S.-B.N. and A.D.J. are supported by the Singapore Ministry of Health&#39;s National Medical Research Council Transition Awards (NMRC/TA/0020/2013 and NMRC/TA/0052/2016). The authors acknowledge a Yong Siew Yoon Research Grant to A.D.J. from the National University Cancer Institute of Singapore toward the purchase of a Vectra spectral imaging microscope. This study is approved by the Singapore NHG Domain Specific Review Board B (2014/00693).

<ol>
	<li>Swerdlow, S. H., 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> WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. , (2017).</li><li>Swerdlow, S. H., 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=The+2016+revision+of+the+World+Health+Organization+classification+of+lymphoid+neoplasms.">The 2016 revision of the World Health Organization classification of lymphoid neoplasms.</a> Blood. 127 (20), 2375-2390 (2016).</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. Theranostic and Genomic Applications. , (2010).</li><li>Kim, S. -. W., Roh, J., Park, C. -. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Immunohistochemistry+for+Pathologists:+Protocols,+Pitfalls,+and+Tips.">Immunohistochemistry for Pathologists: Protocols, Pitfalls, and Tips.</a> Journal of Pathology and Translational Medicine. 50 (6), 411-418 (2016).</li><li>Stack, E. C., Wang, C., Roman, K. A., Hoyt, C. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Multiplexed+immunohistochemistry,+imaging,+and+quantitation:+a+review,+with+an+assessment+of+Tyramide+signal+amplification,+multispectral+imaging+and+multiplex+analysis.">Multiplexed immunohistochemistry, imaging, and quantitation: a review, with an assessment of Tyramide signal amplification, multispectral imaging and multiplex analysis.</a> Methods. 70 (1), 46-58 (2014).</li><li>Anderson, M. W., Natkunam, Y., Jones, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Immunohistochemical+profiling+of+lymphoma.">Immunohistochemical profiling of lymphoma.</a> Neoplastic Hematopathology: Experimental and Clinical Approaches. , 21-44 (2010).</li><li>Parra, E. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Novel+Platforms+of+Multiplexed+Immunofluorescence+for+Study+of+Paraffin+Tumor+Tissues.">Novel Platforms of Multiplexed Immunofluorescence for Study of Paraffin Tumor Tissues.</a> Journal of Cancer Treatment and Diagnosis. 2 (1), 43-53 (2018).</li><li>Cregger, M., Berger, A. J., Rimm, D. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Immunohistochemistry+and+Quantitative+Analysis+of+Protein+Expression.">Immunohistochemistry and Quantitative Analysis of Protein Expression.</a> Archives of Pathology &amp; Laboratory Medicine. 130 (7), 1026-1030 (2006).</li><li>Parra, E. R., 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=Validation+of+multiplex+immunofluorescence+panels+using+multispectral+microscopy+for+immune-profiling+of+formalin-fixed+and+paraffin-embedded+human+tumor+tissues.">Validation of multiplex immunofluorescence panels using multispectral microscopy for immune-profiling of formalin-fixed and paraffin-embedded human tumor tissues.</a> Scientific Reports. 7 (1), 13380 (2017).</li><li>T&#243;th, Z. E., Mezey, &. #. 2. 0. 1. ;. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Simultaneous+Visualization+of+Multiple+Antigens+with+Tyramide+Signal+Amplification+using+Antibodies+from+the+same+Species.">Simultaneous Visualization of Multiple Antigens with Tyramide Signal Amplification using Antibodies from the same Species.</a> Journal of Histochemistry &amp; Cytochemistry. 55 (6), 545-554 (2007).</li><li>Ng, S. -. B., 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=Quantitative+Analysis+of+a+Multiplexed+Immunofluorescence+Panel+in+T-Cell+Lymphoma.">Quantitative Analysis of a Multiplexed Immunofluorescence Panel in T-Cell Lymphoma.</a> SLAS TECHNOLOGY: Translating Life Sciences Innovation. 23 (3), 252-258 (2017).</li><li>Bogusz, A. M., 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=Diffuse+large+B-cell+lymphoma+with+concurrent+high+MYC+and+BCL2+expression+shows+evidence+of+active+B-cell+receptor+signaling+by+quantitative+immunofluorescence.">Diffuse large B-cell lymphoma with concurrent high MYC and BCL2 expression shows evidence of active B-cell receptor signaling by quantitative immunofluorescence.</a> PLoS One. 12 (2), e0172364 (2017).</li><li>Kalyuzhny, A. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Signal Transduction Immunohistochemistry: Methods and Protocols. , (2011).</li><li>Bordeaux, 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=Antibody+validation.">Antibody validation.</a> BioTechniques. 48 (3), 197-209 (2010).</li><li>PerkinElmer. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Vectra 3 Quantitative Pathology Imaging System User's Manual. , (2012).</li><li>Ho, J., Tumkaya, T., Aryal, S., Choi, H., Claridge-Chang, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Moving+beyond+P+values:+Everyday+data+analysis+with+estimation+plots.">Moving beyond P values: Everyday data analysis with estimation plots.</a> bioRxiv. , (2018).</li><li>Feng, Z., 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=Multispectral+Imaging+of+T+and+B+Cells+in+Murine+Spleen+and+Tumor.">Multispectral Imaging of T and B Cells in Murine Spleen and Tumor.</a> The Journal of Immunology Author Choice. 196 (9), 3943-3950 (2016).</li><li>PerkinElmer. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Opal Multiplex IHC Assay Development Guide. , (2017).</li></ol>

A.D.J. has received funding from PerkinElmer toward travel to user-group meetings. The authors have no other conflict of interest to disclose.

mf-IHC has the potential to enable pathologists to refine diagnosticcriteria in lymphoid pathology and to analyze the role of biomarkers in specific cell types toward a prediction of clinical outcome. As a new research method, mf-IHC is increasingly applied to the quantitative and spatial identification of multiple immune parameters of tumor cells17. The detection of mf-IHC for the co-expression of tumor biomarkers has been shown to be reproducible and reliable5. However, t...

Lymphoid neoplasms are caused by the uncontrolled malignant proliferation of lymphocytes. These cells are vital components of the immune system and localize to the primary and secondary immune organs, such as the bone marrow, lymph nodes, spleen, and other mucosa-associated lymphoid system. Lymphoid neoplasms are a heterogeneous group of disorders who are classified based on a constellation of features, including morphology, immunophenotype, genetic features, and clinical presentation. While each parameter plays a part, lineage remains a defining feature and forms the basis for the WHO classification system which recognizes neoplasms derived from B cells, T cells, and natural killer (NK) cells1.
Key to the classification of lymphoma has been the characterization of the antibodies against leukocyte surface markers of the various subtypes of lymphocytes2. Immunohistochemistry (IHC) has been traditionally used for the analysis of such markers and is based on the principle of the specific antigen-antibody recognition to detect cell- and tissue-based molecules that can be visualized through the light microscope3. However, the identification of multiple targets on a single slide by conventional bright-field chromogenic multiplex IHC has limitations because it is often difficult to distinguish multiple color signals on a single tissue section reliably&#8212;especially for antigens with a very low expression4. Visual assessment and quantification of staining can also be subjective, causing variability in the analysis and data interpretation5.
Therefore, conventional IHC on formalin-fixed, paraffin-embedded (FFPE) samples is not feasible for the simultaneous detection of multiple targets in immunologically diverse diseases like lymphoma. Furthermore, distinguishing neoplastic lymphocytes from the surrounding immune cells is often imprecise. This hinders studies looking at the relevance of novel biomarkers in lymphoma. In this context, multiplex fluorescent IHC (mf-IHC) offers a promising alternative as it allows the quantitative assessment of antigen coexpression and a spatial relationship with higher precision while conserving limited samples6,7. When this imaging technology is partnered with the digital image analysis software, the data interpretation is made more efficient and facilitates the study of tumor and microenvironment heterogeneity8,9. In this protocol, a tyramide-based immunofluorescence (IF) multiplexing method is applied to amplify the signal and is compatible with any IHC-validated antibody from any host species, even those developed in the&#160;same species5,7,10. The tyramide-based protocol allows for the direct conjugation of the fluorophore to the tissue of interest so that the primary and secondary antibody can be stripped after each step, allowing for the sequential application of multiple stains without antibody cross-reactivity.
A multiplexed strategy will be useful for predicting prognosis and treatment outcomes by identifying targets and their variant immunologic patterns in lymphomas. Multiplex fluorescent IHC has been applied in our lab for the study of a panel of T and B lymphocyte markers and T-follicular helper markers in angioimmunoblastic T-cell lymphoma (AITL), a subtype of a peripheral T-cell lymphoma characterized by aggressive clinical behavior and tumor heterogeneity11. The utility of this method is also illustrated in diffuse large B-cell lymphoma (DLBCL) where the increased signaling of a B-cell receptor with simultaneous C-MYC and BCL-2 expression suggests the potential therapeutic use of Bruton&#39;s tyrosine kinase inhibition12. 
Here we describe the entire protocol from antibody validation to the selection of appropriate control tissues and multiplexing using lymphoma FFPE tissues, with an eventual analysis of stained slides using a scanning automated quantitative pathology imaging system.

<table><tbody><tr><td>Antibody diluent</td><td>DAKO</td><td>REF S3022</td><td>Blocking</td></tr><tr><td>Peroxidase Blocking Solution</td><td>DAKO</td><td>S2023</td><td>For peroxide blocking</td></tr><tr><td>Vectra multispectral automated microscope</td><td>Perkin Elmer</td><td>Vectra2.0.8</td><td>Spectral imaging</td></tr><tr><td>absolute Ethanol</td><td>EMSURE</td><td>1.00983.2500</td><td>Ethyl alcohol for rehydration</td></tr><tr><td>Amplification Diluent</td><td>PERKIN ELMER</td><td>FP1135</td><td>Fluorophore diluent buffer</td></tr><tr><td>Anti-Mouse IgG [Goat] HRP-Labeled</td><td>PERKIN ELMER</td><td>NEF822001EA</td><td>Secondary antibody</td></tr><tr><td>Anti-Rabbit IgG [Goat] HRP-Labeled</td><td>PERKIN ELMER</td><td>NEF812001EA</td><td>Secondary antibody</td></tr><tr><td>BCL2</td><td>DAKO</td><td>clone 124 ( Lot No. 20031561)(RRID-AB578693)</td><td>primary antibody</td></tr><tr><td>BCL6</td><td>LEICA</td><td>NCL-L-Bcl6-564(Lot No.6050438)(RRID-AB563429)</td><td>primary antibody</td></tr><tr><td>CD20</td><td>DAKO</td><td>Clone L26 (Lot No.20028627) (RRID-AB442055)</td><td>primary antibody</td></tr><tr><td>c-MYC</td><td>ABCAM</td><td>Y 69 clone ab32072 (Lot NO.GR29511133)(RRID-AB731658)</td><td>primary antibody</td></tr><tr><td>Cy 5</td><td>PERKIN ELMER</td><td>FP1171</td><td>Appropriate tyramide based fluorescent reagent</td></tr><tr><td>Graphpad Prism 7</td><td>Graph pad</td><td></td><td>Statisitcal software</td></tr><tr><td>HistoClear Clearing Agent</td><td>SIGMA</td><td>H2779-1L</td><td>Histoclear for dewaxing and clearing</td></tr><tr><td>inForm Advanced&lt;br/&gt; Image Analysis Software</td><td>Perkin Elmer</td><td>Inform Software 2.2.1</td><td>Data Analysis software</td></tr><tr><td>KI67</td><td>DAKO</td><td>Clone MIB-1 (Lot No.20040401) (RRID-AB2314699)</td><td>primary antibody</td></tr><tr><td>KOS MILESTONE multifunctional tissue processor</td><td>Milestone</td><td></td><td>Microwave for Heat induced epitope retrieval</td></tr><tr><td>Microwave</td><td>PANASONIC</td><td>NN-ST651M</td><td>Microwave stripping</td></tr><tr><td>Mowiol</td><td>SIGMA ALDRICH</td><td>81381 Aldrich Mowiol&amp;reg; 4-88</td><td>mounting media</td></tr><tr><td>Opal 570</td><td>PERKIN ELMER</td><td>FP1488</td><td>Appropriate tyramide based fluorescent reagent</td></tr><tr><td>Opal520</td><td>PERKIN ELMER</td><td>FP1487B21</td><td>Appropriate tyramide based fluorescent reagent</td></tr><tr><td>Opal540</td><td>PERKIN ELMER</td><td>FP1494</td><td>Appropriate tyramide based fluorescent reagent</td></tr><tr><td>Opal620</td><td>PERKIN ELMER</td><td>FP1495</td><td>Appropriate tyramide based fluorescent reagent</td></tr><tr><td>Poly-L-lysine coated slide</td><td>FISHER SCIENTIFIC</td><td>120-550-15</td><td>Slide for tissue section adhesion in routine histological use</td></tr><tr><td>Spectral DAPI</td><td>PERKIN ELMER</td><td>FP1490</td><td>nucleic acid stain</td></tr><tr><td>Target Retrieval Solution, pH9.0(10x)</td><td>DAKO</td><td>S2367</td><td>For HIER</td></tr><tr><td>Tris Buffer saline (TBS)</td><td>1st BASE</td><td>BUF3030 20X4L</td><td>for buffer wash</td></tr><tr><td>Tween 20</td><td>SIGMA ALDRICH</td><td>P1379-1L</td><td>Tween</td></tr></tbody></table>

multiplexed fluorescent immunohistochemical staining, imaging, and analysis in histological samples of lymphoma

Immunohistochemical (IHC) methods for the in-situ analysis of protein expression by light microscopy are a powerful tool for both research and diagnostic purposes. However, the visualization and quantification of multiple antigens in a single tissue section using conventional chromogenic IHC is challenging. Multiplexed imaging is especially relevant in lymphoma research and diagnostics, where markers have to be interpreted in the context of a complex tumor microenvironment. Here we describe a protocol for multiplexed fluorescent IHC staining to enable the quantitative assessment of multiple targets in specific cell types of interest in lymphoma.The method covers aspects of antibody validation, antibody optimization, the multiplex optimization with markers of lymphoma subtypes, the staining of tissue microarray (TMA) slides, and the scanning of the slides, followed by data analysis, with specific reference to lymphoma. Using this method, scores for both the mean intensity of a marker of interest and the percentage positivity are generated to facilitate further quantitative analysis. Multiplexing minimizes sample utilization and provides spatial information for each marker of interest.

mf-IHC images for a DLBCL sample with C-MYC and BCL2 gene rearrangement (double-hit lymphoma) are shown in Figure 1. Figure 2 illustrates the simulated bright-field immunohistochemical images. Figure 3 indicates the generation of percentage data. Figure 4 displays the details of a median formula for the generation of numeric data. Figure 5 s...

Watch this Scientific Journal Video about Multiplexed Fluorescent Immunohistochemical Staining, Imaging, and Analysis in Histological Samples of Lymphoma at JoVE.com

Multiplexed Fluorescent Immunohistochemical Staining, Imaging, and Analysis in Histological Samples of Lymphoma

Here we describe a protocol for multiplex fluorescent immunohistochemical staining and imaging for the simultaneous localization of multiple cancer-associated antigens in lymphoma. This protocol can be extended to the colocalization analysis of biomarkers within all tissue sections.

Immunohistochemical (IHC) methods for the in-situ analysis of protein expression by light microscopy are a powerful tool for both research and diagnostic ...

multiplexed-fluorescent-immunohistochemical-staining-imaging-analysis

Research

JoVE Journal

Immunology and Infection

19.7K Views.  AnSteel Group General Hospital. Lymfoom zijn histologisch complexe tumoren. Daarom biedt multiplexed fluorescerende immunohistochemie voordelen ten opzichte van conventionele chromogene immunohistochemie om markers van belang in de tumorcellen en de micro-omgeving te bestuderen. Deze techniek heeft het potentieel voor het standaardiseren van het scoren van antilichaam gebaseerde kleuring in histologische lymfoommonsters, een proces dat historisch gezien uitdagend is geweest vanwege de complexiteit van de tumormicro-omgeving...

Video: Multiplexed Fluorescent Immunohistochemical Staining, Imaging, and Analysis in Histological Samples of Lymphoma

Automated Multiplex Immunofluorescence Panel for Immuno-oncology Studies on Formalin-fixed Carcinoma Tissue Specimens

Continued developments in immuno-oncology require an increased understanding of the mechanisms of cancer immunology. The immunoprofiling analysis of tissue samples from formalin-fixed, paraffin-embedded (FFPE) biopsies has become a key tool for understanding the complexity of tumor immunology and discovering novel predictive biomarkers for cancer immunotherapy. Immunoprofiling analysis of tissues requires the evaluation of combined markers, including inflammatory cell subpopulations and immune checkpoints, in the tumor microenvironment. The advent of novel multiplex immunohistochemical methods allows for a more efficient multiparametric analysis of single tissue sections than does standard monoplex immunohistochemistry (IHC). One commercially available multiplex immunofluorescence (IF) method is based on tyramide-signal amplification and, combined with multispectral microscopic analysis, allows for a better signal separation of diverse markers in tissue. This methodology is compatible with the use of unconjugated primary antibodies that have been optimized for standard IHC on FFPE tissue samples. Herein we describe in detail an automated protocol that allows multiplex IF labeling of carcinoma tissue samples with a six-marker multiplex antibody panel comprising PD-L1, PD-1, CD68, CD8, Ki-67, and AE1/AE3 cytokeratins with 4&#8242;,6-diamidino-2-phenylindole as a nuclear cell counterstain. The multiplex panel protocol is optimized in an automated IHC stainer for a staining time that is shorter than that of the manual protocol and can be directly applied and adapted by any laboratory investigator for immuno-oncology studies on human FFPE tissue samples. Also described are several controls and tools, including a drop-control method for fine quality control of a new multiplex IF panel, that are useful for the optimization and validation of the technique.

A detailed protocol for a six-marker multiplex immunofluorescence panel is optimized and performed, using an automated stainer for more consistent results and a shorter procedure time. This approach can be directly adapted by any laboratory for immuno-oncology studies.

Continued developments in immuno-oncology require an increased understanding of the mechanisms of cancer immunology. The immunoprofiling analysis of ...

Cancer Research

Optimization, Design and Avoiding Pitfalls in Manual Multiplex Fluorescent Immunohistochemistry

Microenvironment evaluation of intact tissue for analysis of cell infiltration and spatial organization are essential in understanding the complexity of disease processes. The principle techniques used in the past include immunohistochemistry (IHC) and immunofluorescence (IF) which enable visualization of cells as a snapshot in time using between 1 and 4 markers. Both techniques have shortcomings including difficulty staining poorly antigenic targets and limitations related to cross-species reactivity. IHC is reliable and reproducible, but the nature of the chemistry and reliance on the visible light spectrum allows for only a few markers to be used and makes co-localization challenging. Use of IF broadens potential markers but typically relies on frozen tissue due to the extensive tissue autofluorescence following formalin fixation. Flow cytometry, a technique that enables simultaneous labeling of multiple epitopes, abrogates many of the deficiencies of IF and IHC, however, the need to examine cells as a single cell suspension loses the spatial context of cells discarding important biologic relationships. Multiplex fluorescent immunohistochemistry (mfIHC) bridges these technologies allowing for multi-epitope cellular phenotyping in formalin fixed paraffin embedded (FFPE) tissue while preserving the overall microenvironment architecture and spatial relationship of cells within intact undisrupted tissue. High fluorescent intensity fluorophores that covalently bond to the tissue epitope enables multiple applications of primary antibodies without worry of species specific cross-reactivity by secondary antibodies. Although this technology has been proven to produce reliable and accurate images for the study of disease, the process of creating a useful mfIHC staining strategy can be time consuming and exacting due to extensive optimization and design. In order to make robust images that represent accurate cellular interactions in-situ and to mitigate the optimization period for manual analysis, presented here are methods for slide preparation, optimizing antibodies, multiplex design as well as errors commonly encountered during the staining process.

Multiplex fluorescent immunohistochemistry is an emerging technology that enables the visualization of multiple cell types within intact formalin-fixed, paraffin embedded (FFPE) tissue. Presented are guidelines for ensuring a successful 7-color multiplex with instructions for optimizing antibodies and reagents, preparing slides, design and tips for avoiding common problems.

Microenvironment evaluation of intact tissue for analysis of cell infiltration and spatial organization are essential in understanding the complexity of ...

Quantitative Multispectral Analysis Following Fluorescent Tissue Transplant for Visualization of Cell Origins, Types, and Interactions

With the desire to understand the contributions of multiple cellular elements to the development of a complex tissue; such as the numerous cell types that participate in regenerating tissue, tumor formation, or vasculogenesis, we devised a multi-colored cellular transplant model of tumor development in which cell populations originate from different fluorescently colored reporter gene mice and are transplanted, engrafted or injected in and around a developing tumor. These colored cells are then recruited and incorporated into the tumor stroma. In order to quantitatively assess bone marrow derived tumor stromal cells, we transplanted GFP expressing transgenic whole bone marrow into lethally irradiated RFP expressing mice as approved by IACUC. 0ovarian tumors that were orthotopically injected into the transplanted mice were excised 6-8 weeks post engraftment and analyzed for bone marrow marker of origin (GFP) as well as antibody markers to detect tumor associated stroma using multispectral imaging techniques. We then adapted a methodology we call MIMicc- Multispectral Interrogation of Multiplexed cellular compositions, using multispectral unmixing of fluoroprobes to quantitatively assess which labeled cell came from which starting populations (based on original reporter gene labels), and as our ability to unmix 4, 5, 6 or more spectra per slide increases, we&#39;ve added additional immunohistochemistry associated with cell lineages or differentiation to increase precision. Utilizing software to detect co-localized multiplexed-fluorescent signals, tumor stromal populations can be traced, enumerated and characterized based on marker staining.1

Complex tissue masses, from organs to tumors, are composed of various cellular elements. We elucidated the contribution of cellular phenotypes within a tissue utilizing multi-labeled fluorescent transgenic mice in combination with multiparameter immunofluorescent staining followed by spectral unmixing to decipher cell origin as well as cell characteristics based on protein expression.

With the desire to understand the contributions of multiple cellular elements to the development of a complex tissue; such as the numerous cell types that ...

Medicine

Multiplexed Barcoding Image Analysis for Immunoprofiling and Spatial Mapping Characterization in the Single-Cell Analysis of Paraffin Tissue Samples

Multiplexed imaging technology using antibody barcoding with oligonucleotides, which sequentially detects multiple epitopes in the same tissue section, is an effective methodology for tumor evaluation that improves the understanding of the tumor microenvironment. The visualization of protein expression in formalin-fixed, paraffin-embedded&#160;tissues is achieved when a specific fluorophore is annealed to an antibody-bound barcode via complementary oligonucleotides and then sample imaging is performed; indeed, this method allows for the use of customizable panels of more than 40 antibodies in a single tissue staining reaction. This method is compatible with fresh frozen tissue, formalin-fixed, paraffin-embedded tissue, cultured cells, and peripheral blood mononuclear cells, meaning that researchers can use this technology to view a variety of sample types at single-cell resolution. This method starts with a manual staining and fixing protocol, and all the antibody barcodes are applied using an antibody cocktail. The staining fluidics instrument is fully automated and performs iterative cycles of labeling, imaging, and removing spectrally distinct fluorophores until all the biomarkers have been imaged using a standard fluorescence microscope. The images are then collected and compiled across all the imaging cycles to achieve single-cell resolution for all the markers. The single-step staining and gentle fluorophore removal not only allow for highly multiplexed biomarker analysis but also preserve the sample for additional downstream analysis if desired (e.g., hematoxylin and eosin staining). Furthermore, the image analysis software enables image processing-drift compensation, background subtraction, cell segmentation, and clustering-as well as the visualization and analysis of the images and cell phenotypes for the generation of spatial network maps. In summary, this technology employs a computerized microfluidics system and fluorescence microscope to iteratively hybridize, image, and strip fluorescently labeled DNA probes that are complementary to tissue-bound, oligonucleotide-conjugated antibodies.

Multiplexed barcoding image analysis has recently improved the characterization of the tumor microenvironment, permitting comprehensive studies of cell composition, functional state, and cell-cell interactions. Herein, we describe a staining and imaging protocol using the barcoding of oligonucleotide-conjugated antibodies and cycle imaging, which allows for the use of a high-dimensional image&#160;analysis technique.

Multiplexed imaging technology using antibody barcoding with oligonucleotides, which sequentially detects multiple epitopes in the same tissue section, is ...

Multiplex Immunofluorescence and Spatial Image Analysis of the Tumor Microenvironment

Multiplex Immunofluorescence Combined with Spatial Image Analysis for the Clinical and Biological Assessment of the Tumor Microenvironment

The tumor microenvironment (TME) is composed of a plethora of different cell types, such as cytotoxic immune cells and immunomodulatory cells. Depending on its composition and the interactions between cancer cells and peri-tumoral cells, the TME may affect cancer progression. The characterization of tumors and their complex microenvironment could improve the understanding of cancer diseases and may help scientists and clinicians to discover new biomarkers.
We recently developed several multiplex immunofluorescence (mIF) panels based on tyramide signal amplification (TSA) for the characterization of the TME in colorectal cancer, head and neck squamous cell carcinoma, melanoma, and lung cancer. Once the staining and scanning of the corresponding panels are completed, the samples are analyzed on an image analysis software. The spatial position and the staining of each cell are then exported from this quantification software into R. We developed R scripts that allow us not only to analyze the density of each cell type in several tumor compartments (e.g. the center of the tumor, the margin of the tumor, and the stroma) but also to perform distance-based analyses between different cell types.
This particular workflow adds a spatial dimension to the classical density analysis already routinely performed for several markers. mIF analysis could allow scientists to have a better understanding of the complex interaction between cancer cells and the TME and to discover new predictive biomarkers of response to treatments, such as immune checkpoint inhibitors, and targeted therapies.

Author Spotlight: Multiplex Immunofluorescence Combined with Spatial Image Analysis for the Clinical and Biological Assessment of the Tumor Microenvironment  

In this article, a protocol for manual tyramide signal amplification (TSA) multiplex immunofluorescence (mIF) combined with image analysis and spatial analysis is described. This protocol can be used with formalin-fixed paraffin-embedded (FFPE) sections for the staining of two to six antigens per slide depending on the slide scanner available in the laboratory.

The tumor microenvironment (TME) is composed of a plethora of different cell types, such as cytotoxic immune cells and immunomodulatory cells. Depending ...

Mapping the Tumor Immune Landscape: An In-Depth Multiplex IHC Analysis Protocol

Multiplex Immunohistochemical Analysis of the Spatial Immune Cell Landscape of the Tumor Microenvironment

The immune cell landscape of the tumor microenvironment potentially contains information for the discovery of prognostic and predictive biomarkers. Multiplex immunohistochemistry is a valuable tool to visualize and identify different types of immune cells in tumor tissues while retaining its spatial information. Here we provide detailed protocols to analyze lymphocyte, myeloid, and dendritic cell populations in tissue sections. Starting from cutting formalin-fixed paraffin-embedded sections, automatic multiplex staining procedures on an automated platform, scanning of the slides on a multispectral imaging microscope, to the analysis of images using an in-house-developed machine learning algorithm ImmuNet. These protocols can be applied to a variety of tumor specimens by simply switching tumor markers to analyze immune cells in different compartments of the sample (tumor versus invasive margin) and apply nearest-neighbor analysis. This analysis is not limited to tumor samples but can also be applied to other (non-)pathogenic tissues. Improvements to the equipment and workflow over the past few years have significantly shortened throughput times, which facilitates the future application of this procedure in the diagnostic setting.

Author Spotlight: Unlocking Insights into the Immune Cell Landscape of Tumors

This protocol describes in detail how immune cell characterization of the tumor microenvironment using multiplex immunohistochemistry is carried out.

The immune cell landscape of the tumor microenvironment potentially contains information for the discovery of prognostic and predictive biomarkers. ...

Deciphering Tumor Microenvironment Using mIHC in Lung Squamous Carcinoma

Multiplex Immunohistochemistry Staining for Paraffin-embedded Lung Cancer Tissue

Lung cancer is the leading cause of malignant tumor-related morbidity and mortality all over the world, and the complex tumor microenvironment has been considered the leading cause of death in lung cancer patients. The complexity of the tumor microenvironment requires effective methods to understand cell-to-cell relationships in tumor tissues. The multiplex immunohistochemistry (mIHC) technique has become a key tool for inferring the relationship between the expression of proteins upstream and downstream of signaling pathways in tumor tissues and developing clinical diagnoses and treatment plans. mIHC is a multi-label immunofluorescence staining method based on Tyramine Signal Amplification (TSA) technology, which can simultaneously detect multiple target molecules on the same tissue section sample to achieve different protein co-expression and co-localization analysis. In this experimental protocol, paraffin-embedded tissue sections of lung squamous carcinoma of clinical origin were subjected to multiplex immunohistochemical staining. By optimizing the experimental protocol, multiplex immunohistochemical staining of labeled target cells and proteins was achieved, solving the problem of autofluorescence and channel crosstalk in lung tissues. In addition, multiplex immunohistochemical staining is widely used in the experimental validation of tumor-related, high-throughput sequencing, including single-cell sequencing, proteomics, and tissue space sequencing, providing intuitive and visual pathology validation results.

Author Spotlight: Enhancing Multicolor Fluorescence Localization in Lung Carcinoma Sample

This experimental protocol describes and optimizes a multiplex immunohistochemistry (IHC) staining method, mainly by optimizing single-channel antibody incubation conditions and adjusting the settings of antibodies and channels to solve the problems of autofluorescence and channel crosstalk in lung cancer tissues of clinical origin.

Lung cancer is the leading cause of malignant tumor-related morbidity and mortality all over the world, and the complex tumor microenvironment has been ...

In Situ Immunohistochemical Detection of Immune Cell Markers in Cancer Tissues

Multiplex Cyclic Fluorescent Immunohistochemistry

The tumor microenvironment involves interactions between host cells, tumor cells, immune cells, stromal cells, and vasculature. Characterizing and spatially organizing immune cell subsets and target proteins are crucial for prognostic and therapeutic purposes. This has led to the development of multiplexed immunohistochemistry staining methods. Multiplex fluorescence immunohistochemistry allows the simultaneous detection of multiple markers, facilitating a comprehensive understanding of cell function and intercellular interactions. In this paper, we describe a workflow for the multiplex cyclic fluorescent immunohistochemistry assay and its application in the quantification analysis of lymphocyte subsets. The multiplex cyclic fluorescent immunohistochemistry staining follows similar steps and reagents as standard immunohistochemistry, involving antigen retrieval, cyclic antibody incubation, and staining on a formalin-fixed paraffin-embedded (FFPE) tissue slide. During the antigen-antibody reaction, a mixture of antibodies from different species is prepared. Conditions, such as antigen retrieval time and antibody concentration, are optimized and validated to increase the signal-to-noise ratio. This technique is reproducible and serves as a valuable tool for immunotherapy research and clinical applications.

Author Spotlight: Efficient Detection of Immune Cell-Infiltration in Cancer Tissues Using Fluorescent Immunohistochemistry

Multiplex cyclic immunohistochemistry allows in situ detection of multiple markers simultaneously using repeated antigen-antibody incubation, image scanning, and image alignment and integration. Here, we present the operating protocol for identifying immune cell substrates with this technology in lung cancer and paired brain metastasis samples.

The tumor microenvironment involves interactions between host cells, tumor cells, immune cells, stromal cells, and vasculature. Characterizing and ...

Visualization, Quantification, and Mapping of Immune Cell Populations in the Tumor Microenvironment

The immune landscape of the tumor microenvironment (TME) is a determining factor in cancer progression and response to therapy. Specifically, the density and the location of immune cells in the TME have important diagnostic and prognostic values. Multiomic profiling of the TME has exponentially increased our understanding of the numerous cellular and molecular networks regulating tumor initiation and progression. However, these techniques do not provide information about the spatial organization of cells or cell-cell interactions. Affordable, accessible, and easy to execute multiplexing techniques that allow spatial resolution of immune cells in tissue sections are needed to complement single cell-based high-throughput technologies. Here, we describe a strategy that integrates serial imaging, sequential labeling, and image alignment to generate virtual multiparameter slides of whole tissue sections. Virtual slides are subsequently analyzed in an automated fashion using user-defined protocols that enable identification, quantification, and mapping of cell populations of interest. The image analysis is done, in this case using the analysis modules Tissuealign, Author, and HISTOmap. We present an example where we applied this strategy successfully to one clinical specimen, maximizing the information that can be obtained from limited tissue samples and providing an unbiased view of the TME in the entire tissue section.

Here, we describe a simple and accessible strategy for visualizing, quantifying, and mapping immune cells in formalin-fixed paraffin-embedded tumor tissue sections. This methodology combines existing imaging and digital analysis techniques with the purpose of expanding the multiplexing capability and multiparameter analysis of imaging assays.

The immune landscape of the tumor microenvironment (TME) is a determining factor in cancer progression and response to therapy. Specifically, the density ...

A Rapid Method for Multispectral Fluorescence Imaging of Frozen Tissue Sections

Multispectral fluorescence imaging on formalin-fixed paraffin-embedded (FFPE) tissues enables the detection of multiple markers in a single tissue sample that can provide information about antigen coexpression and spatial distribution of the markers. However, a lack of suitable antibodies for formalin-fixed tissues may restrict the nature of markers that can be detected. In addition, the staining method is time-consuming. Here we describe a rapid method to perform multispectral fluorescence imaging on frozen tissues. The method includes the fluorophore combinations used, detailed steps for the staining of mouse and human frozen tissues, and the scanning, acquisition, and analysis procedures. For staining analysis, a commercially available semiautomated multispectral fluorescence imaging system is used. Through this method, up to six different markers were stained and detected in a single frozen tissue section. The machine learning analysis software can phenotype cells that can be used for quantitative analysis. The method described here for frozen tissues is useful for the detection of markers that cannot be detected in FFPE tissues or for which antibodies are not available for FFPE tissues.

We describe a rapid staining method to perform multispectral imaging on frozen tissues.

Multispectral fluorescence imaging on formalin-fixed paraffin-embedded (FFPE) tissues enables the detection of multiple markers in a single tissue sample ...

Multiplexed Fluorescent Immunohistochemical Staining, Imaging, and Analysis in Histological Samples of Lymphoma

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