We would like to thank Aimee Pugh-Bernard for her intellectual input and helpful comments. This work was supported by the Boettcher Foundation Webb-Waring Biomedical Research Award and award number K23-1K23AR070897 from the NIH to Elena W.Y. Hsieh. She was also supported by award number K12-HD000850 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the Lucile Packard Foundation for Children&#39;s Health, Stanford CTSA UL1 TR001085, and Child Health Research Institute of Stanford University.

All methods described here have been approved by the Colorado Multiple Institutional Review Board (COMIRB) of the University of Colorado. All described procedures below should be performed in a sterile tissue culture hood unless stated otherwise, with filtered pipette tips, and all reagents filtered.
1. Preparation of Reagents for Peripheral Whole Blood Processing
<ol>
	<li>Prepare ruxolitinib stock aliquots (10&#8211;15 &#956;L/vial for single use) at 10 mM by diluting the lyophilized reage...

<ol>
	<li>Walsh, S. J., Rau, L. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Autoimmune+diseases:+a+leading+cause+of+death+among+young+and+middle-aged+women+in+the+United+States.">Autoimmune diseases: a leading cause of death among young and middle-aged women in the United States.</a> American journal of public health. 90 (9), 1463-1466 (2000).</li><li>Mak, A., Cheung, M. W. -. L., Chiew, H. J., Liu, Y., Ho, R. 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=Global+trend+of+survival+and+damage+of+systemic+lupus+erythematosus:+meta-analysis+and+meta-regression+of+observational+studies+from+the+1950s+to+2000s.">Global trend of survival and damage of systemic lupus erythematosus: meta-analysis and meta-regression of observational studies from the 1950s to 2000s.</a> Seminars in arthritis and rheumatism. 41 (6), 830-839 (2012).</li><li>Kaul, A., Gordon, C., 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=Systemic+lupus+erythematosus.">Systemic lupus erythematosus.</a> Nature reviews. Disease primers. 2, 16039 (2016).</li><li>Annunziato, F., Romagnani, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Heterogeneity+of+human+effector+CD4++T+cells.">Heterogeneity of human effector CD4+ T cells.</a> Arthritis Research &amp; Therapy. 11 (6), 257 (2009).</li><li>Peck, A., Mellins, E. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Plasticity+of+T-cell+phenotype+and+function:+the+T+helper+type+17+example.">Plasticity of T-cell phenotype and function: the T helper type 17 example.</a> Immunology. 129 (2), 147-153 (2010).</li><li>Basso, A. S., Cheroutre, H., Mucida, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=More+stories+on+Th17+cells.">More stories on Th17 cells.</a> Cell research. 19 (4), 399-411 (2009).</li><li>Ornatsky, O., Bandura, D., Baranov, V., Nitz, M., Winnik, M. A., Tanner, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Highly+multiparametric+analysis+by+mass+cytometry.">Highly multiparametric analysis by mass cytometry.</a> Journal of Immunological Methods. 361 (1-2), 1-20 (2010).</li><li>Ornatsky, O., Baranov, V. I., Bandura, D. R., Tanner, S. D., Dick, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Multiple+cellular+antigen+detection+by+ICP-MS.">Multiple cellular antigen detection by ICP-MS.</a> Journal of Immunological Methods. 308 (1-2), 68-76 (2006).</li><li>Bendall, S. C., Simonds, E. 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=Single-Cell+Mass+Cytometry+of+Differential+Immune+and+Drug+Responses+Across+a+Human+Hematopoietic+Continuum.">Single-Cell Mass Cytometry of Differential Immune and Drug Responses Across a Human Hematopoietic Continuum.</a> Science. 332 (6030), 687-696 (2011).</li><li>Bandura, D. R., Baranov, V. I., 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=Mass+Cytometry:+Technique+for+Real+Time+Single+Cell+Multitarget+Immunoassay+Based+on+Inductively+Coupled+Plasma+Time-of-Flight+Mass+Spectrometry.">Mass Cytometry: Technique for Real Time Single Cell Multitarget Immunoassay Based on Inductively Coupled Plasma Time-of-Flight Mass Spectrometry.</a> Analytical Chemistry. 81 (16), 6813-6822 (2009).</li><li>Leipold, M. D., Maecker, H. T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Mass+cytometry:+protocol+for+daily+tuning+and+running+cell+samples+on+a+CyTOF+mass+cytometer.">Mass cytometry: protocol for daily tuning and running cell samples on a CyTOF mass cytometer.</a> Journal of visualized experiments : JoVE. (69), e4398 (2012).</li><li>McCarthy, R. L., Duncan, A. D., Barton, M. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Sample+Preparation+for+Mass+Cytometry+Analysis.">Sample Preparation for Mass Cytometry Analysis.</a> Journal of visualized experiments : JoVE. (122), (2017).</li><li>Rahman, A., Isenberg, D. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Systemic+lupus+erythematosus.">Systemic lupus erythematosus.</a> The New England journal of medicine. 358 (9), 929-939 (2008).</li><li>O'Gorman, W. E., Hsieh, E. W. Y., 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=Single-cell+systems-level+analysis+of+human+Toll-like+receptor+activation+defines+a+chemokine+signature+in+patients+with+systemic+lupus+erythematosus.">Single-cell systems-level analysis of human Toll-like receptor activation defines a chemokine signature in patients with systemic lupus erythematosus.</a> The Journal of allergy and clinical immunology. 136 (5), 1326-1336 (2015).</li><li>O'Gorman, W. E., Kong, D. 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=Mass+cytometry+identifies+a+distinct+monocyte+cytokine+signature+shared+by+clinically+heterogeneous+pediatric+SLE+patients.">Mass cytometry identifies a distinct monocyte cytokine signature shared by clinically heterogeneous pediatric SLE patients.</a> Journal of Autoimmunity. 81, 74-89 (2017).</li><li>Simonds, E. F., Bendall, S. C., 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=Extracting+a+cellular+hierarchy+from+high-dimensional+cytometry+data+with+SPADE.">Extracting a cellular hierarchy from high-dimensional cytometry data with SPADE.</a> Nature Biotechnology. , 1-8 (2011).</li><li>Amir, E. -. A. D., Davis, K. L., 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=viSNE+enables+visualization+of+high+dimensional+single-cell+data+and+reveals+phenotypic+heterogeneity+of+leukemia.">viSNE enables visualization of high dimensional single-cell data and reveals phenotypic heterogeneity of leukemia.</a> Nature Biotechnology. 31 (6), 545-552 (2013).</li><li>Bruggner, R. V., Bodenmiller, B., Dill, D. L., Tibshirani, R. J., Nolan, G. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Automated+identification+of+stratifying+signatures+in+cellular+subpopulations.">Automated identification of stratifying signatures in cellular subpopulations.</a> Proceedings of the National Academy of Sciences of the United States of America. 111 (26), E2770-E2777 (2014).</li><li>Levine, J. H., Simonds, E. 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=Data-Driven+Phenotypic+Dissection+of+AML+Reveals+Progenitor-like+Cells+that+Correlate+with+Prognosis.">Data-Driven Phenotypic Dissection of AML Reveals Progenitor-like Cells that Correlate with Prognosis.</a> Cell. 162 (1), 184-197 (2015).</li><li>Samusik, N., Good, Z., Spitzer, M. H., Davis, K. L., Nolan, G. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Automated+mapping+of+phenotype+space+with+single-cell+data.">Automated mapping of phenotype space with single-cell data.</a> Nature Publishing Group. 13 (6), 493-496 (2016).</li><li>Spitzer, M. H., Gherardini, P. 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=IMMUNOLOGY.+An+interactive+reference+framework+for+modeling+a+dynamic+immune+system.">IMMUNOLOGY. An interactive reference framework for modeling a dynamic immune system.</a> Science. 349 (6244), 1259425 (2015).</li><li>Fienberg, H. G., Simonds, E. F., Fantl, W. J., Nolan, G. P., Bodenmiller, B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+platinum-based+covalent+viability+reagent+for+single-cell+mass+cytometry.">A platinum-based covalent viability reagent for single-cell mass cytometry.</a> Cytometry Part A. 81 (6), 467-475 (2012).</li><li>Jansen, K., Blimkie, 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=Polychromatic+flow+cytometric+high-throughput+assay+to+analyze+the+innate+immune+response+to+Toll-like+receptor+stimulation.">Polychromatic flow cytometric high-throughput assay to analyze the innate immune response to Toll-like receptor stimulation.</a> Journal of Immunological Methods. 336 (2), 183-192 (2008).</li><li>Zunder, E. R., Finck, 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=Palladium-based+mass+tag+cell+barcoding+with+a+doublet-filtering+scheme+and+single-cell+deconvolution+algorithm.">Palladium-based mass tag cell barcoding with a doublet-filtering scheme and single-cell deconvolution algorithm.</a> Nature Protocols. 10 (2), 316-333 (2015).</li><li>Lai, L., Ong, R., Li, J., Albani, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+CD45-based+barcoding+approach+to+multiplex+mass-cytometry+(CyTOF).">A CD45-based barcoding approach to multiplex mass-cytometry (CyTOF).</a> Cytometry Part A. , (2015).</li><li>Mei, H. E., Leipold, M. D., Schulz, A. R., Chester, C., Maecker, H. T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Barcoding+of+live+human+peripheral+blood+mononuclear+cells+for+multiplexed+mass+cytometry.">Barcoding of live human peripheral blood mononuclear cells for multiplexed mass cytometry.</a> The Journal of Immunology. 194 (4), 2022-2031 (2015).</li><li>Finck, R., Simonds, E. 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=Normalization+of+mass+cytometry+data+with+bead+standards.">Normalization of mass cytometry data with bead standards.</a> Cytometry Part A. 83 (5), 483-494 (2013).</li><li>Takahashi, C., Au-Yeung, 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=Mass+cytometry+panel+optimization+through+the+designed+distribution+of+signal+interference.">Mass cytometry panel optimization through the designed distribution of signal interference.</a> Cytometry. Part A : the journal of the International Society for Analytical Cytology. 91 (1), 39-47 (2017).</li></ol>

The authors have nothing to disclose.

Here we describe a novel, single-cell, proteomic approach to simultaneously assess multiple immune cell types and detect their various cytokine perturbations in the milieu of patient specific &#34;pathogenic&#34; peripheral blood plasma circulating factors. This method employs peripheral whole blood as the analytical vehicle, and mass cytometry as the tool for the evaluation of immune cellular phenotypic and functional abnormalities. The method is readily applicable to human and mice studies21, an...

Autoimmune diseases are a major cause of morbidity and mortality affecting 3-8% of the population. In the United States, autoimmune disorders are among the leading causes of death among young and middle-aged women (ages &#60;65 years)1,2. Autoimmune disorders are characterized by heterogeneous clinical presentation and diverse underlying immunological processes. The spectrum of heterogeneity is well represented across different disorders, such as joint involvement in rheumatoid arthritis (RA) and neurological disease in multiple sclerosis (MS). However, this level of heterogeneity is also exemplified within a single disorder, such as systemic lupus erythematosus (SLE): some patients may present with renal pathology, while others suffer from hematologic or joint involvement3.
The underlying immunopathogenesis in autoimmune disorders mirrors the clinical heterogeneity, involving auto- and hyper-activation of multiple innate and adaptive immune cell subsets, and concomitant dysregulated cytokine production. While cytokines play a pivotal role in the pathogenesis of autoimmune disease, understanding their specific role in the mechanism of disease has proven to be challenging. Cytokines are characterized by pleiotropy (one cytokine can have multiple effects on different cell types), redundancy (multiple cytokines can have the same effect), duality (one cytokine can have pro- or anti-inflammatory effects under different conditions), and plasticity (cytokines can be molded into a role different from its &#34;original&#34; one, depending on the environment)4,5,6. Consequently, population-level methods cannot distinguish heterogeneous cellular responses to the same &#34;cytokine milieu&#34;. Similarly, study designs that focus on one specific aspect of the immune system (a single cell type or cytokine), do not offer a global assessment of all the elements involved in complex autoimmune disease. While patient sera-based studies have afforded important insights into autoimmunity, they do not provide the specific cellular source of the dysregulated cytokines detected.
Recently, we developed a single-cell proteomic approach to simultaneously assess multiple immune cell types, and detect their various cytokine perturbations in the milieu of patient specific &#34;pathogenic&#34; peripheral blood plasma circulating factors. The workflow described here is characterized by the use of intact peripheral whole blood samples, as opposed to isolated peripheral blood mononuclear cells (PBMCs). Peripheral whole blood represents the most physiologically relevant vehicle to study systemic immune-mediated disease, including 1) non-mononuclear blood cells often involved in autoimmune disease (i.e., neutrophils, platelets), and 2) plasma circulating factors, such as nucleic acids, immune complexes, and cytokines, which have immune activating roles. To capture the &#34;intrinsic pathogenic&#34; dysregulated cytokine production, peripheral blood samples are processed immediately after the blood draw (T0, Time zero), and after 6 h of incubation at 37 &#176;C (physiological body temperature) with a protein transport inhibitor in the absence of any exogenous stimulating condition (T6, Time 6 h), to detect cytokine production (accumulation, T6-T0) that would reflect the &#34;intrinsic&#34; disease state (Figure 1). To study dysregulated processes that reflect over or under-activation of signaling pathways involved in immune responses relevant to the disease, peripheral blood samples are treated (6 h incubation at 37 &#176;C with a protein transport inhibitor) with an exogenous stimulating condition that reflects disease pathogenesis, such as Toll-Like-Receptor (TLR) agonists in the case of SLE (T6 + R848, Time 6 h with 1 &#181;g/mL R848), to detect cytokine production that would reflect a response to nucleic acids (comparing T0 vs. T6 vs. T6 + R848, Figure 1). To study immunomodulatory effects of available therapeutics ex vivo, as they pertain to the precise immune dysregulated processes for specific patients, peripheral blood samples are treated with a JAK inhibitor at the relevant therapeutic concentration (here, 5 uM ruxolitinib; T6 + 5R, Time 6 h with 5 uM ruxolitinib), to detect changes in &#34;intrinsic&#34; disease state in response to the drug (T0 vs. T6 vs. T6 + 5R, Figure 1). A JAK inhibitor was chosen for this study because JAK inhibitors have been shown to be successful in the treatment of autoimmune disorders such as RA.
To simultaneously evaluate the dysregulated processes described above in multiple immune cell subsets, peripheral blood samples from SLE patients and healthy controls were processed as described above and analyzed by mass cytometry. Mass cytometry, also known as Cytometry-Time-Of-Flight, offers single-cell analysis of over 40 parameters without issues of spectral overlap7,8,9. This technique utilizes rare earth metal isotopes in the form of soluble metal ions as tags bound to antibodies, instead of fluorophores10. Additional details regarding the mass cytometry technological platform (i.e., tuning and calibration, sample acquisition) can be found in Leipold et al. and McCarthy et al.11,12 The high-dimensionality of mass cytometry enables simultaneous measurement of multiple cytokines throughout innate and adaptive immune cell subsets with single-cell granularity (Table of Materials).
Current conventional clinical and laboratory parameters are often not sensitive or specific enough for detecting ongoing disease activity or the response to specific immunomodulators13, reflecting the need to better delineate the underlying immune changes that drive flare-ups. Given the pervasiveness of cytokine dysregulation in autoimmune disease, a plethora of treatment approaches that use antibodies or small molecular inhibitors targeting cytokines or signaling proteins involved in the regulation of cytokine production have recently emerged. In its basic format, the peripheral blood analytical approach described here provides a platform to identify patient-specific dysregulated cell subsets and their abnormal cytokine production in autoimmune disease with systemic manifestations. This methodology allows for the personalization of therapeutic choices as specific dysregulated cytokines can be identified, and specific treatment options can be tested ex vivo to assess their ability to immunomodulate the patient specific disease process.

<table>
	<tbody>
		<tr>
			<td>Ruxolitinib</td>
			<td>Santa Cruz</td>
			<td>SC-364729A</td>
			<td>Stock Conc: 10 mM; Final Conc: 5 &#956;M</td>
		</tr>
		<tr>
			<td>R848</td>
			<td>Invivogen</td>
			<td>tlrl-r848-5</td>
			<td>Stock Conc: 1 &#956;g/&#956;L; Final Conc: 1 &#956;g/mL</td>
		</tr>
		<tr>
			<td>LPS-EK</td>
			<td>Invivogen</td>
			<td>tlrl-eklps</td>
			<td>Stock Conc: 1 &#956;g/&#956;L; Final Conc: 0.1 &#956;g/mL</td>
		</tr>
		<tr>
			<td>Sterile PBS</td>
			<td>Lonza</td>
			<td>17-516F</td>
			<td></td>
		</tr>
		<tr>
			<td>Lyse/Fix Buffer</td>
			<td>BD biosciences</td>
			<td>558049</td>
			<td>Stock Conc: 5X; Final Conc: 1X (dilute in ddH2O)</td>
		</tr>
		<tr>
			<td>&#160;BD Phosflow perm/wash buffer I</td>
			<td>BD biosciences</td>
			<td>557885</td>
			<td>Stock Conc: 10X; Final Conc: 1:10 (dilute in ddH2O)</td>
		</tr>
		<tr>
			<td>RPMI</td>
			<td>Gibco</td>
			<td>21870-076</td>
			<td></td>
		</tr>
		<tr>
			<td>Sodium Azide (NaN3)</td>
			<td>Sigma-Aldrich</td>
			<td>S-8032</td>
			<td>Stock Conc: &#62;99.9%; Final Conc: 0.0002</td>
		</tr>
		<tr>
			<td>Protein Transport Inhibitor (PTI)</td>
			<td>eBiosciences</td>
			<td>00-4980-93</td>
			<td>Stock Conc: 500X; Final Conc: 1X</td>
		</tr>
		<tr>
			<td>DNA Intercalator</td>
			<td>Fluidigm</td>
			<td>201192B</td>
			<td>Stock Conc: 500 &#956;M; Final Conc: 0.1 &#956;M</td>
		</tr>
		<tr>
			<td>Cell Staining Media (CSM)</td>
			<td></td>
			<td></td>
			<td>PBS + 0.5% BSA, 0.02% NaN3</td>
		</tr>
		<tr>
			<td>MaxPar Barcode Perm Buffer</td>
			<td>Fluidigm</td>
			<td>201057</td>
			<td>Stock Conc: 10X; Final Conc: 1X</td>
		</tr>
		<tr>
			<td>20-plex Pd Barcode Set</td>
			<td>Fluidigm</td>
			<td>S0014</td>
			<td>Stock Conc: n/a; Final Conc: n/a</td>
		</tr>
		<tr>
			<td>EQ TM Four Element Calibration Beads</td>
			<td>Fluidigm</td>
			<td>201078</td>
			<td>Stock Conc: 10X; Final Conc: 1X</td>
		</tr>
		<tr>
			<td>16% MeOH-free Formaldehyde Solution</td>
			<td>Thermo</td>
			<td>28908</td>
			<td>Stock Conc: 16% (w/v); Final Conc: 1.6% (w/v)</td>
		</tr>
		<tr>
			<td>Sterile round bottom polystyrene tubes</td>
			<td>VWR</td>
			<td>60818-496</td>
			<td>Stock Conc: n/a; Final Conc: n/a</td>
		</tr>
		<tr>
			<td>Polypropylene cluster tubes</td>
			<td>Light Labs</td>
			<td>A-9001</td>
			<td>Stock Conc: n/a; Final Conc: n/a</td>
		</tr>
		<tr>
			<td>Helios CyTOF instrument</td>
			<td>Fluidigm</td>
			<td>Helios</td>
			<td>All solutions to be used in CyTOF analysis need to be free of metal contamination. ddH2O is used in the preparation of any solutions should have a resistivity of at least 18.0 M&#937;.cm. ddH2O and any self-prepared solutions should be stored in new plastic or glass bottles that have never been autoclaved.</td>
		</tr>
		<tr>
			<td>Name</td>
			<td>Company</td>
			<td>Catalog Number</td>
			<td>Comments</td>
		</tr>
		<tr>
			<td>Antibodies used for Mass Cytometry</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Surface markers</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>CD1c</td>
			<td>Biolegend</td>
			<td>L161</td>
			<td>Mass: 161</td>
		</tr>
		<tr>
			<td>CD3</td>
			<td>BD</td>
			<td>UCHT1</td>
			<td>Mass: 144</td>
		</tr>
		<tr>
			<td>CD4</td>
			<td>Biolegend</td>
			<td>SK3</td>
			<td>Mass: 174</td>
		</tr>
		<tr>
			<td>CD7</td>
			<td>BD</td>
			<td>M-T701</td>
			<td>Mass: 149</td>
		</tr>
		<tr>
			<td>CD8</td>
			<td>Biolegend</td>
			<td>SK1</td>
			<td>Mass: 142</td>
		</tr>
		<tr>
			<td>CD11b</td>
			<td>Fluidigm</td>
			<td>ICRF44</td>
			<td>Mass: 209</td>
		</tr>
		<tr>
			<td>CD11c</td>
			<td>BD</td>
			<td>B-ly6</td>
			<td>Mass: 152</td>
		</tr>
		<tr>
			<td>CD15</td>
			<td>BD</td>
			<td>HI98</td>
			<td>Mass: 115</td>
		</tr>
		<tr>
			<td>CD14</td>
			<td>Biolegend</td>
			<td>M5E2</td>
			<td>Mass: 154</td>
		</tr>
		<tr>
			<td>CD16</td>
			<td>eBioscience/Thermo</td>
			<td>B73.1</td>
			<td>Mass: 165</td>
		</tr>
		<tr>
			<td>CD19</td>
			<td>Santa Cruz</td>
			<td>SJ25C1</td>
			<td>Mass: 163</td>
		</tr>
		<tr>
			<td>CD21</td>
			<td>Biolegend</td>
			<td>Bu32</td>
			<td>Mass: 141</td>
		</tr>
		<tr>
			<td>CD27</td>
			<td>BD</td>
			<td>L128</td>
			<td>Mass: 155</td>
		</tr>
		<tr>
			<td>CD38</td>
			<td>Fluidigm</td>
			<td>HIT2</td>
			<td>Mass: 172</td>
		</tr>
		<tr>
			<td>CD45 total</td>
			<td>Biolegend</td>
			<td>HI30</td>
			<td>Mass: 89</td>
		</tr>
		<tr>
			<td>CD45RA</td>
			<td>Biolegend</td>
			<td>HI100</td>
			<td>Mass: 153</td>
		</tr>
		<tr>
			<td>CD56</td>
			<td>Miltenyi</td>
			<td>REA196</td>
			<td>Mass: 168</td>
		</tr>
		<tr>
			<td>CD66</td>
			<td>BD</td>
			<td>B1.1/CD66</td>
			<td>Mass: 113</td>
		</tr>
		<tr>
			<td>CD86</td>
			<td>Fluidigm</td>
			<td>IT2.2</td>
			<td>Mass: 150</td>
		</tr>
		<tr>
			<td>CD123</td>
			<td>Fluidigm</td>
			<td>6H6</td>
			<td>Mass: 143</td>
		</tr>
		<tr>
			<td>CD278/ICOS</td>
			<td>Biolegend</td>
			<td>C398.4A</td>
			<td>Mass: 156</td>
		</tr>
		<tr>
			<td>CD179/PD1</td>
			<td>Biolegend</td>
			<td>EH12.2H7</td>
			<td>Mass: 162</td>
		</tr>
		<tr>
			<td>IgD</td>
			<td>Biolegend</td>
			<td>IA6-2</td>
			<td>Mass: 146</td>
		</tr>
		<tr>
			<td>IgM</td>
			<td>Biolegend</td>
			<td>MHM-88</td>
			<td>Mass: 151</td>
		</tr>
		<tr>
			<td>CXCR5</td>
			<td>BD</td>
			<td>RF8B2</td>
			<td>Mass: 173</td>
		</tr>
		<tr>
			<td>HLADR</td>
			<td>Biolegend</td>
			<td>L243</td>
			<td>Mass: 167</td>
		</tr>
		<tr>
			<td>Cytokines</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>IL-1&#945;</td>
			<td>Biolegend</td>
			<td>364-3B3-14</td>
			<td>Mass: 147</td>
		</tr>
		<tr>
			<td>IL-1&#946;</td>
			<td>Biolegend&#160;</td>
			<td>H1b-98</td>
			<td>Mass: 169</td>
		</tr>
		<tr>
			<td>IL-1RA</td>
			<td>Santa Cruz&#160;</td>
			<td>AS17</td>
			<td>Mass: 157</td>
		</tr>
		<tr>
			<td>IL-6</td>
			<td>Biolegend</td>
			<td>MQ2-13A5</td>
			<td>Mass: 164</td>
		</tr>
		<tr>
			<td>IL-8</td>
			<td>BD</td>
			<td>E8N1</td>
			<td>Mass: 160</td>
		</tr>
		<tr>
			<td>IL-12/IL-23p40</td>
			<td>Biolegend&#160;</td>
			<td>C8.6</td>
			<td>Mass: 171</td>
		</tr>
		<tr>
			<td>IL-17A</td>
			<td>Biolegend&#160;</td>
			<td>BL168</td>
			<td>Mass: 148</td>
		</tr>
		<tr>
			<td>IL23p19</td>
			<td>eBioscience/Thermo</td>
			<td>23dcdp</td>
			<td>Mass: 176</td>
		</tr>
		<tr>
			<td>MIP1&#946;</td>
			<td>BD</td>
			<td>D21-1351</td>
			<td>Mass: 158</td>
		</tr>
		<tr>
			<td>MCP1</td>
			<td>BD</td>
			<td>5D3-F7</td>
			<td>Mass: 170</td>
		</tr>
		<tr>
			<td>IFN&#945;</td>
			<td>Miltenyi&#160;</td>
			<td>LT27:295</td>
			<td>Mass: 175</td>
		</tr>
		<tr>
			<td>IFN&#947;</td>
			<td>Biolegend</td>
			<td>4S.B3</td>
			<td>Mass: 165</td>
		</tr>
		<tr>
			<td>PTEN</td>
			<td>BD</td>
			<td>A2B1</td>
			<td>Mass: 159</td>
		</tr>
		<tr>
			<td>TNF&#945;</td>
			<td>Biolegend</td>
			<td>Mab11</td>
			<td>Mass: 166</td>
		</tr>
		<tr>
			<td>Note: If the manufacturer is stated as Fluidigm, this antibody was purchased from Fluidigm with metal pre-conjugated. If the manufacturer is stated as other than Fluidigm, this antibody was self-conjugated using the MaxPar Multi-Metal Labeling&#160; Kit (Fluidigm Cat: 201300) according to manufacturer protocol.&#160;</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
	</tbody>
</table>

single-cell analysis of immunophenotype and cytokine production in peripheral whole blood via mass cytometry

Cytokines play a pivotal role in the pathogenesis of autoimmune diseases. Hence, the measurement of cytokine levels has been the focus of multiple studies in an attempt to understand the precise mechanisms that lead to the breakdown of self-tolerance and subsequent autoimmunity. Approaches thus far have been based on the study of one specific aspect of the immune system (a single or few cell types or cytokines), and do not offer a global assessment of complex autoimmune disease. While patient sera-based studies have afforded important insights into autoimmunity, they do not provide the specific cellular source of the dysregulated cytokines detected. A comprehensive single-cell approach to evaluate cytokine production in multiple immune cell subsets, within the context of &#34;intrinsic&#34; patient-specific plasma circulating factors, is described here. This approach enables monitoring of the patient-specific immune phenotype (surface markers) and function (cytokines), either in its native &#34;intrinsic pathogenic&#34; disease state, or in the presence of therapeutic agents (in vivo or ex vivo).

Figure 1 demonstrates the workflow for the stimulation and processing of the peripheral blood samples, including allocation of blood sample aliquots, timing of the addition of stimulation agents, protein transport inhibitor cocktail, and incubation times until the red blood cell (RBC) lysis and fixation. The choice of stimulating agents will depend on the signaling and cytokine pathways that are targeted for assessment. For example, in the protocol described ...

Watch this Scientific Journal Video about Single-cell Analysis of Immunophenotype and Cytokine Production in Peripheral Whole Blood via Mass Cytometry at JoVE.com

Single-cell Analysis of Immunophenotype and Cytokine Production in Peripheral Whole Blood via Mass Cytometry

Here we describe a single-cell proteomic approach to evaluate immune phenotypic and functional (intracellular cytokine induction) alterations in peripheral whole blood samples, analyzed via mass cytometry.

Cytokines play a pivotal role in the pathogenesis of autoimmune diseases. Hence, the measurement of cytokine levels has been the focus of multiple studies ...

This method can help answer questions in the autoimmunity field such as identifying cell frequency abnormalities and function differences such as production of key cytokines in the setting of autoimmune disease. The main advantage of this method is that it can capture a broad repertoire or different cell types and function differences from a easily obtainable peripheral blood sample. Generally, individuals new to this process may struggle with getting the timing of the blood processing steps right, the antibody panel design, the barcoding process itself, and analysis of high dimensional single cell data.This systems immunology approach is particularly suitable for autoimmune diseases like SLE where immune dysregulation is pervasive and evident in peripheral blood. Visual demonstration of this method is important to clarify the timing of steps and also to show how multiple samples can be barcoded and pooled prior to mass cytometry analysis. To begin this procedure, place the labeled round bottom polystyrene tubes of five different conditions for whole blood processing on a rack.Next, add one milliliter of 37 degree Celsius RPMI to each tube. Then, add one milliliter of whole blood to each tube and pipette up and down several times to mix thoroughly with RPMI. Subsequently, add 10 microliters of pre-diluted ruxolitinib to the tube labeled T six plus five R and mix thoroughly.Place the rack of tubes in the incubator at 37 degrees Celsius and begin timing the incubation. To process the T zero sample, pipette the entire content of the T zero tube into a labeled conical tube containing 20 milliliters of 37 degree Celsius lyse/fix buffer at working concentration. To optimize cell recovery, rinse the tube with lyse/fix buffer and mix by inverting the conical tube.Incubate the cells at 37 degrees Celsius for 15 minutes to allow for lysis and fixation. Then, centrifuge the cells at 500 times G for five minutes at room temperature. Afterward, decant the supernatant and re-suspend the cells in one milliliter of ice cold PBS to break up the pellet.Then, fill the conical tube to a 15 milliliter volume with PBS. Subsequently, centrifuge the cells at 500 times G for five minutes at room temperature. Re-suspend the cells in one milliliter of CSM to break up the pellet.Then, transfer the sample to a labeled microcentrifuge tube for antibody staining. Using an automated cell counter, count the cells with a 10 microliter sample. Next, centrifuge the cells at 500 times G for five minutes at room temperature.Afterward, aspirate the supernatant, leaving the pellet in about 60 microliters of residual. Keep this pellet on ice until the samples from other conditions have completed processing. At T equals 30 minutes, transfer the tube rack to the tissue culture hood.Add 10 microliters of R848 at 0.1 grams per microliter to the T six plus R848 tube and mix thoroughly. Then, add 10 microliters of LPS at 0.01 micrograms per microliter to the T six plus LPS tube and mix thoroughly. Afterward, add four microliters of protein transport inhibitor to the tubes labeled T six, T six plus five R, and T six plus LPS and return the samples to the incubator until T equals six hours.Mix the samples thoroughly with a P1000 pipette every two hours. At T equals two hours, add four microliters of protein transport inhibitor cocktail to the T six plus R848 tube. Mix all samples and return the rack to the incubator until T equals six hours.At T equals four hours, mix the samples with a P1000 pipette one more time. At T equals six hours, process T six, T six plus LPS, T six plus R848, and T six plus five R blood sample tubes as described for the T zero sample. Then, store the pellets in residual CSM volume at minus 80 degrees Celsius to process later.To barcode the lysed, fixed cells, thaw the samples from the minus 80 degrees Celsius storage slowly on ice. Dilute the 10X barcoding perm buffer with PBS by one to 10 and make enough buffer for three milliliters per sample. Fill one non-sterile trough with CSM and one with the one X barcoding perm buffer.Then, add one milliliter of ice cold CSM to the freshly thawed samples, mix thoroughly, and transfer to the respective pre-labeled polypropylene cluster tubes. Now, take a 10 microliter sample and count the cells using an automated cell counter. Normalize the cell counts in each cluster tube by removing the volume of excess cells.Then, centrifuge the cells at 600 times G for five minutes at room temperature. Re-suspend the cells in one milliliter of one X barcoding perm buffer with a multichannel pipette and centrifuge at 600 times G for five minutes at room temperature. Afterward, aspirate off the supernatant.Line up the cluster tubes on a rack in the same order as indicated on the barcode key so the sample matches with its barcode. Add 800 microliters of one X barcoding perm buffer by multichannel pipette to all samples in the cluster tubes without touching the cell pellet to reduce cell loss. Then, set aside the rack with the cluster tubes.Remove the 20-plex palladium barcoding kit tube strips from minus 20 degrees Celsius and thaw at room temperature. Add 100 microliters of one X barcoding perm buffer, mix thoroughly, and transfer 120 microliters of the re-suspended barcode mix into the corresponding cell samples in the cluster tubes. Mix thoroughly by multichannel pipette so that there is no cross-contamination between individually barcoded samples.Incubate cluster tubes for 30 minutes at room temperature to allow the barcodes to label the cells. After 30 minutes, centrifuge the samples at 600 times G for five minutes at room temperature. Aspirate the supernatant, then re-suspend them in one milliliter of CSM.Subsequently, centrifuge and re-suspend in CSM again. Afterward, centrifuge at 600 times G for five minutes at room temperature and aspirate the supernatant. With a single pipette and using the same tip, transfer all cell pellets in about 70 to 80 microliters of residual volume to one polystyrene tube.Do not eject the pipette tip. Set aside the single pipette with this tip. With a multichannel pipette and new tips, add 100 microliters of CSM to each original cluster tube to maximize cell recovery.Using the single pipette with the tip that was set aside, transfer all cell pellets in 100 microliters of residual volume to the same polystyrene tube. Add CSM to top off the polystyrene tube to about three milliliters. Count and record the cell number of the pooled barcode set.Then, centrifuge at 600 times G for five minutes at room temperature and aspirate the supernatant. Proceed to staining the barcoded samples on the same day. This schematic demonstrates the workflow for the stimulation and processing of the peripheral blood samples, including allocation of blood sample aliquots, timing of the addition of stimulation agents, protein transport inhibitor cocktail, and incubation times until the red blood cell lysis and fixation.The choice of stimulating agents will depend on the signaling and cytokine pathways that are targeted for assessment. Following fixation and RBC lysis, the individual lysed, fixed cell samples from a healthy donor were barcoded, labeled with 26 antibodies against surface markers, permeabilized, and stained with 14 antibodies against cytokines. The limited gating strategy representing the identification of CD14 high monocytes is shown here.From left to right, each 2D plot represented is a population subset from the parent population that is gated from the 2D plot immediately to the left. Using CD14 high monocytes as representative in eight immune cell subsets, a mass cytometry analysis was performed on peripheral blood samples from a healthy donor at time zero unstimulated and following stimulation with TLR agonist LPS and R848 and the T-cell activator PMA ionomycin. An example of the cytokine induction in CD14 high monocytes is shown and selected cytokines with specificity to the stimulating agent used are depicted.R848 selectively induces IL-12p40 subunit and MCP1 in CD14 high monocytes while LPS does not. In contrast, PMA ionomycin does not induce cytokines in CD14 high monocytes. Once mastered, the blood stimulations can be done in about seven hours and the barcoding step can get done in just about an hour.When attempting this procedure, it's important to be mindful of the timing of the steps and to plan ahead accordingly. Once you have this procedure in place, you can consider altering the blood stimulation conditions in the mass cytometry panel in order to assess the immune cell responses that are specific to your own research aims. After watching this video, you should have a good understanding of how to elicit cytokine responses from whole blood samples and how to pool multiple samples into a barcoded set for mass cytometry analysis.

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JoVE Journal

Immunology and Infection

9.3K visualizações.  University of Colorado School of Medicine. This method can help answer questions in the autoimmunity field such as identifying cell frequency abnormalities and function differences such as production of key cytokines in the setting of autoimmune disease. The main advantage of this method is that it can capture a broad repertoire or different cell types and function differences from a easily obtainable peripheral blood sample. Generally, individuals new to this process may struggle with getting the timing of the blood processing steps ...