klearman, M., Collinson, N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Trial+of+Tocilizumab+in+Giant-Cell+Arteritis.">Trial of Tocilizumab in Giant-Cell Arteritis.</a> New England Journal of Medicine. 377 (15), 1494-1495 (2017).</li><li>Milman, N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Tocilizumab+increased+sustained+glucocorticoid-free+remission+from+giant+cell+arteritis.">Tocilizumab increased sustained glucocorticoid-free remission from giant cell arteritis.</a> Annals of Internal Medicine. 167 (12), JC63 (2017).</li><li>Xia, W., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+functional+folate+receptor+is+induced+during+macrophage+activation+and+can+be+used+to+target+drugs+to+activated+macrophages.">A functional folate receptor is induced during macrophage activation and can be used to target drugs to activated macrophages.</a> Blood. 113 (2), 438-446 (2009).</li><li>Shen, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Folate+receptor-beta+constitutes+a+marker+for+human+proinflammatory+monocytes.">Folate receptor-beta constitutes a marker for human proinflammatory monocytes.</a> Journal of Leukocyte Biology. 96 (4), 563-570 (2014).</li><li>Salazar, M. D., Ratnam, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+folate+receptor:+what+does+it+promise+in+tissue-targeted+therapeutics.">The folate receptor: what does it promise in tissue-targeted therapeutics.</a> Cancer and Metastasis Reviews. 26 (1), 141-152 (2007).</li><li>Low, P. S., Henne, W. A., Doorneweerd, D. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Discovery+and+development+of+folic-acid-based+receptor+targeting+for+imaging+and+therapy+of+cancer+and+inflammatory+diseases.">Discovery and development of folic-acid-based receptor targeting for imaging and therapy of cancer and inflammatory diseases.</a> Accounts of Chemical Research. 41 (1), 120-129 (2008).</li><li>Puig-Kroger, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Folate+receptor+beta+is+expressed+by+tumor-associated+macrophages+and+constitutes+a+marker+for+M2+anti-inflammatory/regulatory+macrophages.">Folate receptor beta is expressed by tumor-associated macrophages and constitutes a marker for M2 anti-inflammatory/regulatory macrophages.</a> Cancer Research. 69 (24), 9395-9403 (2009).</li><li>Nakashima-Matsushita, N., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Selective+expression+of+folate+receptor+beta+and+its+possible+role+in+methotrexate+transport+in+synovial+macrophages+from+patients+with+rheumatoid+arthritis.">Selective expression of folate receptor beta and its possible role in methotrexate transport in synovial macrophages from patients with rheumatoid arthritis.</a> Arthritis &amp; Rheumatology. 42 (8), 1609-1616 (1999).</li><li>vander Heijden, J. W., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Folate+receptor+beta+as+a+potential+delivery+route+for+novel+folate+antagonists+to+macrophages+in+the+synovial+tissue+of+rheumatoid+arthritis+patients.">Folate receptor beta as a potential delivery route for novel folate antagonists to macrophages in the synovial tissue of rheumatoid arthritis patients.</a> Arthritis &amp; Rheumatology. 60 (1), 12-21 (2009).</li><li>Jansen, G., Peters, G. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Novel+insights+in+folate+receptors+and+transporters:+implications+for+disease+and+treatment+of+immune+diseases+and+cancer.">Novel insights in folate receptors and transporters: implications for disease and treatment of immune diseases and cancer.</a> Pteridines. 26 (2), 41-53 (2015).</li><li>Albano-Aluquin, S., Malysz, J., Aluquin, V. R., Ratnam, M., Olsen, N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=An+immunohistochemical+analysis+of+folate+receptor+beta+expression+and+distribution+in+giant+cell+arteritis+-+a+pilot+study.">An immunohistochemical analysis of folate receptor beta expression and distribution in giant cell arteritis - a pilot study.</a> American Journal of Clinical and Experimental Immunology. 6 (6), 107-114 (2017).</li><li>Ross, J. F., Chaudhuri, P. K., Ratnam, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Differential+regulation+of+folate+receptor+isoforms+in+normal+and+malignant+tissues+in+vivo+and+in+established+cell+lines.+Physiologic+and+clinical+implications.">Differential regulation of folate receptor isoforms in normal and malignant tissues in vivo and in established cell lines. Physiologic and clinical implications.</a> Cancer. 73 (9), 2432-2443 (1994).</li><li>Reiner, N. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Methods+in+molecular+biology.+Macrophages+and+dendritic+cells.+Methods+and+protocols.+Preface.">Methods in molecular biology. Macrophages and dendritic cells. Methods and protocols. Preface.</a> Methods in Molecular Biology. 531, (2009).</li><li>Robertson, D., Savage, K., Reis-Filho, J. S., Isacke, C. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Multiple+immunofluorescence+labelling+of+formalin-fixed+paraffin-embedded+(FFPE)+tissue.">Multiple immunofluorescence labelling of formalin-fixed paraffin-embedded (FFPE) tissue.</a> BMC Cell Biology. 9, 13 (2008).</li><li>Pawlina, W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Histology: A text and atlas with correlated cell and molecular biology. , (2016).</li><li>Kumar, V., Abbas, A., Robbins Aster, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Robbins and Cotran pathologic basis of disease. , (2015).</li><li>Dabbs, D. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Diagnostic immunohistochemistry. , (2019).</li><li>Ross, J. F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Folate+receptor+type+beta+is+a+neutrophilic+lineage+marker+and+is+differentially+expressed+in+myeloid+leukemia.">Folate receptor type beta is a neutrophilic lineage marker and is differentially expressed in myeloid leukemia.</a> Cancer. 85 (2), 348-357 (1999).</li><li>Holzapfel, G. A., Fratzl, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Collagen+in+arterial+walls:+biomechanical+aspects.">Collagen in arterial walls: biomechanical aspects.</a> Collagen. Structure and Mechanics. , 285-324 (2008).</li><li>Sultan, H., Smith, S. V., Lee, A. G., Chevez-Barrios, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Pathologic+Markers+Determining+Prognosis+in+Patients+with+Treated+or+Healing+Giant+Cell+Arteritis.">Pathologic Markers Determining Prognosis in Patients with Treated or Healing Giant Cell Arteritis.</a> American Journal of Ophthalmology. , (2018).</li></ol>

GCA is the most common vasculitis in adults, and its pathologic hallmark exemplifies a potent combination of T helper lymphocytes and activated macrophages that can also be found in other granulomatous diseases or vasculopathies like sarcoidosis and granulomatous polyangiitis2,3. In GCA, the temporal artery provides a good representation of a medium-to-large sized artery and the TA biopsy gives a sizeable sample that can be stored in paraffin blocks for years, th...

Giant cell arteritis (GCA) is an inflammatory disease of medium-to-large arteries, targeting the aorta and its branches and affecting older adults. It presents with mild to severe ischemic complications such as headaches, jaw pain, vision loss, stroke and tissue gangrene. The diagnosis is confirmed by high inflammatory markers like erythrocyte sedimentation rate (ESR) and a distinct histopathologic pattern on the temporal artery biopsy (TAB)1. GCA is the most common adult vasculitis, and the accessibility of the temporal artery obtained for diagnosis presents an advantage over other vasculopathies, thus enabling one to study its pathogenesis more readily. The typical findings on TAB include an infiltrate of macrophages/histiocytes and T lymphocytes found across all vascular layers of the tunica intima, media, and adventitia with concurrent destruction of the elastic lamina that normally separates these compartments2. The current evidence demonstrates that GCA involves an unknown antigen that activates dendritic cells in the vascular adventitia, followed by the recruitment of helper T (Th) cells, specifically Th1 and Th17 subtypes which secrete interleukin-17 and interferon-gamma (IFG) respectively. IFG then recruits and activates macrophages to produce cytokines and proteases. These include pro-inflammatory cytokines; including IL-12, which reciprocally activates Th1 cells thus providing a positive feedback loop; tumor necrosis factor&#160;and interleukin-6, which cause arthritis and fevers and metalloproteases that damage the elastic lamina. Glucocorticoids (GC), which constitute the standard chronic therapy, partially control the cytokine pathways by attenuating the Th17/IL-17 but not the Th1/IFG arm of the immune response3,4. Unfortunately, discontinuation of GC results in disease relapse. As an alternative modality, methotrexate has been repurposed for GCA treatment, but the desired clinical endpoints were not consistently achieved although more sensitive biomarkers have not been utilized for therapeutic monitoring5,6. In 2017, the interleukin 6 blocker, tocilizumab, was approved for the treatment of GCA as it effectively demonstrated disease control and steroid sparing effects7,8.
To date, there are no good biomarkers for GCA. As a result, it is difficult to monitor disease activity and titrate doses of available drugs to avoid adverse effects and reduce the burden of cost to society. Thus, it is imperative to look for a candidate biomarker that correlates with disease activity, provide novel insights on pathogenesis and aid in therapeutic decisions.
The dysregulation of macrophage activation is a critical factor in GCA pathogenesis. Thus, an effective means of treating GCA may be the selective targeting of activated macrophages. The folate receptor beta (FRB) is a glycosyl-phosphatidylinositol glycoprotein that is anchored on the cell membrane expressed in normal myelomonocytic cells, myeloid leukemia cells and activated macrophages. Its ligand, folic acid, is an essential vitamin in its reduced form, which enables cellular DNA synthesis, methylation and repair9. FRB expression is induced in autoimmune disease and during carcinogenesis. Its expression is restricted to the surface of monocytes or pro-inflammatory M1 macrophages in rheumatoid arthritis, or to anti-inflammatory M2 macrophages in solid organ and myeloid malignancies10,11,12,13. In addition to its potential role as a biomarker of activated macrophages, the FRB can enable selective drug transport thru a multi-step process that starts with the receptor binding to folic acid, antifolates or folate-conjugated drugs at the cell surface, followed by internalization, release and eventual delivery of desired drug to the internal cell machinery12,14,15,16. In contrast to FRB expressed in cancer cells and activated macrophages, FRB expressed in normal hematopoietic cells is unable to bind folates thereby ensuring that FRB/folate-mediated drug delivery is limited to FRB-positive inflammatory or cancer cells.
In our previous study, we demonstrated for the first time that FRB is expressed in GCA macrophages and its expression correlated with CD68+ and endothelin receptor beta macrophages, which contribute to GCA pathogenesis17. In this report, we describe the histopathological and immunohistochemical methods used to assess the FRB macrophage, and analyzed the total lymphocyte and macrophage counts to gain insight into the FRB&#39;s position in the GCA vascular landscape.

<table>
	<tbody>
		<tr>
			<td>Microtome</td>
			<td>Reichert-Jung</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>plain and frosted microscope slides and cover slips</td>
			<td>Fisher Scientific&#160;</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Vertical rack</td>
			<td>Fisher Scientific&#160;</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Light microscope</td>
			<td>Olympus BX60&#160; microscope</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Xylene</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Acetone in distilled water</td>
			<td></td>
			<td></td>
			<td>concentrations 100%, 90%, 70%</td>
		</tr>
		<tr>
			<td>Tris-buffered saline solution (TBS)&#160;</td>
			<td>Dako Wash BufferS3006</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>3% hydrogen peroxide in TBS</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Diaminobenzidine (DAB)</td>
			<td>Sigma Fast Tablet set</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Chemical Permount&#160; Mounting Medium</td>
			<td>Fisher Scientific&#160;</td>
			<td>SP-15-100</td>
			<td></td>
		</tr>
		<tr>
			<td>Harleco Gill&#39;s III Hematoxylin</td>
			<td>Fiisher Scientific 23-750-019</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Harleco Eosin Y 1% Alcoholic Stock Solution</td>
			<td>Fisher Scientific&#160;</td>
			<td>23-749-977</td>
			<td></td>
		</tr>
		<tr>
			<td>10 mM citric acid monohydrate (pH 6.0)</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Polyclonal rabbit anti-folate receptor beta&#160;</td>
			<td>Manohar Ratnam</td>
			<td></td>
			<td>optimized at 1:800</td>
		</tr>
		<tr>
			<td>Monoclonal mouse anti-human CD68</td>
			<td>Dako&#160;</td>
			<td>M071801</td>
			<td>optimized at 1:200</td>
		</tr>
		<tr>
			<td>Polyclonal rabbit anti-CD3</td>
			<td>Agilent Dako</td>
			<td>A0452</td>
			<td>optimized at 1:100</td>
		</tr>
		<tr>
			<td>Polymer goat anti- rabbit/mouse secondary antibody</td>
			<td>Dako</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Placental tissue</td>
			<td></td>
			<td></td>
			<td>&#160;for FRB positive control</td>
		</tr>
	</tbody>
</table>

an immunohistopathologic study to profile the folate receptor beta macrophage and vascular immune microenvironment in giant cell arteritis

Giant cell arteritis (GCA) is a chronic immune-mediated disease of medium-to-large sized arteries that affects older adults. GCA manifests with arthritis and occlusive symptoms of headaches, stroke or vision loss. Macrophages and T-helper lymphocytes infiltrate the vascular wall and produce a pro-inflammatory response that lead to vessel damage and ischemia. To date, there is no GCA biomarker that can monitor disease activity and guide therapeutic response.
Folate receptor beta (FRB) is a glycosylphosphatidylinositol protein that is anchored on cell membranes and normally expressed in the myelomonocytic lineage and in the majority of myeloid leukemia cells as well as in tumor and rheumatoid synovial macrophages, where its expression correlates with disease severity. The ability of FRB to bind folate compounds, folic acid-conjugates and antifolate drugs has made it a druggable target in cancer and inflammatory disease research. This report describes the histopathologic and immunohistochemical methods used to assess expression and distribution of FRB in relation to GCAimmunopathology.
Formalin-fixed and paraffin-embedded temporal artery biopsies from GCA and normal controls were stained with Hematoxylin and Eosin to review tissue histology and identify pathognomonic features.Immunohistochemistry was used to detect FRB, CD68 and CD3 expression. A microscopic analysis was performed to quantify the number of positively stained cells on 10 selected high-power-field sections and their respective locations in the arterial wall.
Lymphohistiocytic (LH) inflammation accompanied by intimal hyperplasia and disrupted elastic lamina was seen in GCA with none found in controls. The LH infiltrate was composed of approximately 60% lymphocytes and 40% macrophages. FRB expression was restricted to macrophages, comprising 31% of the total CD68+ macrophage population and localized to the media and adventitia. No FRB was seen in controls.
This protocol demonstrated a distinct numerical and spatial pattern of the FRB macrophage relative to the vascular immune microenvironment in GCA.

Histopathologic findings
The H&#38;E stains in normal specimens demonstrated normal arterial anatomy with endothelial cells in the tunica intima, smooth muscle cells in the tunica media, and a heterogenous collagen matrix which include fibroblasts and feeder vessels called vasa vasorum in the tunica adventitia. There is no inflammatory infiltrate identified. GCA positive temporal arteries demonstrated moderate t...

Watch this Scientific Journal Video about An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis at JoVE.com

An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis

The protocol illustrates the use of histopathologic examination and immunohistochemistry to profile the folate receptor beta macrophage and its relationship with the total immune cell infiltrate in temporal artery biopsies in giant cell arteritis.

Giant cell arteritis (GCA) is a chronic immune-mediated disease of medium-to-large sized arteries that affects older adults. GCA manifests with arthritis ...

This immunohistochemical and histopathologic protocol can be used to examine folate receptor beta, which is a candidate protein with potential prognostic and therapeutic value to the vascular microenvironment in giant cell arteritis. This protocol is time-tested and widely employed and can be used to explore the folate receptor beta attributes in temporal artery tissues, even after long-term storage. To acquire tissue sections, use a microtome to slice four to five micrometer thick sections of paraffin-embedded temporal arteries, floating each section in a 40 degree Celsius water bath as they are obtained, to remove wrinkles.Use glass microscope slides to capture three sections per slide, and warm the slides on a warming plate, in a 60 degree Celsius oven for 60 minutes. When the sections have adhered to the slides, place the slides into a vertical rack for drying at 37 degrees celsius for 24 hours. The next day, transfer the slides to a slide container for storage at four degrees Celsius for at least 12 hours.Next, load slides into a slide rack and hydrate the tissues with two five-minute, 100%xylene immersions and a descending, five-minute per concentration ethanol immersion series, with 10 seconds of agitation every 30 seconds. After the 70%ethanol immersion, rinse the slides two times in double-distilled water for five minutes, with 10 seconds of agitation every 30 seconds. For antigen retrieval, transfer the rack into a glass container with 200 microliters of 95 degrees Celsius, 10 millimolar per liter citrate buffer for 30 minutes.At the end of the incubation, allow the slides to cool to room temperature for 20 minutes before rinsing with running water for five minutes. To remove the endogenous peroxidase activity, first use a hydrophobic marker to draw a circle around each tissue sample, before incubating the samples in 200 microliters of 3%hydrogen peroxide for 10 minutes, followed by 3 washes in 200 micoliters of tris-buffered saline solution, or TBSS, per wash. After the last wash, dab each slide gently to remove any excess buffer and add 200 microliters of the primary antibody cocktail of interest and a cover slip to each slide for a one-hour incubation in a humid chamber at room temperature.At the end of the incubation, discard the cover slips and rinse the slides with three two-minute washes in fresh TBSS. After removing the excess buffer, add 200 microliters of an appropriate biotinylated secondary antibody solution and a cover slip to each slide for a 45-minute incubation in the humid chamber at room temperature. After discarding the cover slips, rinse the slides with TBSS as demonstrated.Remove any excess buffer. And label the sections with 200 microliters of DAB substrate buffer for 10 minutes at room temperature. At the end of the incubation, wash the slides with TBSS and running tap water for 10 minutes, before counterstaining with hematoxylin for three minutes.Then, add 70 microliters of an appropriate mounting medium to each slide and slowly tip a glass cover strip onto the mounting medium to avoid creating bubbles as the cover slip is lowered into place. For histopathologic analysis, place the slide onto the stage of a light microscope and assess the vascular architecture of the first tissue section. Then, quantify the number of macrophages relative to the number of lymphocytes per section.For immunohistochemical analysis, examine the folate receptor beta staining pattern on each tissue section and quantify the number of folate receptor beta positive, CD68 positive, and CD3 positive cells in 10 randomly selected high power fields per section. Hematoxylin and eosin staining in normal specimens reveals a normal arterial anatomy, with endothelial cells in the tunica intima, smooth muscle cells in the tunica media, and a heterogeneous collagen matrix, that include fibroblasts and feeder vessels called vasa vasorum in the tunica adventitia. Giant cell arteritis positive temporal arteries demonstrate a moderate to severe inflammation, with aggregates and macrophages, or histiocytes, lymphocytes, occasional plasma cells, and multi-nucleated giant cells.Luminal narrowing is also noted, and accompanied by intimal thickening and a 90%disruption of the internal elastic lamina. CD3 positive lymphocytes and CD68 positive macrophages are also present in all giant cell arteritis positive specimens, with similar staining patterns observed in all of the biopsies. Staining for folate receptor beta is restricted to macrophages and multi-nucleated giant cells that preferentially localize to the adventitia and media.Notably, folate receptor beta comprised approximately 30%of the total macrophages. The temporal artery biopsy processing, cutting, and dewaxing require careful dexteriety in order to perform subsequent steps. The slide interpretation requires the expertise of an experienced cardiovascular pathologist.Remind the viewers to use contact and respiratory precautions, such as gloves and ventilated hoods, when handling specimens and the reagents.

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Immunology and Infection

Seven Steps to Stellate Cells

Hepatic stellate cells are liver-resident cells of star-like morphology and are located in the space of Disse between liver sinusoidal endothelial cells and hepatocytes1,2. Stellate cells are derived from bone marrow precursors and store up to 80% of the total body vitamin A1, 2. Upon activation, stellate cells differentiate into myofibroblasts to produce extracellular matrix, thus contributing to liver fibrosis3. Based on their ability to contract, myofibroblastic stellate cells can regulate the vascular tone associated with portal hypertension4. Recently, we demonstrated that hepatic stellate cells are potent antigen presenting cells and can activate NKT cells as well as conventional T lymphocytes5. 

 Here we present a method for the efficient preparation of hepatic stellate cells from mouse liver. Due to their perisinusoidal localization, the isolation of hepatic stellate cells is a multi-step process. In order to render stellate cells accessible to isolation from the space of Disse, mouse livers are perfused in situ with the digestive enzymes Pronase E and Collagenase P. Following perfusion, the liver tissue is subjected to additional enzymatic treatment with Pronase E and Collagenase P in vitro. Subsequently, the method takes advantage of the massive amount of vitamin A-storing lipid droplets in hepatic stellate cells. This feature allows the separation of stellate cells from other hepatic cell types by centrifugation on an 8% Nycodenz gradient. The protocol described here yields a highly pure and homogenous population of stellate cells. Purity of preparations can be assessed by staining for the marker molecule glial fibrillary acidic protein (GFAP), prior to analysis by fluorescence microscopy or flow cytometry. Further, light microscopy reveals the unique appearance of star-shaped hepatic stellate cells that harbor high amounts of lipid droplets. 


 Taken together, we present a detailed protocol for the efficient isolation of hepatic stellate cells, including representative images of their morphological appearance and GFAP expression that help to define the stellate cell entity.

Here we describe a method for the isolation of hepatic stellate cells from mouse liver. For stellate cell purification, mouse livers are digested in situ and in vitro by pronase-collagenase treatment prior to density gradient centrifugation. This technique yields highly pure hepatic stellate cells.

Hepatic stellate cells are liver-resident  cells of star-like morphology and are located in the space of Disse between  liver sinusoidal endothelial cells ...

An Introduction to Parasitic Wasps of Drosophila and the Antiparasite Immune Response

Most known parasitoid wasp species attack the larval or pupal stages of Drosophila. While Trichopria drosophilae infect the pupal stages of the host (Fig. 1A-C), females of the genus Leptopilina (Fig. 1D, 1F, 1G) and Ganaspis (Fig. 1E) attack the larval stages. We use these parasites to study the molecular basis of a biological arms race. Parasitic wasps have tremendous value as biocontrol agents. Most of them carry virulence and other factors that modify host physiology and immunity. Analysis of Drosophila wasps is providing insights into how species-specific interactions shape the genetic structures of natural communities. These studies also serve as a model for understanding the hosts' immune physiology and how coordinated immune reactions are thwarted by this class of parasites.
The larval/pupal cuticle serves as the first line of defense. The wasp ovipositor is a sharp needle-like structure that efficiently delivers eggs into the host hemocoel. Oviposition is followed by a wound healing reaction at the cuticle (Fig. 1C, arrowheads). Some wasps can insert two or more eggs into the same host, although the development of only one egg succeeds. Supernumerary eggs or developing larvae are eliminated by a process that is not yet understood. These wasps are therefore referred to as solitary parasitoids.
Depending on the fly strain and the wasp species, the wasp egg has one of two fates. It is either encapsulated, so that its development is blocked (host emerges; Fig. 2 left); or the wasp egg hatches, develops, molts, and grows into an adult (wasp emerges; Fig. 2 right). L. heterotoma is one of the best-studied species of Drosophila parasitic wasps. It is a "generalist," which means that it can utilize most Drosophila species as hosts1. L. heterotoma and L. victoriae are sister species and they produce virus-like particles that actively interfere with the encapsulation response2. Unlike L. heterotoma, L. boulardi is a specialist parasite and the range of Drosophila species it utilizes is relatively limited1. Strains of L. boulardi also produce virus-like particles3 although they differ significantly in their ability to succeed on D. melanogaster1. Some of these L. boulardi strains are difficult to grow on D. melanogaster1 as the fly host frequently succeeds in encapsulating their eggs. Thus, it is important to have the knowledge of both partners in specific experimental protocols.
In addition to barrier tissues (cuticle, gut and trachea), Drosophila larvae have systemic cellular and humoral immune responses that arise from functions of blood cells and the fat body, respectively. Oviposition by L. boulardi activates both immune arms1,4. Blood cells are found in circulation, in sessile populations under the segmented cuticle, and in the lymph gland. The lymph gland is a small hematopoietic organ on the dorsal side of the larva. Clusters of hematopoietic cells, called lobes, are arranged segmentally in pairs along the dorsal vessel that runs along the anterior-posterior axis of the animal (Fig. 3A). The fat body is a large multifunctional organ (Fig. 3B). It secretes antimicrobial peptides in response to microbial and metazoan infections.
Wasp infection activates immune signaling (Fig. 4)4. At the cellular level, it triggers division and differentiation of blood cells. In self defense, aggregates and capsules develop in the hemocoel of infected animals (Fig. 5)5,6. Activated blood cells migrate toward the wasp egg (or wasp larva) and begin to form a capsule around it (Fig. 5A-F). Some blood cells aggregate to form nodules (Fig. 5G-H). Careful analysis reveals that wasp infection induces the anterior-most lymph gland lobes to disperse at their peripheries (Fig. 6C, D).
We present representative data with Toll signal transduction pathway components Dorsal and Sp&auml;tzle (Figs. 4,5,7), and its target Drosomycin (Fig. 6), to illustrate how specific changes in the lymph gland and hemocoel can be studied after wasp infection. The dissection protocols described here also yield the wasp eggs (or developing stages of wasps) from the host hemolymph (Fig. 8).

An Introduction to Parasitic Wasps of Drosophila and the Antiparasite Immune Response

Parasitoid (parasitic) wasps constitute a major class of natural enemies of many insects including Drosophila melanogaster. We will introduce the techniques to propagate these parasites in Drosophila spp. and demonstrate how to analyze their effects on immune tissues of Drosophila larvae.

Most known parasitoid wasp species attack the larval or pupal stages of Drosophila. While Trichopria drosophilae infect the pupal stages of the host (Fig. ...

An In vitro Model to Study Heterogeneity of Human Macrophage Differentiation and Polarization

Monocyte-derived macrophages represent an important cell type of the innate immune system. Mouse models studying macrophage biology suffer from the phenotypic and functional differences between murine and human monocyte-derived macrophages. Therefore, we here describe an in vitro model to generate and study primary human macrophages. Briefly, after density gradient centrifugation of peripheral blood drawn from a forearm vein, monocytes are isolated from peripheral blood mononuclear cells using negative magnetic bead isolation. These monocytes are then cultured for six days under specific conditions to induce different types of macrophage differentiation or polarization. The model is easy to use and circumvents the problems caused by species-specific differences between mouse and man. Furthermore, it is closer to the in vivo conditions than the use of immortalized cell lines. In conclusion, the model described here is suitable to study macrophage biology, identify disease mechanisms and novel therapeutic targets. Even though not fully replacing experiments with animals or human tissues obtained post mortem, the model described here allows identification and validation of disease mechanisms and therapeutic targets that may be highly relevant to various human diseases.

An In vitro Model to Study Heterogeneity of Human Macrophage Differentiation and Polarization

Monocyte-derived macrophages are important cells of the innate immune system. Here, we describe an easy to use in vitro model to generate these cells. Using gradient centrifugation, negative bead isolation and specific cell culture conditions, monocyte-derived macrophages can be generated for phenotypic and functional studies.

Monocyte-derived macrophages represent an important cell type of the innate immune system. Mouse models studying macrophage biology suffer from the ...

Generation of Lymph Node-fat Pad Chimeras for the Study of Lymph Node Stromal Cell Origin

The stroma is a key component of the lymph node structure and function. However, little is known about its origin, exact cellular composition and the mechanisms governing its formation. Lymph nodes are always encapsulated in adipose tissue and we recently demonstrated the importance of this relation for the formation of lymph node stroma. Adipocyte precursor cells migrate into the lymph node during its development and upon engagement of the Lymphotoxin-b receptor switch off adipogenesis and differentiate into lymphoid stromal cells (B&#233;n&#233;zech&#160;et al.14). Based on the lymphoid stroma potential of adipose tissue, we present a method using a lymph node/fat pad chimera that allows the lineage tracing of lymph node stromal cell precursors. We show how to isolate newborn lymph nodes and EYFP+ embryonic adipose tissue and make a LN/ EYFP+ fat pad chimera. After transfer under the kidney capsule of a host mouse, the lymph node incorporates local adipose tissue precursor cells and finishes its formation. Progeny analysis of EYFP+ fat pad cells in the resulting lymph nodes can be performed by flow-cytometric analysis of enzymatically digested lymph nodes or by immunofluorescence analysis of lymph nodes cryosections. By using fat pads from different knockout mouse models, this method will provide an efficient way of analyzing the origin of the different lymph node stromal cell populations.

Generation of lymph node/fat pad chimeras for the study of lymph node stromal cell origin is described. The method involves the isolation of lymph nodes from newborn mice and embryonic fat pads, the generation of chimeric lymph node-fat pads, and their transfer under the kidney capsule of a host mouse.

The stroma is a key component of the lymph node structure and function. However, little is known about its origin, exact cellular composition and the ...

In Vitro and In Vivo Model to Study Bacterial Adhesion to the Vessel Wall Under Flow Conditions

In order to cause endovascular infections and infective endocarditis, bacteria need to be able to adhere to the vessel wall while being exposed to the shear stress of flowing blood.
To identify the bacterial and host factors that contribute to vascular adhesion of microorganisms, appropriate models that study these interactions under physiological shear conditions are needed. Here, we describe an in vitro flow chamber model that allows to investigate bacterial adhesion to different components of the extracellular matrix or to endothelial cells, and an intravital microscopy model that was developed to directly visualize the initial adhesion of bacteria to the splanchnic circulation in vivo. These methods can be used to identify the bacterial and host factors required for the adhesion of bacteria under flow. We illustrate the relevance of shear stress and the role of von Willebrand factor for the adhesion of Staphylococcus aureus using both the in vitro and in vivo model.

In Vitro and In Vivo Model to Study Bacterial Adhesion to the Vessel Wall Under Flow Conditions

To study the interaction of bacteria with the blood vessels under shear stress, a flow chamber and an in vivo mesenteric intravital microscopy model are described that allow to dissect the bacterial and host factors contributing to vascular adhesion.

In order to cause endovascular infections and infective endocarditis, bacteria need to be able to adhere to the vessel wall while being exposed to the ...

Neutrophil Isolation and Analysis to Determine their Role in Lymphoma Cell Sensitivity to Therapeutic Agents

Neutrophils are the most abundant (40% to 75%) type of white blood cells and among the first inflammatory cells to migrate towards the site of inflammation. They are key players in the innate immune system and play major roles in cancer biology. Neutrophils have been proposed as key mediators of malignant transformation, tumor progression, angiogenesis and in the modulation of the antitumor immunity; through their release of soluble factors or their interaction with tumor cells. To characterize the specific functions of neutrophils, a fast and reliable method is coveted for in vitro isolation of neutrophils from human blood. Here, a density gradient separation method is demonstrated to isolate neutrophils as well as mononuclear cells from the blood. The procedure consists of layering the density gradient solution such as Ficoll carefully above the diluted blood obtained from patients diagnosed with chronic lymphocytic leukemia (CLL), followed by centrifugation, isolation of mononuclear layer, separation of neutrophils from RBCsby dextran then lysis of residual erythrocytes. This method has been shown to isolate neutrophils &#8805; 90 % pure. To mimic the tumor microenvironment, 3-dimensional (3D) experiments were performed using basement membrane matrix such as Matrigel. Given the short half-life of neutrophils in vitro, 3D experiments with fresh human neutrophils cannot be performed. For this reason promyelocytic HL60 cells are differentiated along the granulocytic pathway using the differentiation inducers dimethyl sulfoxide (DMSO) and retinoic acid (RA). The aim of our experiments is to study the role of neutrophils on the sensitivity of lymphoma cells to anti-lymphoma agents. However these methods can be generalized to study the interactions of neutrophils or neutrophil-like cells with a large range of cell types in different situations.

Neutrophils are the most abundant type of white blood cells. The isolation of neutrophils from human blood by density gradient separation method and the differentiation of human promyelocytic (HL60) cells along the granulocytic pathway are described here; to test their role on sensitivity of lymphoma cells to anti-lymphoma agents.

Neutrophils are the most abundant (40% to 75%) type of white blood cells and among the first inflammatory cells to migrate towards the site of ...

Fabricating Optical-quality Glass Surfaces to Study Macrophage Fusion

Visualizing the formation of multinucleated giant cells (MGCs) from living specimens has been challenging due to the fact that most live imaging techniques require propagation of light through glass, but on glass macrophage fusion is a rare event. This protocol presents the fabrication of several optical-quality glass surfaces where adsorption of compounds containing long-chain hydrocarbons transforms glass into a fusogenic surface. First, preparation of clean glass surfaces as starting material for surface modification is described. Second, a method is provided for the adsorption of compounds containing long-chain hydrocarbons to convert non-fusogenic glass into a fusogenic substrate. Third, this protocol describes fabrication of surface micropatterns that promote a high degree of spatiotemporal control over MGC formation. Finally, fabricating glass bottom dishes is described. Examples of use of this in vitro cell system as a model to study macrophage fusion and MGC formation are shown.

This protocol describes the fabrication of optical-quality glass surfaces adsorbed with compounds containing long-chain hydrocarbons that can be used to monitor macrophage fusion of living specimens and enables super-resolution microscopy of fixed specimens.

Visualizing the formation of multinucleated giant cells (MGCs) from living specimens has been challenging due to the fact that most live imaging ...

An Ex Vivo Chicken Primary Bursal-cell Culture Model to Study Infectious Bursal Disease Virus Pathogenesis

Infectious bursal disease virus (IBDV) is a birnavirus of economic importance to the poultry industry. The virus infects B cells, causing morbidity, mortality, and immunosuppression in infected birds. In this study, we describe the isolation of chicken primary bursal cells from the bursa of Fabricius, the culture and infection of the cells with IBDV, and the quantification of viral replication. The addition of chicken CD40 ligand significantly increased cell proliferation fourfold over six days of culture and significantly enhanced cell viability. Two strains of IBDV, a cell-culture adapted strain, D78, and a very virulent strain, UK661, replicated well in the ex vivo cell cultures. This model will be of use in determining how cells respond to IBDV infection and will permit a reduction in the number of infected birds used in IBDV pathogenesis studies. The model can also be expanded to include other viruses and could be applied to different species of birds.

An Ex Vivo Chicken Primary Bursal-cell Culture Model to Study Infectious Bursal Disease Virus Pathogenesis

Here we describe the isolation of chicken primary bursal cells from the bursa of Fabricius, the culture and infection of the cells with infectious bursal disease virus, and the quantification of viral replication.

Infectious bursal disease virus (IBDV) is a birnavirus of economic importance to the poultry industry. The virus infects B cells, causing morbidity, ...

Assessing the Cellular Immune Response of the Fruit Fly, Drosophila melanogaster, Using an In Vivo Phagocytosis Assay

In all animals, innate immunity provides an immediate and robust defense against a broad spectrum of pathogens. Humoral and cellular immune responses are the main branches of innate immunity, and many of the factors regulating these responses are evolutionarily conserved between invertebrates and mammals. Phagocytosis, the central component of cellular innate immunity, is carried out by specialized blood cells of the immune system. The fruit fly, Drosophila melanogaster, has emerged as a powerful genetic model to investigate the molecular mechanisms and physiological impacts of phagocytosis in whole animals. Here we demonstrate an injection-based in vivo phagocytosis assay to quantify the particle uptake and destruction by Drosophila blood cells, hemocytes. The procedure allows researchers to precisely control the particle concentration and dose, making it possible to obtain highly reproducible results in a short amount of time. The experiment is quantitative, easy to perform, and can be applied to screen for host factors that influence pathogen recognition, uptake, and clearance.

Assessing the Cellular Immune Response of the Fruit Fly, Drosophila melanogaster, Using an In Vivo Phagocytosis Assay

This protocol describes an in vivo phagocytosis assay in adult Drosophila melanogaster to quantify phagocyte recognition and clearance of microbial infections.

In all animals, innate immunity provides an immediate and robust defense against a broad spectrum of pathogens. Humoral and cellular immune responses are ...

Bacterial Cell Culture at the Single-cell Level Inside Giant Vesicles

We developed a method for culturing bacterial cells at the single-cell level inside giant vesicles (GVs). Bacterial cell culture is important for understanding the function of bacterial cells in the natural environment. Because of technological advances, various bacterial cell functions can be revealed at the single-cell level inside a confined space. GVs are spherical micro-sized compartments composed of amphiphilic lipid molecules and can hold various materials, including cells. In this study, a single bacterial cell was encapsulated into 10&#8211;30 &#956;m GVs by the droplet transfer method and the GVs containing bacterial cells were immobilized on a supported membrane on a glass substrate. Our method is useful for observing the real-time growth of single bacteria inside GVs. We cultured Escherichia coli (E. coli) cells as a model inside GVs, but this method can be adapted to other cell types. Our method can be used in the science and industrial fields of microbiology, biology, biotechnology, and synthetic biology.

We demonstrate single-cell culture of bacteria inside giant vesicles (GVs). GVs containing bacterial cells were prepared by the droplet transfer method and were immobilized on a supported membrane on a glass substrate for direct observation of bacterial growth. This approach may also be adaptable to other cells.