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Immunology and Infection

Measuring Granulocyte and Monocyte Phagocytosis and Oxidative Burst Activity in Human Blood

Published: September 12th, 2016



1Human Performance Laboratory, North Carolina Research Campus, Appalachian State University, 2Department of Biology, Appalachian State University, 3David H. Murdock Research Institute

The purpose of this manuscript is to present a method for measuring monocyte and granulocyte phagocytosis and oxidative burst activity in human blood samples.

The granulocyte and monocyte phagocytosis and oxidative burst (OB) activity assay can be used to study the innate immune system. This manuscript provides the necessary methodology to add this assay to an exercise immunology arsenal. The first step in this assay is to prepare two aliquots ("H" and "F") of whole blood (heparin). Then, dihydroethidium is added to the H aliquot, and both aliquots are incubated in a warm water bath followed by a cold water bath. Next, Staphylococcus aureus (S. aureus) is added to the H aliquot and fluorescein isothiocyanate-labeled S. aureus is added to the F aliquot (bacteria:phagocyte = 8:1), and both aliquots are incubated in a warm water bath followed by a cold water bath. Then, trypan blue is added to each aliquot to quench extracellular fluorescence, and the cells are washed with phosphate-buffered saline. Next, the red blood cells are lysed, and the white blood cells are fixed. Finally, a flow cytometer and appropriate analysis software are used to measure granulocyte and monocyte phagocytosis and OB activity. This assay has been used for over 20 years. After heavy and prolonged exertion, athletes experience a significant but transient increase in phagocytosis and an extended decrease in OB activity. The post-exercise increase in phagocytosis is correlated with inflammation. In contrast to normal weight individuals, granulocyte and monocyte phagocytosis is chronically elevated in overweight and obese participants, and is modestly correlated with C-reactive protein. In summary, this flow cytometry-based assay measures the phagocytosis and OB activity of phagocytes and can be used as an additional measure of exercise- and obesity-induced inflammation.

The granulocyte and monocyte phagocytosis/oxidative burst (OB) activity assay is a simple, straight-forward technique that is frequently used to gather information about innate immune function following prolonged and intensive exercise.1-4 When studying the response of the immune system to a stimulus, granulocytes and monocytes are of particular interest because they play a central role in host defense and are the first immune cells to accumulate at the site of infection.5 Neutrophils, a type of granulocyte, are the first cells to translocate into damaged muscle tissue following intensive exercise.6 Phagocytosis and OB activit....

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NOTE: All blood collection procedures were conducted in accordance with the guidelines set forth by the Appalachian State University (ASU) Institutional Review Board (IRB).

1. Assay Preparation

  1. Gather, prepare, and organize the materials specified for the procedure (please refer to Table of Specific Materials/Equipment).
    1. Label 12 x 75 mm tubes.
      1. Label two tubes for each participant: one tube for the phagocytosis assay (label this tube with black ink and an .......

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Prolonged and intensive exercise has profound effects on innate immune function, including natural killer cell function, macrophage cytokine-mediated response to viral infection, and granulocyte and monocyte phagocytosis and OB activity. Multiple studies indicate that granulocyte and monocyte phagocytosis increases significantly post-exercise, reflecting the inflammation induced by muscle damage and metabolic demands. In contrast, granulocyte and monocyte OB activity decreases post-exerci.......

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This manuscript provides a step-by-step protocol for the determination of two indicators of granulocyte and monocyte function. We have identified a few steps that are critical to the success of this assay. One such step is the ice-bath incubation that occurs immediately prior to the addition of bacteria. Thorough cooling of all samples will minimize the effect of temperature on phagocytosis and OB activity. Another critical step is the addition of bacteria to each sample. A 8:1 bacteria:phagocyte ratio produces optimal r.......

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The authors would like to acknowledge Zack Shue, Casey John, and Lynn Cialdella-Kam for their assistance during the optimization of this procedure.


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Name Company Catalog Number Comments
12 x 75 mm tubes, with cap VWR 20170-579 You will need 2 tubes per sample ("H" and "F") plus 3 tubes per batch (for assay controls; "F", "H", and "Blood only").
PBS (10X), pH 7.4 Life Technologies 70011-044
Bottle top 0.2 µm cellulose acetate filter (500 ml capacity) Fisher Scientific 09-741-07 
Glucose, powder Life Technologies 15023-021
Citric acid (anhydrous, cell culture tested, plant cell culture tested) Sigma-Aldrich C2404-100G
Sodium citrate tribasic dihydrate Sigma-Aldrich S4641-25G
Dihydroethidium (Hydroethidine) (HE) Life Technologies D11347
Dimethyl sulfoxide (DMSO) Anhydrous Life Technologies D12345
Staphylococcus aureus (Wood strain without protein A) BioParticles, fluorescein conjugate (FITC) Life Technologies S2851
Staphylococcus aureus (Wood strain without protein A) BioParticles, unlabeled Life Technologies S-2859
Trypan Blue Solution, 0.4% Life Technologies 15250-061
4.0 mL vacutainer containing 7.2 mg K2EDTA, spray-dried VWR BD367861 You will need 1 K2 EDTA blood collection tube per sample.
4.0 mL vacutainer containing 68 USP units Lithium Heparin, spray-coated VWR BD367884 You will need 1 Lithium Heparin blood collection tube per sample.
COULTER Ac·T 5diff CP Beckman Coulter 6605705 i.e., hematology analyzer
COULTER Ac·T 5diff Rinse Beckman Coulter 8547167
COULTER Ac·T 5diff Fix Beckman Coulter 8547171
COULTER Ac·T 5diff WBC Lyse Beckman Coulter 8547170
COULTER Ac·T 5diff Hgb Lyse Beckman Coulter 8547168
COULTER Ac·T 5diff Cal Calibrator Beckman Coulter 7547175
COULTER Ac·T 5diff Control Plus Beckman Coulter 7547198
AcT 5diff Diluent Beckman Coulter 8547169
200 µL extended-length pipette tips VWR 37001-526
Insulated ice pan VWR 89198-980 For ice water bath.
Open metal tube rack VWR 60916-702
Fetal Bovine Serum Life Technologies 26140-111
TQ-Prep Workstation Beckman Coulter 6605429 i.e., automated cell lyse preparation workstation
ImmunoPrep Reagent System Beckman Coulter 7546999 i.e., RBC lyse/WBC fix reagent system
Cytomics FC500 MCL Flow Cytometry System with CXP Software Beckman Coulter 626553
IsoFlow Sheath Fluid Beckman Coulter 8547008
COULTER CLENZ Beckman Coulter 8546929
Flow-Check Fluorospheres  Beckman Coulter 6605359 i.e., alignment and fluidics verification fluorospheres
FlowJo Software FlowJo FlowJo i.e., flow cytometry analysis software
Excel Software Microsoft Microsoft Excel i.e., electronic spreadsheet program

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