Name: isolation of primary human decidual cells from the fetal membranes of term placentae
Uploaded: 2018-04-30T14:45:00
Description: Watch this Scientific Journal Video about Isolation of Primary Human Decidual Cells from the Fetal Membranes of Term Placentae at JoVE.com

The authors would like to thank the donors, the RCWIH BioBank, and the Mount Sinai Hospital/UHN Department of Obstetrics and Gynaecology for the human specimens used in this study. We would like to thank the members of the Lye lab, particularly Dr. Caroline Dunk for her help with the method development. This work is supported by the Burroughs Welcome Fund (grant #1013759).

Placentae are collected from healthy term, not in labor women undergoing elective cesarean sections. The Collection, processing, and disposable of human samples adhere to the guidelines of the Mount Sinai Hospital Ethics board. A written consent is obtained from each patient. This study is approved by the Research Ethics Board at Mount Sinai Hospital.
1. Preparations
NOTE: All steps must be conducted under a fume hood and all surgical equipment must be sterilized via ...

<ol>
	<li>Brosens, N., Hayashi, N., White, J. O. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Progesterone+receptor+regulates+decidual+prolactin+expression+in+differentiating+human+endometrial+stromal+cells.">Progesterone receptor regulates decidual prolactin expression in differentiating human endometrial stromal cells.</a> Endocrinology. 140, 4809-4820 (1999).</li><li>Bell, S. C., D'Arcangues, C., Frase, I. S., Newton, J. R., Odlind, V. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Decidualization and relevance to menstruation. , 187-212 (1990).</li><li>Kariya, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Interleukin-1+inhibits+in+vitro+decidualization+of+human+endometrial+stromal+cells.">Interleukin-1 inhibits in vitro decidualization of human endometrial stromal cells.</a> Journal of Clinical Endocrinology and Metabolism. 73, 1170-1174 (1991).</li><li>Dimitriadis, E., Robb, L., Salamonsen, L. 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The protocol described here demonstrates a cost and time effective method for isolating primary decidual cells collected from the fetal membranes of whole human term placentae that is highly accessible and straightforward. The success of this protocol is dependent on two critical factors, (1) efficiency of decidual scraping from the chorion layer of the fetal membranes and (2) the care with which the decidual cells are handled throughout the protocol. It is important that chorion tissue contamination is controlled by ens...

The endometrium, one of the most active adult female tissues, undergoes dramatic remodeling each menstrual cycle in response to stimulation by ovarian hormones, estrogen (E2) and progesterone (P4). The decidua, also known as the pregnant endometrium, is a critically important reproductive tissue that is formed by the end of the postovulatory phase as a result of P4-driven differentiation following the E2-dominant proliferative phase. Decidual cells are responsible for the secretion of hormonal factors for successful blastocyst implantation and for development of the utero-placental interface for maintaining maternal tolerance to the fetal allograft.
Decidualization is required for implantation and subsequent remodeling of the decidual spiral arteries. Endometrial stromal cells undergo decidualization, under the control of P4 and cAMP, during the late luteal phase of the menstrual cycle1. This process is initiated around the blood vessels and spreads throughout the stroma, suggesting its role in vasculature remodeling and leukocyte trafficking regulation. This cellular transformation is characterized by a circular morphology, increased nuclear size, and expansion of the rough endoplasmic reticulum and Golgi apparatus2. Decidualized stromal cells are capable of producing paracrine factors supporting blastocyst implantation and characterized by the secretion of numerous hormones (i.e. prolactin), angiogenic growth factors, insulin growth factor binding protein-1 (IGFBP-1), prostaglandin (PG) E (stimulator of intracellular cAMP), cytokines, extracellular matrix components and nutrients essential for placental implantation and development3,4,5,6.
The decidual cell population is not solely comprised of decidualized stromal cells but also contains large, pregnancy-specific decidual leukocyte populations. Decidualization involves transient localized oedema and influx of Natural killer (NK) cells, T-cells, dendritic cells, and macrophages. The largest leukocyte subpopulation is the uterine NK cells, comprising approximately 50-70% of all maternal leukocytes infiltrating the decidua which are a source of cytokines and angiogenic factors which may aid in the decidualization process and increase in number throughout pregnancy7. Macrophages, being the second largest subpopulation of immune cells, are found around the implantation site and increase during pregnancy8. They are a source of cytokines and growth factors such as colony stimulating factor (CSF-1)9, tumor necrosis factor &#945; (TNF&#945;)10 and prostaglandin (PG) E11.
Throughout pregnancy, and before term labor, the decidua is a major source of cytokines and chemokines responsible for maternal peripheral leukocyte activation and subsequent migration into the uterine tissues to initiate labor. Animal studies showed that numerous pro-inflammatory cytokines are up-regulated in the mouse decidua during labor, such as TNF-a, IL-6, IL-12, and IL-1b12. In the human decidua, pro-inflammatory cytokines IL-1b, IL-6 and IL-8 (major neutrophil chemoattractant) exhibit higher expression during labor compared to not in labor13. These secreted cytokines result in an activation and influx of leukocytes into the decidual tissues14; an increase in decidual macrophage and neutrophil infiltration in both the human and rat is seen during term labor, with decidual infiltration preceding myometrial 4-fold greater, indicating a cascade of activation between this two-adjacent uterine tissues15. These infiltrating leukocytes produce PGs capable of activating synchronous contractions of the myometrium16, matrix metalloproteinases (MMPs) to initiate membrane rupture17,18, as well as pro-inflammatory cytokines to amplify the uterine activation process (&#39;cytokine storm&#39;).
Due to many important functions of decidual cells, such as playing a critical role in the implantation process, maintaining maternal-fetal tolerance in early gestation and participating in the activation of labor at term, different pathologies can arise during pregnancy. For instance, (1) infertility due to recurrent implantation failure and recurrent pregnancy loss can result from a failure of decidual maturation; (2) intrauterine growth restriction (IUGR) and preeclampsia due to improper development and dysfunction of the decidua/placenta or compromised vascular transformation at the decidual-myometrial junction; as well as (3) preterm birth which can result from premature decidual activation.
In light of these major disorders, coupled with the ethical and practical limitations of human in vivo studies, establishing primary human decidual cell lines is essential for in vitro analysis with the purpose of better understanding and improving clinical management of pregnancy complications. Therefore, the objective of our research was to develop a protocol which allows for the isolation of human primary decidual cells with high cell yield and viability collected from the fetal membranes of term placentae. This current protocol clearly describes a time- and cost-effective method for isolating of specific subtypes of decidual cells which be used for a variety of in vitro analyses. Characterization of the abundance and phenotype of decidual sub-populations at term and comparison to first or second trimester is crucial to defining their roles throughout human gestation.

<table>
	<tbody>
		<tr>
			<td>Hank&#8217;s balanced salt solution with calcium and magnesium</td>
			<td>Prepared in facility (LTRI)</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Hank&#8217;s balanced salt solution without calcium and magnesium</td>
			<td>Prepared in facility (LTRI)</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Diaper pads</td>
			<td>Sigma-Aldrich</td>
			<td>D9542</td>
			<td></td>
		</tr>
		<tr>
			<td>Large surgical scissors</td>
			<td>AL Medical</td>
			<td>2018-12-20.</td>
			<td></td>
		</tr>
		<tr>
			<td>Large surgical forceps</td>
			<td>Fine Science Tools</td>
			<td>11000-18</td>
			<td></td>
		</tr>
		<tr>
			<td>Plastic disposable cell scraper (25 cm)</td>
			<td>Sarstedt</td>
			<td>83.183</td>
			<td></td>
		</tr>
		<tr>
			<td>250 mm (size 60 mesh) metal sieve</td>
			<td>Sigma-Aldrich</td>
			<td>S1020-5EA</td>
			<td></td>
		</tr>
		<tr>
			<td>Disposable scalpel with plastic handle (#21)</td>
			<td>Fisher Scientific</td>
			<td>08-927-5D</td>
			<td></td>
		</tr>
		<tr>
			<td>Sterile plastic petri dish (diameter 10 cm)</td>
			<td>Sarstedt</td>
			<td>82.1473.001</td>
			<td></td>
		</tr>
		<tr>
			<td>Sterile specimen container (urine cup, 4.5 oz)</td>
			<td>VWR</td>
			<td>25384-146</td>
			<td></td>
		</tr>
		<tr>
			<td>Nylon filter (70 mm)</td>
			<td>VWR/Corning</td>
			<td>21008-952</td>
			<td></td>
		</tr>
		<tr>
			<td>Erythrocyte lysis buffer</td>
			<td>Qiagen</td>
			<td>79217</td>
			<td></td>
		</tr>
		<tr>
			<td>Trypan blue, 0.4% solution</td>
			<td>Lonza</td>
			<td>17-942E</td>
			<td></td>
		</tr>
		<tr>
			<td>Parafilm</td>
			<td>Fisher Scientific</td>
			<td>13-374-10</td>
			<td></td>
		</tr>
		<tr>
			<td>Hemocytometer</td>
			<td>Reichert</td>
			<td>1490</td>
			<td></td>
		</tr>
		<tr>
			<td>Roswell Park Memorial Institute (RPMI) 1640 culture media</td>
			<td>Invitrogen</td>
			<td>11835-055</td>
			<td></td>
		</tr>
		<tr>
			<td>Fetal bovine serum</td>
			<td>Wisent</td>
			<td>080-150</td>
			<td></td>
		</tr>
		<tr>
			<td>Normocin (50mg/ mL)</td>
			<td>Invivogen</td>
			<td>ant-nr-1</td>
			<td></td>
		</tr>
		<tr>
			<td>Plastic top filtration unit (0.22 mm membrane, 500 mL)</td>
			<td>Millipore</td>
			<td>SCGPT05RE</td>
			<td></td>
		</tr>
		<tr>
			<td>Collagenase 2, lyophilized powder</td>
			<td>Sigma-Aldrich</td>
			<td>C6885</td>
			<td></td>
		</tr>
		<tr>
			<td>Soy bean trypsin inhibitor, powder</td>
			<td>Sigma-Aldrich</td>
			<td>T9003-250mg</td>
			<td></td>
		</tr>
		<tr>
			<td>DNase powder</td>
			<td>Roche</td>
			<td>10104159001</td>
			<td></td>
		</tr>
		<tr>
			<td>Bovine serum albumin (BSA powder)</td>
			<td>Fisher Scientific</td>
			<td>BP1600-100</td>
			<td></td>
		</tr>
		<tr>
			<td>Spinning disc confocal microscope - Leica DMI 6000B</td>
			<td>Leica</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Imaging Flow cytometer - Image Stream MK2</td>
			<td>Amnis</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>IDEA software</td>
			<td>Millipore Sigma</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>APC-conjugated Vimentin antibody</td>
			<td>R&#38;D Systems</td>
			<td>IC2105A</td>
			<td></td>
		</tr>
		<tr>
			<td>APC H7-conjugated CD45 antibody</td>
			<td>BD</td>
			<td>641399</td>
			<td></td>
		</tr>
		<tr>
			<td>FITC-conjugated Cytokeratin antibody</td>
			<td>MACs Miltenyi Biotec</td>
			<td>130-080-101</td>
			<td></td>
		</tr>
		<tr>
			<td>PerCP -conjugated Cytokeratin 7 antibody</td>
			<td>Novus</td>
			<td>NBP2-47941PCP</td>
			<td></td>
		</tr>
		<tr>
			<td>eFluor450 Fixable Viability dye</td>
			<td>Thermo Fisher Scientific</td>
			<td>65-0863-14</td>
			<td></td>
		</tr>
		<tr>
			<td>Vimentin primary antibody</td>
			<td>Santa Cruz</td>
			<td>sc-7558</td>
			<td></td>
		</tr>
		<tr>
			<td>CD45 primary antibody</td>
			<td>Dako</td>
			<td>M0701</td>
			<td></td>
		</tr>
		<tr>
			<td>Cytokeratin primary antibody</td>
			<td>Dako</td>
			<td>M0821</td>
			<td></td>
		</tr>
		<tr>
			<td>Cytokeratin 7 primary antibody</td>
			<td>Dako</td>
			<td>M7018</td>
			<td></td>
		</tr>
		<tr>
			<td>Mouse IgG</td>
			<td>Santa Cruz</td>
			<td>sc-2025</td>
			<td></td>
		</tr>
		<tr>
			<td>Goat IgG</td>
			<td>Santa Cruz</td>
			<td>sc-2028</td>
			<td></td>
		</tr>
		<tr>
			<td>Alexa Fluor 546 secondary antibody</td>
			<td>Invitrogen</td>
			<td>A10036</td>
			<td></td>
		</tr>
		<tr>
			<td>Alexa Fluor 594 secondary antibody</td>
			<td>Fisher Scientific</td>
			<td>A-11058</td>
			<td></td>
		</tr>
		<tr>
			<td>DAPI</td>
			<td>Sigma-Aldrich</td>
			<td>D9542</td>
			<td></td>
		</tr>
	</tbody>
</table>

isolation of primary human decidual cells from the fetal membranes of term placentae

The decidua, also known as the pregnant endometrium, is a critically important reproductive tissue. Decidual cells, comprised mainly of decidualized stromal cells and immune cells, are responsible for the secretion of hormonal and inflammatory factors which are critical for successful blastocyst implantation, placental development and play a role in the initiation of labor at term and preterm. Many pregnancy complications can arise from perturbations of a fine balance of different cell populations comprising decidua. Alterations in the proportion of specific decidual cell types may disrupt these crucial processes and increase the risk of developing serious complications of pregnancy, such as embryo implantation failure, intrauterine growth restriction, preeclampsia and preterm labor. The protocol outlined here demonstrates a cost and time effective method for the isolation of primary human decidual cells collected from the fetal membranes of term placentae. By combining enzymatic digestion and gentle mechanical disruption of the decidual tissue, a high yield of decidual cells was obtained with virtually no chorion contamination. Importantly, isolated decidual cells were characterized (stromal cells (55-60%), leukocytes (35%), epithelial (1%) or trophoblast (0.01%) cells) and maintained high viability (80%) which was confirmed by multicolor imaging flow cytometry assay. This protocol is specific to the decidua parietalis and can be adapted to first and second trimester placentae. Once isolated, decidual cells can be used for a multitude of experimental applications aiming to understand the role of different decidual cell sub-populations in pregnancy complications.

To validate the efficiency and viability of the isolated cells, they were characterized by two methods: flow cytometry and immunocytochemistry (ICC). 4 cell populations were targeted; decidualized stromal cells were detected by the anti-vimentin antibody, pan-leukocyte marker CD45 was used to identify decidual immune cells, cytokeratin was used to detect epithelial/endothelial cells and finally, cytokeratin 7 was used to detect any potential trophoblast (chorion or placental) contaminatio...

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Isolation of Primary Human Decidual Cells from the Fetal Membranes of Term Placentae

This protocol demonstrates a method for the isolation of primary human decidual cells collected from the fetal membranes of term placentae which can be used for a variety of applications (i.e. immunocytochemistry, flow cytometry, etc.) aiming to study the role of different cell populations in pregnancy complications.

The decidua, also known as the pregnant endometrium, is a critically important reproductive tissue. Decidual cells, comprised mainly of decidualized ...

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