The project was funded by the DFG (BE 4570/4-1) to S.B.

<ol>
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The authors have nothing to disclose.

The simulation of bacterial interaction with mechanosensitive host proteins such as VWF requires a perfusable cell culture system that enables the generation of a defined, unidirectional, and continuous flow of liquids, thereby generating reliable shear stress. Several microfluidic pump systems have already been described. A comprehensive review from Bergmann et al. summarizes the key aspects of different two- and three-dimensional cell culture models17.
The microfluidi...

The pathogenesis of pneumococcus infections is characterized by a multifaceted interaction with a diversity of extracellular matrix compounds and components of the human hemostasis, such as plasminogen and VWF1,2,3,4,5,6,7,8. The multidomain glycoprotein VWF serves as key regulator of a balanced hemostasis by mediating thrombocyte recruitment and fibrin incorporation at the site of vascular thrombus formation9. The importance of functional, active VWF for bleeding control and wound healing is demonstrated by von Willebrand&#8217;s disease, a common inherited bleeding disorder10.
Globular VWF circulates in the human blood system at a concentration of up to 14.0 &#181;g/mL11,10. In response to vascular injury, the local release of VWF by endothelial Weibel Palade Bodies (WBP) is markedly increased11,12. Previous studies show that pneumococcus adherence to human endothelial cells and its production of the pore-forming toxin pneumolysin significantly stimulates luminal VWF secretion13. The hydrodynamic forces of the blood flow induce a structural opening of the mechanoresponsive VWF domains. At flow rates of 10 dyn/cm2 the VWF multimerizes to long protein strings of up to several hundred micrometers in length that remain attached to the subendothelium10,12.
To understand the function of multimerized VWF strings generated under shear stress in the interaction of pneumococcus with the endothelial surface, a microfluidic-based cell culture infection approach was established. A microfluidic device with a software-controlled air-pressure pump system was used. This enabled a continuous, unidirectional recirculation of cell culture medium with a defined flow rate. Thereby, the system applied a defined shear stress on the surface of endothelial cells, which remained attached inside specialized channel slides. This approach enabled the simulation of the shear force within the blood stream of the human vascular system, in which VWF strings are generated on differentiated endothelial cells under defined constant flow conditions. For this purpose, the endothelial cells were cultivated in specific channel slides (see Table of Materials), which were adapted for microscopic analyses during flow. The microfluidic pump system provided the highly defined and controlled shear stress situation required for the formation of extended VWF strings on the confluent endothelial cell layer. After the stimulation of VWF-secretion of confluently grown human umbilical vein endothelial cells (HUVEC) by histamine supplementation, the string formation was induced by applying a shear stress (&#1295;) of 10 dyn/cm2. The shear stress is defined as the force acting on the cell layer. It is calculated approximately according to Cornish et. al.14 with equation 1: 
<img alt="Equation 1" src="/files/ftp_upload/60323/60323equ01.jpg" />
Where &#1295; = shear stress in dyn/cm2, &#951; = viscosity in (dyn&#8729;s)/cm2, h =half of channel height, w = half of channel width, and &#934; = flowrate in mL/min.
The result of equation 1 depends on the different heights and widths of the different slides used (see Table of Materials). In this study a Luer channel slide of 0.4 &#181;m resulting in a chamber slide factor of 131.6 was used (see formula 2). 
<img alt="Equation 2" src="/files/ftp_upload/60323/60323equ02.jpg" />
Viscosity of the medium at 37 &#176;C is 0.0072 dyn&#8729;s/cm&#178; and a shear stress of 10 dyn/cm&#178; was used. This resulted in a flow rate of 10.5 mL/min (see formula 3). 
<img alt="Equation 3" src="/files/ftp_upload/60323/60323equ03.jpg" />
Here, the adaptation and advancement of a microfluidic cell culturing procedure using a unidirectional laminar flow system for the investigation and visualization of bacterial infection mechanisms in the host vasculature is described in detail. The generation of VWF strings on endothelial layers can also be stimulated by using other pump systems that are able to apply a continuous and steady shear stress15.
After cultivation of primary endothelial cells to confluence in flow and stimulation of VWF string formation, pneumococci expressing red fluorescence protein (RFP)16 were added to the endothelial cell layer under constant microscopic control. The attachment of bacteria to VWF strings on the surface of endothelial cells was microscopically visualized and monitored for up to three hours in real time by using VWF-specific fluorescent-labelled antibodies. With this approach, the role of VWF as an adhesion cofactor promoting bacterial attachment to the vascular endothelium was determined8.
In addition to the microscopic visualization of protein secretion and conformational changes, this method could be used to monitor single steps of bacterial infection processes in real time and to quantify the amount of attached bacteria at different time points of infection. The specific software-controlled pump system also provides the possibility to culture the endothelial cells in defined constant flow conditions for up to several days and enables a defined pulsed medium flow incubation. Moreover, this method can be applied using different cell types. Adapting the staining protocol also enables the detection and visualization of bacteria internalized into eukaryotic cells.
This manuscript describes this advanced experimental protocol that can be used as a defined, reliable, and reproducible approach for an efficient and versatile characterization of pathophysiological processes.

<table>
	<tbody>
		<tr>
			<td>1 mL Luer-syringe</td>
			<td>Fisher Scientific</td>
			<td>10303002</td>
			<td>with 1 mL volume for gelatin injection using the luer-connection of the slides</td>
		</tr>
		<tr>
			<td>2 mL Luer-syringe</td>
			<td>Sarstedt</td>
			<td>9077136</td>
			<td>For pieptting/injecting fluids into the luer connections of the channel chamber slides</td>
		</tr>
		<tr>
			<td>Accutase</td>
			<td>eBioscience now thermo fisher</td>
			<td>00-4555-56</td>
			<td>protease mix used for gentle detachment of endothelial cells</td>
		</tr>
		<tr>
			<td>AlexaFluor350-conjugated Phalloidin</td>
			<td>Abcam</td>
			<td>ab176751</td>
			<td>no concentration available from the manufacturer, stock solution is sufficient for 300 tets, company recommends to use 100 &#181;l of a 1:1000 dilution, blue fluorescence (DAPI-filter settings)</td>
		</tr>
		<tr>
			<td>AlexaFluor488-conjugated goat-derived anti-mouse antibody</td>
			<td>Thermo Fisher Sientific</td>
			<td>A11001</td>
			<td>stock concentration: 2 mg/mL for immunostaining of human VWF in microfluidic slide after PFA fixation, green fluorescence</td>
		</tr>
		<tr>
			<td>AlexaFluor568-conjugated goat-derived anti-rabbit-antibody</td>
			<td>Thermo Fisher Scientific</td>
			<td>A-11011</td>
			<td>stock concentration: 2 mg/mL for immunostaining of pneumococci in microfluidic slide after pFA fixation, red fluorescence</td>
		</tr>
		<tr>
			<td>Bacto Todd-Hewitt-Broth</td>
			<td>Becton Dickinson GmbH</td>
			<td>BD 249210</td>
			<td>complex bacterial culture medium</td>
		</tr>
		<tr>
			<td>Bovine Serum Albumin (BSA)</td>
			<td>Sigma Aldrich</td>
			<td>A2153-25G</td>
			<td>solubilized, for preparation of blocking buffer</td>
		</tr>
		<tr>
			<td>Cell culture flasks with filter</td>
			<td>TPP</td>
			<td>90026</td>
			<td>subcultivation of HUVEC in non-coated cell culture flasks of 25 cm2 surface</td>
		</tr>
		<tr>
			<td>Centrifuge Allegra X-12R</td>
			<td>Beckman Coulter Life Sciences</td>
			<td>392304</td>
			<td>spinning down of bacteria (volumes of &#62; 2mL)</td>
		</tr>
		<tr>
			<td>Centrifuge Allegra X-30</td>
			<td>Beckman Coulter Life Sciences</td>
			<td>B06314</td>
			<td>spinning down of eukaryotic cells</td>
		</tr>
		<tr>
			<td>Centrifuge Z 216 MK</td>
			<td>Hermle</td>
			<td>305.00 V05 - Z 216 M</td>
			<td>spinning down of bacteria (volumes of less than 2 mL)</td>
		</tr>
		<tr>
			<td>Chloramphenicol</td>
			<td>Carl Roth GmbH + Co. KG, Karlsruhe</td>
			<td>3886.2</td>
			<td>used in a concentration of 0.2 /mL for cultivation of pneumococci transformed with genetic construct carrying red fluorescent protein and chloramphenicol resistance cassette</td>
		</tr>
		<tr>
			<td>Clamp for perfusion tubing</td>
			<td>ibidi</td>
			<td>10821</td>
			<td>for holding the liquid in the tube bevor connecting the slide to the pump system</td>
		</tr>
		<tr>
			<td>CO2-Incubator</td>
			<td>Fisher Scientific</td>
			<td>MIDI 40</td>
			<td>incubator size is perfectly adapted to teh size of the fluidic unit with connected channel slide and was used for flow cultivation at 37&#176;C and 5% CO2</td>
		</tr>
		<tr>
			<td>CO2-Incubator</td>
			<td>Sanyo</td>
			<td>MCO-18 AIC</td>
			<td>for incubation of bacteria and cells in a defined atmosphere at 5% CO2 and 37&#176;C</td>
		</tr>
		<tr>
			<td>Colombia blood agar plates</td>
			<td>Becton Dickinson GmbH</td>
			<td>PA-254005.06</td>
			<td>agar-based complex culture medium for S. pneumoniae supplemented with 7% sheep blood</td>
		</tr>
		<tr>
			<td>Computer</td>
			<td>Dell</td>
			<td>Latitude 3440</td>
			<td>Comuter with pressure pump software</td>
		</tr>
		<tr>
			<td>Confocal Laser Scanning Microscope (CLSM)</td>
			<td>Leica</td>
			<td>DMi8</td>
			<td>An inverse microscope with a stage covered by a heatable chamber and with a fluorescence unit equipped with fluorescence filter, Xenon-light source (SP8, DMi8) and DFC 365 FX Kamera (1392 x 1040, 1.4 Megapixel)</td>
		</tr>
		<tr>
			<td>Di Potassium hydrogen phosphate (KH2PO4)</td>
			<td>Carl Roth GmbH + Co. KG, Karlsruhe</td>
			<td>3904.1</td>
			<td>used for PBS buffer</td>
		</tr>
		<tr>
			<td>Drying material</td>
			<td>Merck</td>
			<td>101969</td>
			<td>orange silica beads for drying used in a glass bottle with a tubing adaptor</td>
		</tr>
		<tr>
			<td>ECGM supplement Mix</td>
			<td>Promocell</td>
			<td>C-39215</td>
			<td>supplement mix for ECGM -medium, required for precultivation of endothelial cells: 0.02 mL/mL Fetal calf serum, 0.004 mL/ mL endothelial cell growth supplement, 0.1 ng / mL epidermal growth factor, 1 ng / mL basic fibroblast growth factor, 90 &#181;g / mL heparin, 1 &#181;g / mL Hydrocortisone</td>
		</tr>
		<tr>
			<td>ECGMS</td>
			<td>Promocell</td>
			<td>C-22010</td>
			<td>ECGM supplemented with 5 % [w/w] FCS and 1 mM MgSO4 to increase cell adhesion</td>
		</tr>
		<tr>
			<td>Endothelial Cell growth medium (ECGM, ready to use)</td>
			<td>Promocell</td>
			<td>C-22010</td>
			<td>culture medium of HUVECs, already supplemented with all components of the supplement mix</td>
		</tr>
		<tr>
			<td>Fetal Calf Serum (FCS)</td>
			<td>biochrome now Merck</td>
			<td>S 0415</td>
			<td>supplement for cell culture, used for infection analyses</td>
		</tr>
		<tr>
			<td>FITC-conjugated goat anti-human VWF antibody</td>
			<td>Abcam</td>
			<td>ab8822</td>
			<td>stock concentration: 10 mg/mL, for immunodetection of globular and multimerized VWF in flow</td>
		</tr>
		<tr>
			<td>Fluidic Unit</td>
			<td>ibidi</td>
			<td>10903</td>
			<td>fluidic unit for flow cultivation</td>
		</tr>
		<tr>
			<td>Gelatin (porcine)</td>
			<td>Sigma Aldrich</td>
			<td>G-1890-100g</td>
			<td>for precoating of microslide channel surface</td>
		</tr>
		<tr>
			<td>histamine dihydrochloride</td>
			<td>Sigma Aldrich</td>
			<td>H-7250-10MG</td>
			<td>for induction of VWF secretion from endothelial Weibel Palade Bodies</td>
		</tr>
		<tr>
			<td>Human Umbilical Vein Endothelial Cell (HUVEC)</td>
			<td>Promocell</td>
			<td>C-12203 Lot-Nr. 396Z042</td>
			<td>primary endothelial cells from pooled donor, stored crypcoserved in liquid nitrogen</td>
		</tr>
		<tr>
			<td>Human VWF-specific antibody derived from mouse (monoclonal)</td>
			<td>Santa Cruz</td>
			<td>sc73268</td>
			<td>stock concentration: 200 &#181;g/mL for immunostaining of VWF in microfluidic slide after PFA fixation</td>
		</tr>
		<tr>
			<td>Injection Port</td>
			<td>ibidi</td>
			<td>10820</td>
			<td>for injection of histamin or bacteria into the reservoir tubing during the flow circulation</td>
		</tr>
		<tr>
			<td>Light microscope</td>
			<td>Zeiss</td>
			<td>Axiovert 35M</td>
			<td>inverse light microscope for control of eukaryotic cell detachement and cell counting using a 40 x water objective allowing 400 x magnification</td>
		</tr>
		<tr>
			<td>Luer-slides I0.4 (ibiTreat472microslides)</td>
			<td>ibidi</td>
			<td>80176</td>
			<td>physically modified slides for fludic cultivation (&#956;&#8211;Slide I0.4Luer with a channel hight of 0.4 mm, a channel volume of 100 &#956;l, a growth area of 2.5 cm and a coating area of 25.4 cm2) suitable for all kinds of flow assay, the physical treatment generates a hydrophilic and adhesive surface.</td>
		</tr>
		<tr>
			<td>Magnesium sulfate (MgSO4, unhydrated)</td>
			<td>Sigma Aldrich</td>
			<td>M7506-500G</td>
			<td>For preparation of ECGMS medium</td>
		</tr>
		<tr>
			<td>Microfluidic Pump</td>
			<td>ibidi</td>
			<td>10905</td>
			<td>air pressure pump</td>
		</tr>
		<tr>
			<td>Neubauer cell counting chamber</td>
			<td>Karl Hecht GmbH&#38;Co KG</td>
			<td>40442002</td>
			<td>microscopic counting chamber for HUVECs</td>
		</tr>
		<tr>
			<td>Paraformaldehyde 16% (PFA)</td>
			<td>Electron Microscopy Sciences</td>
			<td>15710-S</td>
			<td>for cross linking of samples</td>
		</tr>
		<tr>
			<td>Perfusion Set</td>
			<td>ibidi</td>
			<td>10964</td>
			<td>Perfusion Set Yellow/Green has a tubing diameter of 1.6 mm, a tube length of 50 cm, a total working volume of 13.6 mL, a dead tube volume of 2.8 mL and a reservoir size of 10 mL. combined with the &#181;-slide L0.4Luer, at 37&#176;C and a viscosity of 0.0072 dyn x s/cm2 a flow rate range of 3.8mL/min up to 33.9 mL/min and shear stress between 3.5 dyn/cm2 and 31.2 dyn/cm2 can be reached. with 50 cm lenght for microfluidic</td>
		</tr>
		<tr>
			<td>Phosphate-buffered saline (PBS)</td>
			<td></td>
			<td></td>
			<td>the solution was prepared using the following chemicals: 0.2 g/L KCl, 1.44 g/L Na2HPO4, 0.24 g/L KH2PO4 , pH 7.4</td>
		</tr>
		<tr>
			<td>Plastic cuvettes</td>
			<td>Sarstedt</td>
			<td>67,741</td>
			<td>(2 x optic) for OD measurement at 600 nm</td>
		</tr>
		<tr>
			<td>Pneumococcus-specific antiserum</td>
			<td>Pineda</td>
			<td></td>
			<td>raised in rabbit using heat-inactivated Streptococcus pneumoniae NCTC10319 and D39, IgG-purified using proteinA-sepharose column.</td>
		</tr>
		<tr>
			<td>Polystyrene or Styrofoam plate</td>
			<td></td>
			<td></td>
			<td>this is a precaution step to avoid cold stress on the cells seeded in the channel slides. Any type of styrofoam such as packaging box-material can be used. The plate might by 0.5 cm thick and should have a size of 20 cm2.</td>
		</tr>
		<tr>
			<td>Potassium chloride (KCl)</td>
			<td>Carl Roth GmbH + Co. KG, Karlsruhe</td>
			<td>6781.1</td>
			<td>used for PBS buffer</td>
		</tr>
		<tr>
			<td>Pump Control Software (PumpControl v1.5.4)</td>
			<td>ibidi</td>
			<td>v1.5.4</td>
			<td>Computer software for controlling the pressure pump, setting the flow conditions and start/end the flow</td>
		</tr>
		<tr>
			<td>reaction tubes 1.5/ 2.0mL</td>
			<td>Sarstedt</td>
			<td>72.706/ 72.695.500</td>
			<td>required for antibody dilutions</td>
		</tr>
		<tr>
			<td>reaction tubes with 50 mL volume</td>
			<td>Sarstedt</td>
			<td>6,25,48,004</td>
			<td></td>
		</tr>
		<tr>
			<td>RFP-expressing pneumococci</td>
			<td>National Collection of Type Cultures, Public Health England</td>
			<td>10,319</td>
			<td>Streptococcus pneumoniae serotype 47 expressing RFP fused to ahistone-like protein integrated into the genome</td>
		</tr>
		<tr>
			<td>serological pipets 5, 10 mL</td>
			<td>Sarstedt</td>
			<td>86.1253.025/ 86.1254.025</td>
			<td>for pipeting larger volumes</td>
		</tr>
		<tr>
			<td>Sodium Carbonate (Na2CO3, water free)</td>
			<td>Sigma Aldrich</td>
			<td>451614-25G</td>
			<td>for preparation of 100 mM Sodium Carbonate buffer</td>
		</tr>
		<tr>
			<td>Sodium dihydrogen phosphate (NaH2PO4)</td>
			<td>Carl Roth GmbH + Co. KG, Karlsruhe</td>
			<td>P030.2</td>
			<td>used for PBS buffer</td>
		</tr>
		<tr>
			<td>Spectral Photometer Libra S22</td>
			<td>Biochrom</td>
			<td>80-2115-20</td>
			<td>measurement of optical density (OD) of bacterial suspension at 600 nm</td>
		</tr>
		<tr>
			<td>Sucrose</td>
			<td>Sigma Aldrich</td>
			<td>S0389-500G</td>
			<td>for preparation of blocking buffer</td>
		</tr>
		<tr>
			<td>Triton X-100</td>
			<td>Sigma Aldrich</td>
			<td>T9284-500ML</td>
			<td>Used in 0.1% end concentration diluted in dH20 for eukaryotic cell permeabilization after PFA fixation</td>
		</tr>
		<tr>
			<td>Yeast extract</td>
			<td>oxoid</td>
			<td>LP0021</td>
			<td>bacteria are cultivated in THB supplement with 1% [w/w] yeast extract = complete bacterial cultivation medium THY</td>
		</tr>
	</tbody>
</table>

pneumococcus infection of primary human endothelial cells in constant flow

Interaction of Streptococcus pneumoniae with the surface of endothelial cells is mediated in blood flow via mechanosensitive proteins such as the Von Willebrand Factor (VWF). This glycoprotein changes its molecular conformation in response to shear stress, thereby exposing binding sites for a broad spectrum of host-ligand interactions. In general, culturing of primary endothelial cells under a defined shear flow is known to promote the specific cellular differentiation and the formation of a stable and tightly linked endothelial layer resembling the physiology of the inner lining of a blood vessel. Thus, the functional analysis of interactions between bacterial pathogens and the host vasculature involving mechanosensitive proteins requires the establishment of pump systems that can simulate the physiological flow forces known to affect the surface of vascular cells.
The microfluidic device used in this study enables a continuous and pulseless recirculation of fluids with a defined flow rate. The computer-controlled air-pressure pump system applies a defined shear stress on endothelial cell surfaces by generating a continuous, unidirectional, and controlled medium flow. Morphological changes of the cells and bacterial attachment can be microscopically monitored and quantified in the flow by using special channel slides that are designed for microscopic visualization. In contrast to static cell culture infection, which in general requires a sample fixation prior to immune labeling and microscopic analyses, the microfluidic slides enable both the fluorescence-based detection of proteins, bacteria, and cellular components after sample fixation; serial immunofluorescence staining; and direct fluorescence-based detection in real time. In combination with fluorescent bacteria and specific fluorescence-labeled antibodies, this infection procedure provides an efficient multiple component visualization system for a huge spectrum of scientific applications related to vascular processes.

Culturing primary HUVEC in a constant unidirectional flow results in the formation of a confluent and tightly packed cell layer that promotes the generation of cellular WPBs filled with the mechanosensitive VWF13,14. This protocol describes the use of an air pressure pump-based, pulseless recirculation system for infection analysis that requires mimicking the shear stress situation in the human blood flow.
This system enables a defined...

Watch this Scientific Journal Video about Pneumococcus Infection of Primary Human Endothelial Cells in Constant Flow at JoVE.com

Pneumococcus Infection of Primary Human Endothelial Cells in Constant Flow

This study describes the microscopic monitoring of pneumococcus adherence to von Willebrand factor strings produced on the surface of differentiated human primary endothelial cells under shear stress in defined flow conditions. This protocol can be extended to detailed visualization of specific cell structures and quantification of bacteria by applying differential immunostaining procedures.

Interaction of Streptococcus pneumoniae with the surface of endothelial cells is mediated in blood flow via mechanosensitive proteins such as the Von ...

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6.3K Views.  Technische Universität Braunschweig. This study describes the microscopic monitoring of pneumococcus adherence to von Willebrand factor strings produced on the surface of differentiated human primary endothelial cells under shear stress in defined flow conditions. This protocol can be extended to detailed visualization of specific cell structures and quantification of bacteria by applying differential immunostaining procedures.

Video: Pneumococcus Infection of Primary Human Endothelial Cells in Constant Flow

Human In Vitro Suppression as Screening Tool for the Recognition of an Early State of Immune Imbalance

Regulatory T cells (Tregs) are critical mediators of immune tolerance to self-antigens. In addition, they are crucial regulators of the immune response following an infection. Despite efforts to identify unique surface marker on Tregs, the only unique feature is their ability to suppress the proliferation and function of effector T cells. While it is clear that only in vitro assays can be used in assessing human Treg function, this becomes problematic when assessing the results from cross-sectional studies where healthy cells and cells isolated from subjects with autoimmune diseases (like Type 1 Diabetes-T1D) need to be compared. There is a great variability among laboratories in the number and type of responder T cells, nature and strength of stimulation, Treg:responder ratios and the number and type of antigen-presenting cells (APC) used in human in vitro suppression assays. This variability makes comparison between studies measuring Treg function difficult. The Treg field needs a standardized suppression assay that will work well with both healthy subjects and those with autoimmune diseases. We have developed an in vitro suppression assay that shows very little intra-assay variability in the stimulation of T cells isolated from healthy volunteers compared to subjects with underlying autoimmune destruction of pancreatic &beta;-cells. The main goal of this piece is to describe an in vitro human suppression assay that allows comparison between different subject groups. Additionally, this assay has the potential to delineate a small loss in nTreg function and anticipate further loss in the future, thus identifying subjects who could benefit from preventive immunomodulatory therapy1. Below, we provide thorough description of the steps involved in this procedure. We hope to contribute to the standardization of the in vitro suppression assay used to measure Treg function. In addition, we offer this assay as a tool to recognize an early state of immune imbalance and a potential functional biomarker for T1D.

Human In Vitro Suppression as Screening Tool for the Recognition of an Early State of Immune Imbalance

Tregs are potent suppressors of the immune system. There is a lack of unique surface markers to define them, hence, definitions of Tregs are primarily functional. Here we describe an optimized in vitro assay capable of identifying immune imbalance in subjects at risk to develop T1D.

Regulatory T cells (Tregs) are critical mediators of immune tolerance to self-antigens. In addition, they are crucial regulators of the immune response ...

Selection of Plasmodium falciparum Parasites for Cytoadhesion to Human Brain Endothelial Cells

Most human malaria deaths are caused by blood-stage Plasmodium falciparum parasites. Cerebral malaria, the most life-threatening complication of the disease, is characterised by an accumulation of Plasmodium falciparum infected red blood cells (iRBC) at pigmented trophozoite stage in the microvasculature of the brain2-4. This microvessel obstruction (sequestration) leads to acidosis, hypoxia and harmful inflammatory cytokines (reviewed in 5). Sequestration is also found in most microvascular tissues of the human body2, 3. The mechanism by which iRBC attach to the blood vessel walls is still poorly understood.
The immortalized Human Brain microvascular Endothelial Cell line (HBEC-5i) has been used as an in vitro model of the blood-brain barrier6. However, Plasmodium falciparum iRBC attach only poorly to HBEC-5i in vitro, unlike the dense sequestration that occurs in cerebral malaria cases. We therefore developed a panning assay to select (enrich) various P. falciparum strains for adhesion to HBEC-5i in order to obtain populations of high-binding parasites, more representative of what occurs in vivo.
A sample of a parasite culture (mixture of iRBC and uninfected RBC) at the pigmented trophozoite stage is washed and incubated on a layer of HBEC-5i grown on a Petri dish. After incubation, the dish is gently washed free from uRBC and unbound iRBC. Fresh uRBC are added to the few iRBC attached to HBEC-5i and incubated overnight. As schizont stage parasites burst, merozoites reinvade RBC and these ring stage parasites are harvested the following day. Parasites are cultured until enough material is obtained (typically 2 to 4 weeks) and a new round of selection can be performed. Depending on the P. falciparum strain, 4 to 7 rounds of selection are needed in order to get a population where most parasites bind to HBEC-5i. The binding phenotype is progressively lost after a few weeks, indicating a switch in variant surface antigen gene expression, thus regular selection on HBEC-5i is required to maintain the phenotype.
In summary, we developed a selection assay rendering P. falciparum parasites a more "cerebral malaria adhesive" phenotype. We were able to select 3 out of 4 P. falciparum strains on HBEC-5i. This assay has also successfully been used to select parasites for binding to human dermal and pulmonary endothelial cells. Importantly, this method can be used to select tissue-specific parasite populations in order to identify candidate parasite ligands for binding to brain endothelium. Moreover, this assay can be used to screen for putative anti-sequestration drugs7.

Selection of Plasmodium falciparum Parasites for Cytoadhesion to Human Brain Endothelial Cells

An in vitro model for cerebral malaria sequestration is described1. Plasmodium falciparum infected red blood cells are selected for binding to immortalized human brain microvascular endothelial cells. The selected parasites show a distinct phenotype. The selection process can be applied using various P. falciparum strains and endothelial cell lines.

Most human malaria deaths are caused by blood-stage Plasmodium falciparum parasites. Cerebral malaria, the most life-threatening complication of the ...

Isolation of Human Umbilical Vein Endothelial Cells and Their Use in the Study of Neutrophil Transmigration Under Flow Conditions

Neutrophils are the most abundant type of white blood cell. They form an essential part of the innate immune system1. During acute inflammation, neutrophils are the first inflammatory cells to migrate to the site of injury. Recruitment of neutrophils to an injury site is a stepwise process that includes first, dilation of blood vessels to increase blood flow; second, microvascular structural changes and escape of plasma proteins from the bloodstream; third, rolling, adhesion and transmigration of the neutrophil across the endothelium; and fourth accumulation of neutrophils at the site of injury2,3. A wide array of in vivo and in vitro methods has evolved to enable the study of these processes4. This method focuses on neutrophil transmigration across human endothelial cells.
One popular method for examining the molecular processes involved in neutrophil transmigration utilizes human neutrophils interacting with primary human umbilical vein endothelial cells (HUVEC)5. Neutrophil isolation has been described visually elsewhere6; thus this article will show the method for isolation of HUVEC. Once isolated and grown to confluence, endothelial cells are activated resulting in the upregulation of adhesion and activation molecules. For example, activation of endothelial cells with cytokines like TNF-&alpha; results in increased E-selectin and IL-8 expression7. E-selectin mediates capture and rolling of neutrophils and IL-8 mediates activation and firm adhesion of neutrophils. After adhesion neutrophils transmigrate. Transmigration can occur paracellularly (through endothelial cell junctions) or transcellularly (through the endothelial cell itself). In most cases, these interactions occur under flow conditions found in the vasculature7,8.
The parallel plate flow chamber is a widely used system that mimics the hydrodynamic shear stresses found in vivo and enables the study of neutrophil recruitment under flow condition in vitro9,10. Several companies produce parallel plate flow chambers and each have advantages and disadvantages. If fluorescent imaging is needed, glass or an optically similar polymer needs to be used. Endothelial cells do not grow well on glass.
Here we present an easy and rapid method for phase-contrast, DIC and fluorescent imaging of neutrophil transmigration using a low volume ibidi channel slide made of a polymer that supports the rapid adhesion and growth of human endothelial cells and has optical qualities that are comparable to glass. In this method, endothelial cells were grown and stimulated in an ibidi &mu;slide. Neutrophils were introduced under flow conditions and transmigration was assessed. Fluorescent imaging of the junctions enabled real-time determination of the extent of paracellular versus transcellular transmigration.

This article first describes a procedure for isolating human endothelial cells from umbilical veins and then shows how to use these cells to examine neutrophil transmigration under flow conditions. By using a low-volume flow chamber made from a polymer with the optical characteristics of glass, live-cell fluorescent imaging of rare cell populations is also possible.

Neutrophils are the most abundant type of white blood cell. They form an essential part of the innate immune system1. During acute inflammation, ...

piggyBac Transposon System Modification of Primary Human T Cells

The piggyBac transposon system is naturally active, originally derived from the cabbage looper moth1,2. This non-viral system is plasmid based, most commonly utilizing two plasmids with one expressing the piggyBac transposase enzyme and a transposon plasmid harboring the gene(s) of interest between inverted repeat elements which are required for gene transfer activity. PiggyBac mediates gene transfer through a "cut and paste" mechanism whereby the transposase integrates the transposon segment into the genome of the target cell(s) of interest. PiggyBac has demonstrated efficient gene delivery activity in a wide variety of insect1,2, mammalian3-5, and human cells6 including primary human T cells7,8. Recently, a hyperactive piggyBac transposase was generated improving gene transfer efficiency9,10.
Human T lymphocytes are of clinical interest for adoptive immunotherapy of cancer11. Of note, the first clinical trial involving transposon modification of human T cells using the Sleeping beauty transposon system has been approved12. We have previously evaluated the utility of piggyBac as a non-viral methodology for genetic modification of human T cells. We found piggyBac to be efficient in genetic modification of human T cells with a reporter gene and a non-immunogenic inducible suicide gene7. Analysis of genomic integration sites revealed a lack of preference for integration into or near known proto-oncogenes13. We used piggyBac to gene-modify cytotoxic T lymphocytes to carry a chimeric antigen receptor directed against the tumor antigen HER2, and found that gene-modified T cells mediated targeted killing of HER2-positive tumor cells in vitro and in vivo in an orthotopic mouse model14. We have also used piggyBac to generate human T cells resistant to rapamycin, which should be useful in cancer therapies where rapamycin is utilized15.
Herein, we describe a method for using piggyBac to genetically modify primary human T cells. This includes isolation of peripheral blood mononuclear cells (PBMCs) from human blood followed by culture, gene modification, and activation of T cells. For the purpose of this report, T cells were modified with a reporter gene (eGFP) for analysis and quantification of gene expression by flow cytometry.
PiggyBac can be used to modify human T cells with a variety of genes of interest. Although we have used piggyBac to direct T cells to tumor antigens14, we have also used piggyBac to add an inducible safety switch in order to eliminate gene modified cells if needed7. The large cargo capacity of piggyBac has also enabled gene transfer of a large rapamycin resistant mTOR molecule (15 kb)15. Therefore, we present a non-viral methodology for stable gene-modification of primary human T cells for a wide variety of purposes.

piggyBac Transposon System Modification of Primary Human T Cells

We describe a method to genetically modify primary human T cells with a transgene using the non-viral piggyBac transposon system. T cells modified to using the piggyBac transposon system exhibit stable transgene expression.

The piggyBac transposon system is naturally active, originally derived from the cabbage looper moth1,2. This non-viral system is plasmid based, most ...

Flow Cytometric Isolation of Primary Murine Type II Alveolar Epithelial Cells for Functional and Molecular Studies

Throughout the last years, the contribution of alveolar type II epithelial cells (AECII) to various aspects of immune regulation in the lung has been increasingly recognized. AECII have been shown to participate in cytokine production in inflamed airways and to even act as antigen-presenting cells in both infection and T-cell mediated autoimmunity 1-8. Therefore, they are especially interesting also in clinical contexts such as airway hyper-reactivity to foreign and self-antigens as well as infections that directly or indirectly target AECII. However, our understanding of the detailed immunologic functions served by alveolar type II epithelial cells in the healthy lung as well as in inflammation remains fragmentary. Many studies regarding AECII function are performed using mouse or human alveolar epithelial cell lines 9-12. Working with cell lines certainly offers a range of benefits, such as the availability of large numbers of cells for extensive analyses. However, we believe the use of primary murine AECII allows a better understanding of the role of this cell type in complex processes like infection or autoimmune inflammation. Primary murine AECII can be isolated directly from animals suffering from such respiratory conditions, meaning they have been subject to all additional extrinsic factors playing a role in the analyzed setting. As an example, viable AECII can be isolated from mice intranasally infected with influenza A virus, which primarily targets these cells for replication 13. Importantly, through ex vivo infection of AECII isolated from healthy mice, studies of the cellular responses mounted upon infection can be further extended.
Our protocol for the isolation of primary murine AECII is based on enzymatic digestion of the mouse lung followed by labeling of the resulting cell suspension with antibodies specific for CD11c, CD11b, F4/80, CD19, CD45 and CD16/CD32. Granular AECII are then identified as the unlabeled and sideward scatter high (SSChigh) cell population and are separated by fluorescence activated cell sorting 3.
In comparison to alternative methods of isolating primary epithelial cells from mouse lungs, our protocol for flow cytometric isolation of AECII by negative selection yields untouched, highly viable and pure AECII in relatively short time. Additionally, and in contrast to conventional methods of isolation by panning and depletion of lymphocytes via binding of antibody-coupled magnetic beads 14, 15, flow cytometric cell-sorting allows discrimination by means of cell size and granularity. Given that instrumentation for flow cytometric cell sorting is available, the described procedure can be applied at relatively low costs. Next to standard antibodies and enzymes for lung disintegration, no additional reagents such as magnetic beads are required. The isolated cells are suitable for a wide range of functional and molecular studies, which include in vitro culture and T-cell stimulation assays as well as transcriptome, proteome or secretome analyses 3, 4.

We describe the rapid isolation of primary murine type II alveolar epithelial cells (AECII) by flow cytometric negative selection. These AECII show high viability and purity and are suitable for a wide range of functional and molecular studies regarding their role in respiratory conditions such as autoimmune or infectious diseases.

Throughout  the last years, the contribution of alveolar type II epithelial cells (AECII)  to various aspects of immune regulation in the lung has been ...

Quantitative In vitro Assay to Measure Neutrophil Adhesion to Activated Primary Human Microvascular Endothelial Cells under Static Conditions

The vascular endothelium plays an integral part in the inflammatory response. During the acute phase of inflammation, endothelial cells (ECs) are activated by host mediators or directly by conserved microbial components or host-derived danger molecules. Activated ECs express cytokines, chemokines and adhesion molecules that mobilize, activate and retain leukocytes at the site of infection or injury. Neutrophils are the first leukocytes to arrive, and adhere to the endothelium through a variety of adhesion molecules present on the surfaces of both cells. The main functions of neutrophils are to directly eliminate microbial threats, promote the recruitment of other leukocytes through the release of additional factors, and initiate wound repair. Therefore, their recruitment and attachment to the endothelium is a critical step in the initiation of the inflammatory response. In this report, we describe an in vitro neutrophil adhesion assay using calcein AM-labeled primary human neutrophils to quantitate the extent of microvascular endothelial cell activation under static conditions. This method has the additional advantage that the same samples quantitated by fluorescence spectrophotometry can also be visualized directly using fluorescence microscopy for a more qualitative assessment of neutrophil binding.

Quantitative In vitro Assay to Measure Neutrophil Adhesion to Activated Primary Human Microvascular Endothelial Cells under Static Conditions

Neutrophil adherence to the activated endothelium at sites of infection is an integral component of the host's inflammatory response. Described in this report is a neutrophil binding assay that allows for the in vitro quantitation of primary human neutrophil binding to endothelial cells activated by inflammatory mediators under static conditions.

The vascular  endothelium plays an integral part in the inflammatory response. During the  acute phase of inflammation, endothelial cells (ECs) are ...

Flow Cytometric Analysis of Natural Killer Cell Lytic Activity in Human Whole Blood

NK cell cytotoxicity is a widely used measure to determine the effect of outside intervention on NK cell function. However, the accuracy and reproducibility of this assay can be considered unstable, either because of user&#39;s errors or because of the sensitivity of NK cells to experimental manipulation. To eliminate these issues, a workflow that reduces them to a minimum was established and is presented here. To illustrate, we obtained blood samples, at various time points, from runners (n = 4) that were submitted to an intense bout of exercise. First, NK cells are simultaneously identified and isolated through CD56 tagging and magnetic-based sorting, directly from whole blood and from as little as one milliliter. The sorted NK cells are removed of any reagent or capping antibodies. They can be counted in order to establish an accurate NK cell count per milliliter of blood. Secondly, the sorted NK cells (effectors cells or E) can be mixed with 3,3&#39;-Diotadecyloxacarbocyanine Perchlorate (DiO) tagged K562 cells (target cells or T) at an assay-optimal 1:5 T:E ratio, and analyzed using an imaging flow-cytometer that allows for the visualization of each event and the elimination of any false positive or false negatives (such as doublets or effector cells). This workflow can be completed in about 4 h, and allows for very stable results even when working with human samples. When available, research teams can test several experimental interventions in human subjects, and compare measurements across several time points without compromising the data&#39;s integrity.

This work describes an advanced workflow for the accurate and fast determination of NK (Natural Killer) cell count and NK cell cytotoxicity in human blood samples.

NK cell cytotoxicity is a widely used measure to determine the effect of outside intervention on NK cell function. However, the accuracy and ...

Small RNA Transfection in Primary Human Th17 Cells by Next Generation Electroporation

CD4+ T cells can differentiate into several subsets of effector T helper cells depending on the surrounding cytokine milieu. Th17 cells can be generated from na&#239;ve CD4+ T cells in vitro by activating them in the presence of the polarizing cytokines IL-1&#946;, IL-6, IL-23, and TGF&#946;. Th17 cells orchestrate immunity against extracellular bacteria and fungi, but their aberrant activity has also been associated with several autoimmune and inflammatory diseases. Th17 cells are identified by the chemokine receptor CCR6 and defined by their master transcription factor, ROR&#947;t, and characteristic effector cytokine, IL-17A. Optimized culture conditions for Th17 cell differentiation facilitate mechanistic studies of human T cell biology in a controlled environment. They also provide a setting for studying the importance of specific genes and gene expression programs through RNA interference or the introduction of microRNA (miRNA) mimics or inhibitors. This protocol provides an easy to use, reproducible, and highly efficient method for transient transfection of differentiating primary human Th17 cells with small RNAs using a next generation electroporation device.

Next generation electroporation is an efficient method for transfecting human Th17 cells with small RNAs to alter gene expression and cell behavior.

CD4+ T cells can differentiate into several subsets of effector T helper cells depending on the surrounding cytokine milieu. Th17 cells can be generated ...

Isolation and In Vitro Culture of Murine and Human Alveolar Macrophages

Alveolar macrophages are terminally differentiated, lung-resident macrophages of prenatal origin. Alveolar macrophages are unique in their long life and their important role in lung development and function, as well as their lung-localized responses to infection and inflammation. To date, no unified method for identification, isolation, and handling of alveolar macrophages from humans and mice exists. Such a method is needed for studies on these important innate immune cells in various experimental settings. The method described here, which can be easily adopted by any laboratory, is a simplified approach to harvesting alveolar macrophages from bronchoalveolar lavage fluid or from lung tissue and maintaining them in vitro. Because alveolar macrophages primarily occur as adherent cells in the alveoli, the focus of this method is on dislodging them prior to harvest and identification. The lung is a highly vascularized organ, and various cell types of myeloid and lymphoid origin inhabit, interact, and are influenced by the lung microenvironment. By using the set of surface markers described here, researchers can easily and unambiguously distinguish alveolar macrophages from other leukocytes, and purify them for downstream applications. The culture method developed herein supports both human and mouse alveolar macrophages for in vitro growth, and is compatible with cellular and molecular studies.

Isolation and In Vitro Culture of Murine and Human Alveolar Macrophages

This communication describes methodologies for isolation and culture of alveolar macrophages from humans and murine models for experimental purposes.

Alveolar macrophages are terminally differentiated, lung-resident macrophages of prenatal origin. Alveolar macrophages are unique in their long life and ...

Digestion of the Murine Liver for a Flow Cytometric Analysis of Lymphatic Endothelial Cells

Within the liver, lymphatic vessels are found within the portal triad, and their described function is to remove interstitial fluid from the liver to the lymph nodes where cellular debris and antigens can be surveyed. We are very interested in understanding how the lymphatic vasculature might be involved in inflammation and immune cell function within the liver. However, very little has been published establishing digestion protocols for the isolation of lymphatic endothelial cells (LECs) from the liver or specific markers that can be used to evaluate liver LECs on a per cell basis. Therefore, we optimized a method for the digestion and staining of the liver in order to evaluate the LEC population in the liver. We are confident that the method outlined here will be useful for the identification and isolation of LECs from the liver and will strengthen our understanding of how LECs respond to the liver microenvironment.

The goal of this protocol is to identify lymphatic endothelial cell populations within the liver using described markers. We utilize collagenase IV and DNase and a gentle mincing of tissue, combined with flow cytometry, to identify a distinct population of lymphatic endothelial cells.

Within the liver, lymphatic vessels are found within the portal triad, and their described function is to remove interstitial fluid from the liver to the ...