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W tym Artykule

  • Podsumowanie
  • Streszczenie
  • Wprowadzenie
  • Protokół
  • Wyniki
  • Dyskusje
  • Ujawnienia
  • Podziękowania
  • Materiały
  • Odniesienia
  • Przedruki i uprawnienia

Podsumowanie

We describe here the method for imaging megakaryocytes and proplatelets in the marrow of the skull bone of living mice using two-photon microscopy.

Streszczenie

Platelets are produced by megakaryocytes, specialized cells located in the bone marrow. The possibility to image megakaryocytes in real time and their native environment was described more than 10 years ago and sheds new light on the process of platelet formation. Megakaryocytes extend elongated protrusions, called proplatelets, through the endothelial lining of sinusoid vessels. This paper presents a protocol to simultaneously image in real time fluorescently labeled megakaryocytes in the skull bone marrow and sinusoid vessels. This technique relies on a minor surgery that keeps the skull intact to limit inflammatory reactions. The mouse head is immobilized with a ring glued to the skull to prevent movements from breathing.

Using two-photon microscopy, megakaryocytes can be visualized for up to a few hours, enabling the observation of cell protrusions and proplatelets in the process of elongation inside sinusoid vessels. This allows the quantification of several parameters related to the morphology of the protrusions (width, length, presence of constriction areas) and their elongation behavior (velocity, regularity, or presence of pauses or retraction phases). This technique also allows simultaneous recording of circulating platelets in sinusoid vessels to determine platelet velocity and blood flow direction. This method is particularly useful to study the role of genes of interest in platelet formation using genetically modified mice and is also amenable to pharmacological testing (study the mechanisms, evaluating drugs in the treatment of platelet production disorders). It has become an invaluable tool, especially to complement in vitro studies as it is now known that in vivo and in vitro proplatelet formation rely on different mechanisms. It has been shown, for example, that in vitro microtubules are required for proplatelet elongation per se. However, in vivo, they rather serve as a scaffold, elongation being mainly promoted by blood flow forces.

Wprowadzenie

Platelets are produced by megakaryocytes-specialized cells located in the bone marrow. The precise way megakaryocytes release platelets in the circulation has long remained unclear owing to the technical challenge in observing real-time events through the bone. Two-photon microscopy has helped overcome this challenge and led to major advances in understanding the platelet formation process. The first in vivo megakaryocyte observations were made by von Andrian and colleagues in 2007, with the visualization of fluorescent megakaryocytes through the skull1. This was possible because the bone layer in the frontoparietal skull of young adult mice has a thickness of a few tens of microns and is sufficiently transparent to allow visualization of fluorescent cells in the underlying bone marrow2.

Ensuing studies applied this procedure to evaluate proplatelet formation under various conditions and to decipher the underlying mechanisms3,4,5,6. These studies provided definitive evidence that megakaryocytes dynamically extend protrusions, called proplatelets, through the endothelial barrier of the sinusoid vessels (Figure 1). These proplatelets are then released as long fragments that represent several hundred platelets in volume. The platelets will be formed after the remodeling of the proplatelets in the microcirculation of downstream organs, notably in the lungs7. To date, however, the precise process and molecular mechanisms remain subject to debate. For instance, the proposed role of the cytoskeletal proteins in the elongation of proplatelets differs between in vitro and in vivo conditions3, and differences in proplatelet formation have been demonstrated under inflammatory conditions6. Complicating things further, a recent study disputed the proplatelet-driven concept and proposed that in vivo, platelets are essentially formed through a membrane-budding mechanism at the megakaryocyte level8.

This paper presents a protocol for the observation of megakaryocytes and proplatelets in the bone marrow from the skull bone in living mice, using a minimally invasive procedure. Similar approaches have been previously described to visualize other marrow cells, notably hematopoietic stem and progenitor cells9. The focus here is on the observation of megakaryocytes and platelets to detail some parameters that can be measured, notably proplatelet morphologies and platelet velocity. This protocol presents how to insert a catheter into the jugular vein to inject fluorescent tracers and drugs and observe through the skull bone. The calvarial bone is exposed using minor surgery so that a ring is glued to the bone. This ring serves to immobilize the head and prevent movements due to breathing and form a cup filled with saline as the immersion medium of the lens. This technique is well suited to i) observe in real time the sinusoid geometry and megakaryocytes interacting with the vessel wall; ii) follow megakaryocytes in the process of proplatelet formation, elongation, and release; and iii) measure platelet movements to monitor the complex sinusoid blood flow. Data obtained using this protocol have been recently published3.

Protokół

All animal experiments were performed in accordance with European standards 2010/63/EU and the CREMEAS Committee on the Ethics of Animal Experiments of the University of Strasbourg (Comité Régional d'Ethique en Matière d'Expérimentation Animale Strasbourg, Animal Facility agreement N°: G67-482-10, project agreement N°: 2018061211274514).

1. Preparation of mice and insertion of a catheter in the jugular vein

NOTE: Here, male or female, 5-7-week-old mTmG reporter mice were used (B6.129(Cg)-Gt(ROSA)26Sortm4(ACTB-tdTomato,-EGFP)Luo10) crossed with Pf4-cre mice11, allowing intense green fluorescence labeling in megakaryocytes and platelets12. Before beginning the experiment, preheat the heating chamber of the microscope for a few hours.

  1. Transport the mouse to the imaging room and proceed to anesthesia.
    1. Anesthetize the mouse by intraperitoneal (i.p.) injection of a solution of ketamine (ketamine (100 µg/g) and xylazine (10 µg/g) (5 µL/g).
      NOTE: Repeated administration of ketamine/xylazine is used here and works well but requires the interruption of recording for regular reinjection. Alternatively, if an anesthesia machine is available, the induction of anesthesia may be performed with ketamine/xylazine and subsequently maintained under inhalation of gases (mixture of isoflurane, air, and oxygen).
    2. Replace the animal in its cage until it reaches deep anesthesia. Place the mouse on a heated plate warmed at 37 °C for all subsequent manipulations.
      NOTE: While the animal reaches deep anesthesia, switch on the microscope and all equipment (see section 4.1) and set up the different parameters needed (see section 4.2) to start the experiment once the surgery is done. Here, the procedure lasts only 3 h and is terminal. The mouse is euthanized after the experiment without waking up. Hence, ethanol disinfection for skin and instruments is sufficient. However, depending on the institutional guidelines, or if the procedure would last longer, more complete disinfection methods should be used such as three alternating scrubs with betadine/povidone and alcohol.
  2. Install a catheter in the jugular vein.
    NOTE: It is important to avoid microbial contamination during the surgery as far as possible. Take care to carefully disinfect the skin with 70% ethanol (EtOH) before proceeding with surgery. Always use sterilized scissors and tweezers, and regularly rinse them in 70% EtOH. Work in a clean place, and wear a face mask. A 22 G "over-the needle" catheter, consisting of a needle inside a plastic tube, is used for intravenous injection (see the Table of Materials).
    1. Place the mouse on its back, and fix the anterior legs with surgical tape to stretch the throat (Figure 2A). Disinfect the throat with 70% ethanol.
      NOTE: For convenience, the throat may be shaved before surgery. If the procedure lasts longer, careful shaving must be performed for proper aseptic technique.
    2. Make a 0.7-1 cm incision over the right or left jugular vein using sterile scissors. Stretch the adjacent connective tissue to expose the external jugular vein and the top of the pectoral muscle (Figure 2A).
    3. Fill the catheter with warm, sterile physiological saline. Insert the catheter into the vein after penetrating through the pectoral muscle (Figure 2B).
      NOTE: Take care to avoid air bubbles inside the catheter. It is important to insert the catheter through the muscle to prevent hemorrhage as the muscle will form a compression point. Even mice with hemostasis defects, such as Itgb3-/- mice, do not bleed upon catheter insertion with this approach.
    4. Gently remove the needle, and if required, carefully move the catheter deeper into the vein. Connect the syringe and stabilize the catheter by adding a drop of surgical glue (Table of Materials).
      NOTE: It is possible to insert a catheter inside the tail vein, although it requires some practice becuase the vein has a smaller caliber. This is especially difficult when using mice with dark hair, whose tail vein is hardly visible. Due to its larger caliber, positioning the catheter inside the jugular vein may allow larger volumes or repeated treatments to be injected more reliably. Please note that the syringe is filled at first time with warm saline, and do not forget to inject the dead volume before injecting the drug solution.
    5. Carefully return the mouse to a prone position  (Figure 2C). Apply gel (Table of Materials) on the eyes to prevent dryness.

2. Surgery and installation of the cranial ring

NOTE: The full support for mouse installation comprises 4 pieces, a block and a plate, the ring to hold the mouse head, and a screw to fix the ring to the block (Figure 3A). All elements of the support have been obtained from i.materialise.com by 3D printing. The plate is made of acrylonitrile butadiene styrene (ABS) polymer, the block and screw of stainless steel, and the ring of high-grade stainless steel (high-detailed stainless steel) (See Supplemental Figure S1 for dimensions and Supplemental Materials for the 3D printing files). The block is fixed permanently to the support, either screwed or glued. Once the ring is fixed on the mouse skull, it should be screwed to the block holder (Figure 3A).

  1. Moisten the hair on the scalp with a paper towel wet with 70% ethanol for disinfection. Remove all the loose hair with a wet paper towel.
    NOTE: For convenience, the scalp may be shaved before surgery.
  2. Incise the scalp by forming a T at the midline up to 1 cm and between the ears to expose the calvarium using sterile fine scissors and tweezers.
    NOTE: The ring will be positioned to overlap the frontal and parietal bones (Figure 3B).
  3. Use sterile tweezers to expose the skull. Carefully remove the periosteum with scissors and tweezers. Use a sterile cotton swab soaked with physiological saline to remove all the periosteum and any debris or hair, which could alter imaging.
    NOTE: To limit inflammatory reactions, take great care not to damage the bone.
  4. Remove any blood traces by rinsing with saline, and rapidly dry the bone with a dry cotton swab. Apply the glue gel to the ring, position it on the exposed bone, and maintain it for a few seconds so that the ring is firmly attached to the skull.
    NOTE: No glue must enter the observation field as it may lead to undesirable autofluorescence.
  5. Lightly moisten the skull with a cotton swab immersed in physiological saline.
  6. Prepare the silicon dental paste by carefully mixing 1:1 blue and yellow components. Apply dental paste all around the ring for sealing to prevent leakage during imaging. Carefully remove any dental paste or glue that may have entered the ring.
  7. Fill the ring with saline and check for leakage.
    NOTE: The saline serves as the immersion medium for the microscope objective. Bleeding may be more critical when using mice with hemostasis-related defects. It is essential to prevent blood from entering the ring as it may blur further imaging.
  8. Place the mouse on the support, and screw the ring on the block holder (Figure 3C). Place folded compresses under the animal's head to raise the head and prevent detachment of the ring from the skull.
    NOTE: The head is directly fixed so that it prevents image movements due to breathing.
  9. Position the support and mouse assembly in the heated microscope chamber (Figure 3D).
    ​NOTE: Be careful not to dislodge the inserted catheter at any time.

3. Follow-up of the anesthetized mice until the end of the experiment

NOTE: Anesthesia is re-induced every 35 min by alternating subcutaneous (s.c.) injections of ketamine (25 µg/g) in a volume of 5 µL/g body weight and a mixture of ketamine (50 µg/g) and xylazine (5 µg/g) (1.2 µL/g). As it is not possible to open the heated microscope chamber during acquisition, anesthetic monitoring is performed before and after re-administration of the anesthetic by toe pinching. Similarly, toe pinch is performed before beginning each new video recording.

  1. If required, stop acquisition and re-induce anesthesia by s.c. injection.
    1. Being careful not to move the mouse head, pinch the skin of the back between the thumb and index finger of the left hand. Subcutaneously inject the anesthetic in the fold of the back skin using the right hand (or vice versa for left-handed people).
  2. Check for the presence of saline in the ring, and if necessary, fill with fresh saline. Go on recording for the next 35 min, and proceed similarly for the recording duration.
  3. At the end of the experiment, euthanize the mouse by cervical dislocation before it wakes up.
    ​NOTE: The mouse is kept anesthetized for a maximum duration of 3 h, in agreement with the local ethical and animal welfare committee.

4. Two-photon imaging

NOTE: See the Table of Materials for details about the microscope and related equipment. Images were recorded with a resonant scanner (12 or 8 kHz). The bidirectional mode was set up to increase speed acquisition as pixels are recorded in both directions; hence, any mismatch in the phase must be corrected with the control panel "phase correction." Finally, an adapted averaging was set up as a compromise between speed of acquisition and signal-to-noise ratio.

  1. Switch on the two-photon microscope, including the laser and resonant scanner (output laser power usually ~1.8-2.5 W depending on the laser).
  2. Set the appropriate laser wavelength for the chosen fluorophores. Set the appropriate wavelength for the recovery of emitted lights.
    NOTE: Here, a wavelength of 913 nm and hybrid detectors (500-550 nm and 575-625 nm) were used to simultaneously excite and detect AlexaFluor-488 and Qtracker-655, respectively.
  3. Using the intrajugular catheter, inject the fluorescent tracer to label the vasculature (Qtracker-655; Table of Materials). Inject 50 µL/mouse of a solution at 0.2 µM, renewed once every hour for a maximum of 150 µL/experiment.
    NOTE: Other tracers can be used such as high molecular weight dextran1. In that case, consider that blood viscosity can be altered by dextran and modify some hemorheological parameters.
  4. Place the microscope stage with the support and mouse under the objective of the microscope. Check that the ring is always filled with saline and immerse the objective. Use epifluorescence to locate the bone marrow vessels (red) and the presence of megakaryocytes (green) aligned along sinusoid vessels.
    NOTE: The skull bone has a thickness lower than 100 µm2. The marrow is located beneath the bone and is easily recognized by the fluorescent green megakaryocytes and the dense red anastomosed sinusoid vessels labeled by Qtracker-655.
  5. Long acquisitions (megakaryocytes, proplatelets)
    1. Search for the region of interest. Apply image acquisition parameters as mentioned above.
    2. For long acquisitions (e.g., visualization of proplatelet formation or elongation), acquire z-stack images with optimized intervals (usually between 0.85 to 1.34 µm) using an 8 kHz resonant scanner.
      NOTE: A 12 kHz resonant scanner can increase acquisition speed.
    3. Acquire 384 x 384 pixel images to visualize the entire megakaryocyte and vessel. Use line averaging, as desired, for rapid acquisition with good resolution. Determine the time interval of image stack acquisition, usually 10 s or 30 s for proplatelet visualization.
      NOTE: Here, a line averaging of 8 was used to obtain a higher signal-to-noise ratio, which allowed the acquisition of 1 image/10 s with an 8 kHz resonant scanner. Ensure that line averaging during live acquisition is allowed.
  6. Short and rapid acquisition (platelets)
    NOTE: For shorter acquisition of rapid events, such as platelet velocity, it is essential to maximize the frame acquisition rate. Selecting the proper acquisition type will optimized the frame acquisition rate (i.e. a space-time acquisition type “xyt”). 
    1. Minimize (e.g., 256 x 90 pixels) and adjust image size to the vessel by rotating the imaging field, if required.
    2. Use the highest available scanning speed.
    3. Use bidirectional scanning.
      NOTE: For bidirectional scanning, ensure that the phase is well-adjusted.
    4. Minimize line averaging to find the optimal compromise between image definition and rapidity of acquisition.
      NOTE: For platelet velocity measurements, a pixelized image may be sufficient if it helps increase the rapidity of acquisition.
    5. Minimize z-stack to increase acquisition rapidity. Acquiring only 1 z-stack is sufficient to quantify platelet velocity. Acquire for 10-20 s to measure platelet velocity.
      NOTE: A maximum of 133 frames/s can be obtained using these conditions with a 12 kHz resonant scanner. The parameters must be adapted to the conditions. In some vessels, platelet velocity is nevertheless too high to quantify platelet velocity with these settings reliably.
  7. Proplatelet width and length measurement
    NOTE: To load LIF-files obtained on Leica software with ImageJ, first download and install the LOCI plug-in on ImageJ to use the Bio-Formats Importer.
    1. Proplatelet width
      1. Open the movie with ImageJ. To perform width measurement, use only the movie of the proplatelets without the vessel. To separate the different channels, click on Image|Color and select Split Channels.
      2. For a z-stack movie, make an average z-projection for each time point by clicking on Image|Stacks and select Z Project. For Projection type, enter average Intensity.
      3. Treat the image to remove the noise. Subtract the background by clicking on Process|Subtract background and apply Rolling ball radius: 50.0 pixels. Smooth the image by clicking on Process and Smooth.
      4. Trace a line close to the base of the proplatelet (near the megakaryocyte, avoiding any other object).
        NOTE: Do not forget to set the scale of the image to obtain the value in the desired unit by clicking on Analyze and Set Scale. By default, the unit of the image is in pixels.
      5. Plot the intensity profile, fit a gaussian curve, and calculate the Full Width at Half Maximum (FWHM). For that, write the following script in a macro by clicking on Plugins|New and select Macro and run it by clicking on Macro|Run Macro: y=getProfile(); x=Array.getSequence(y.length); Fit.doFit("Gaussian",x,y); Fit.plot(); sigma=Fit.p(3); FWHM = (2 * sqrt( 2 * log(2) ) ) * sigma; print(FWHM).
        NOTE: Ensure that there is only a single peak in the line scan, corresponding to the proplatelet intensity.
      6. Perform the actions described in step 4.7.5 on 1 slice or repeated over time to get the mean width of the proplatelet
    2. Proplatelet length
      1. Trace a line along the proplatelet, from the base close to the megakaryocyte to the top. Use a segmented line to follow the proplatelet shape. Repeat it for each time point.
      2. Remember to save each line using the ROI Manager: click on Analyze | Tools and select ROI Manager. Click on Add in the ROI Manager window to add each line to the manager as is it selected. To save all the lines in a folder, click in the ROI Manager on Deselect | More and click on Save. From the ROI Manager, extract the length value of each line (Measure) from the results table.
        NOTE: Do not forget to set the scale of the image to obtain the value in the desired units by clicking on Analyze and Set Scale. By default, the unit of the image is in pixels.
  8. Platelet velocity measurement
    NOTE: Platelet velocity is calculated from the video recording of fluorescent platelets flowing inside the vessel over 10-20 s. A first-image treatment is performed to obtain cyclically repeated line-scan data. Motion leads to streaks whose angle depends on the velocity, allowing its calculation. Here, velocity was calculated with a method that uses the Radon transform, which is more robust than the classical Singular Value Decomposition (SVD) method15.
    1. Image treatment with ImageJ
      1. Open the movie with ImageJ. Apply a Gaussian Blur filter by clicking on Process | Filters, select Gaussian Blur, and apply Sigma (Radius): 2.00. Choose a small region to measure the flow, and trace 3 adjacent lines following the flow direction.
        NOTE: Do not forget to save each line by using the ROI Manager by clicking on Analyze | Tools | ROI Manager. Click on Add in the ROI Manager window to add each line and save them; click first on Deselect | More and then click on Save.
      2. Using ImageJ line-scan software, build a kymograph for each line by clicking on Image | Stacks; select Reslice and apply the following parameters: Output spacing (microns): 1.000 / Slice count: 1 / Avoid interpolation. Save the resulting space-time images.
        NOTE: The resulting image shows streaks corresponding to the linear motion of the platelets in the blood flow over time. The angle of a streak is a function of the velocity.
    2. Velocity measurement using Matlab or GNU Octave software
      NOTE: The velocity of the platelets in the blood flow is estimated from the space-time images using a computational analysis method based on the Radon transform described by Drew and collaborators15. The description of this mathematical method is beyond the scope of this review, and the reader is referred to the publication by Drew et al. for details regarding the calculation15. Both the Matlab code and more information are available on their website https://www.drew-lab.org/code.
      1. Open the code using Matlab or GNU Octave software.
        NOTE: The code may require adaptation according to the desired study.
      2. Extract the value from the 3 space-time images, corresponding to the adjacent lines drawn in the same vessel portion. Calculate the mean platelet flow velocity value for this portion of the vessel.
        NOTE: Do not forget to convert the result in the correct unit of measure (e.g., µm/s).

Wyniki

Using this protocol, the fluorescent tracer, Qtracker-655, was intravenously administered to image anastomosed marrow sinusoid vessels in the skull bone marrow and the flow direction as depicted by the arrows (Figure 4A, left). Using mTmG mice, eGFP-fluorescent platelets were recorded over 20 s in each vessel branch, and their velocity was measured using ImageJ and GNU Octave software (Figure 4A, right). Note the heterogeneity in flow velocity and direction. Sin...

Dyskusje

The mechanisms of platelet formation are highly dependent on the bone marrow environment. Hence, intravital microscopy has become an important tool in the field to visualize the process in real-time. Mice with fluorescent megakaryocytes can be obtained by crossing mice expressing the Cre recombinase in megakaryocytes with any floxed reporter mice containing a conditional fluorescent gene expression cassette. Here, mTmG reporter mice were used (B6.129(Cg)-Gt(ROSA)26Sortm4(ACTB-tdTomato,-EGFP)Luo10) cro...

Ujawnienia

The authors have no conflicts of interest to declare.

Podziękowania

The authors would like to thank Florian Gaertner (Institute of Science and Technology Austria, Klosterneuburg, Austria) for his expert advice on two-photon microscopy experiments at the time when we established the technique in the lab, and Yves Lutz at the Imaging Center IGBMC /CBI (Illkirch, France) for his expertise and help with the two-photon microscope. We also thank Jean-Yves Rinkel for his technical help and Ines Guinard for the drawing of the schema in Figure 1. We thank ARMESA (Association de Recherche et Développement en Médecine et Santé Publique) for its support in the acquisition of the two-photon microscope. AB was supported by post-doctoral fellowships from Etablissement Français du Sang (APR2016) and from Agence Nationale de la Recherche (ANR-18-CE14-0037-01).

Materiały

NameCompanyCatalog NumberComments
GNU Octave softwareGNU Projecthttps://www.gnu.org/software/octave/
 Histoacryl 5 x 0, 5 mLBraun1050052injectable solution of surgical glue
HyD hybrid detectors Leica Microsystems 4tunesLeica Microsystems
ImageJGNU projectMinimum version required
Imalgene/Ketamine 1000 fl/10 mLBoehring03661103003199eye protection
Leica SP8 MP DIVE microscope equipped with a 25x water objective, numerical aperture of 0.95Leica Microsystemssimultaneous excitation of AlexaFluor-488 and Qtracker-655
MatlabMathWorkshttps://www.mathworks.com/
Ocrygel 10 gLaboratoires T.V.M.03700454505621Silicon dental paste blue and yellow
Picodent twinsin speedRotec13001002
Qtracker 655 vascular labelInvitrogenQ21021MPinjectable solution
Resonant scanner, 8 or 12 kHz
Rompun Xylazine 2% fl/25 mLBayer04007221032311
Superglue gelto glue the ring to the bone
Surflo IV catheter - Blue 22 GTerumoSR-OX2225C1
Ti:Saph pulsing laser (Coherent) (femtosecond)Coherent

Odniesienia

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  6. Nishimura, S., et al. IL-1alpha induces thrombopoiesis through megakaryocyte rupture in response to acute platelet needs. Journal of Cell Biology. 209 (3), 453-466 (2015).
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  10. Muzumdar, M. D., Tasic, B., Miyamichi, K., Li, L., Luo, L. A global double-fluorescent Cre reporter mouse. Genesis. 45 (9), 593-605 (2007).
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  12. Pertuy, F., et al. Broader expression of the mouse platelet factor 4-cre transgene beyond the megakaryocyte lineage. Journal of Thrombosis and Haemostasis. 13 (1), 115-125 (2015).
  13. Calaminus, S. D., et al. Lineage tracing of Pf4-Cre marks hematopoietic stem cells and their progeny. PLoS One. 7 (12), 51361 (2012).
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  15. Drew, P. J., Blinder, P., Cauwenberghs, G., Shih, A. Y., Kleinfeld, D. Rapid determination of particle velocity from space-time images using the Radon transform. Journal of Computational Neuroscience. 29 (1-2), 5-11 (2010).
  16. Nakagawa, T., et al. Ketamine suppresses platelet aggregation possibly by suppressed inositol triphosphate formation and subsequent suppression of cytosolic calcium increase. Anesthesiology. 96 (5), 1147-1152 (2002).
  17. Kim, S., Lin, L., Brown, G. A. J., Hosaka, K., Scott, E. W. Extended time-lapse in vivo imaging of tibia bone marrow to visualize dynamic hematopoietic stem cell engraftment. Leukemia. 31 (7), 1582-1592 (2017).
  18. Kohler, A., Geiger, H., Gunzer, M. Imaging hematopoietic stem cells in the marrow of long bones in vivo. Methods in Molecular Biology. 750, 215-224 (2011).
  19. Lewandowski, D., et al. In vivo cellular imaging pinpoints the role of reactive oxygen species in the early steps of adult hematopoietic reconstitution. Blood. 115 (3), 443-452 (2010).
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