Name: culture and imaging of human nasal epithelial organoids
Uploaded: 2021-12-17T14:00:00
Description: Watch this Scientific Journal Video about Culture and Imaging of Human Nasal Epithelial Organoids at JoVE.com

We gratefully acknowledge the contributions of all the participants who donated HNE brush biopsies to develop this protocol. We thank Latona Kersh and Children&#39;s Research Unit staff for coordinating study volunteer recruitment and sample collections. We thank Lily Deng, Johnathan Bailey, and Stephen Mackay, former trainees in our laboratory, for technical assistance. We thank Zhong Liu and Rui Zhao for their technical help. Steven M. Rowe, Director of the CF Research Center at UAB, provides leadership and resources, without which this work would not be possible. We also would like to thank Sarah Guadiana at Biotek for assistance with instrument training, Robert Grabski for confocal microscopy assistance at the UAB High-Resolution Imaging Facility, and Dezhi Wang for histological assistance at the UAB Histology Core. This work was supported by the National Institutes of Health (NIH.) Grant K23HL143167 (to JSG), Cystic Fibrosis Foundation (CFF) Grant GUIMBE18A0-Q (to JSG), the Gregory Fleming James Cystic Fibrosis Center [NIH Grants R35HL135816 and DK072482 and the CFF University of Alabama at Birmingham (UAB) Research and Development Program (Rowe19RO)], and the UAB Center for Clinical and Translational Science (NIH Grant UL1TR001417).

HNE samples were collected at the Children&#39;s of Alabama hospital. All procedures and methods described here have been approved by the IRB University of Alabama at Birmingham (UAB IRB #151030001). To facilitate the expansion and improve the function of human nasal epithelial cells (HNEs), the present culturing methods are adapted from the well-known air-liquid interface (ALI) culture method28,34. HNEs were initially collected by brush biopsy as previously desc...

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This manuscript provides detailed methodologies for comprehensive live and fixed imaging of the airway epithelial organoids derived from HNE brush biopsy. It describes functional assays that can determine CFTR activity in an individual. HNEs provide a minimally invasive, primary tissue for a variety of applications. The expansion techniques offered here can be used for modeling airways disease, including organoids. Organoids can be used for precision therapeutic approaches and to monitor the stability of gene or mRNA-bas...

Introduction to the technique 
Ex vivo culture-based assays are an increasingly utilized tool for precision medicine and the study of disease pathophysiology. Primary human nasal epithelial (HNE) cell culture has been used in numerous studies of cystic fibrosis1,2,3,4,5,6,7,8,9,10,11,12,13, an autosomal recessive disease that affects epithelial cell function in multiple organs. HNE culture provides a renewable source of airway epithelia that may be obtained prospectively and recapitulates electrophysiological and biochemical qualities to test Cystic Fibrosis Transmembrane conductance Regulator (CFTR) activity. HNE cells can be sampled with minimal side effects14, similar to common viral respiratory swabs. Research work describing a model for cystic fibrosis study derived from HNE brush biopsies has been recently published11,13. While similar to other models using primary HNE2,3 and intestinal tissue15,16,17,18,19, detailed characterization of the differentiation and imaging of this model are described here for use in CF research and for aiding in the studies of other airways diseases13. The organoid model is not unlimited like immortalized cell lines but can be expanded by conditional reprogramming (using irradiated and inactivated feeder fibroblasts and Rho-kinase inhibitors) to a more stem cell-like state20,21,22,23. The processing of HNE brush biopsies using this method yields large numbers of epithelial cells for use in multiple applications at higher throughput while still retaining the ability to differentiate fully. While this protocol was developed using feeder cells, other methodologies may be used by investigators wishing to avoid feeder cell technology14,24.
Importance of the technique to pulmonary biology 
A significant study has been devoted to understanding how the absence of regular, functioning CFTR in the cell membrane of epithelial cells results in dysfunction in the lungs, pancreas, liver, intestine, or other tissues. Dysfunctional epithelial ion transport, particularly that of chloride and bicarbonate, results in a decreased volume of the epithelial lining fluids and changes in mucous secretions, leading to mucous stasis and obstruction. In other airway diseases, such as primary ciliary dyskinesia, altered ciliary motion impairs mucociliary clearance and leads to mucous stasis and obstruction25. Therefore, the current HNE organoid model has been developed for various applications, depending on the investigator&#39;s experimental design and resources. This includes live-cell imaging using live-cell stains; fixation and sectioning to characterize the morphology; immunofluorescence staining with antibodies and whole-mount confocal imaging to avoid disrupting intraluminal structures; and bright-field imaging and micro-optical coherence tomography for quantitative measurements of ciliary beat frequency and mucociliary transport13. To facilitate expansion to other investigators, commercially available reagents and supplies were used for culturing. A functional assay was developed that used common microscope techniques and more specialized equipment. Overall, while the present model was designed to assess CFTR activity at baseline or in response to therapeutics, the techniques described in this protocol can be applied to other diseases involving epithelial cell function, especially epithelial cell fluid transport.
Comparison to other methodologies 
Recently the utility of this organoid model was developed by correlating in vitro CFTR modulator responses of patients&#39; organoids with their clinical response11. Notably, it is also demonstrated that the present model paralleled short-circuit current responses, the current gold standard for assessing CFTR function, in the same patients. Short-circuit current differs from the swelling assay because the former measures CFTR function via ion transport26. In contrast, this assay measures a more downstream effect with fluid transport, providing additional information about the overall function of CFTR27,28,29,30,31,32. Short-circuit current measurements have continued to be a common and reliable method for determining CFTR chloride channel activity1,33. These electrophysiological assays require specialized, expensive equipment, require many times more cells for each experimental replicate than the organoid assay, cannot be easily automated, and are not amenable to scaling up for higher throughput applications. Another organoid model derived from intestinal epithelia has additional advantages15,16,17,18, such as more excellent replicative capability, but is neither derived from an airway tissue nor is universally available. HNE brushings are obtained with inexpensive cytology brushes without the need for sedation and at minimal risk. Getting the brushing does not require a clinician and can be performed by trained research coordinators and other research staff14. The HNE organoid model can be cultured by any laboratory with primary cell culture capabilities, and some of the applications can be performed with standard microscopy techniques. Altogether, these advantages provide additional access to technology for assessing airway epithelial function that might otherwise be unavailable to some laboratories. Furthermore, HNE organoids can be utilized to study other disease states that affect the airway, such as primary ciliary dyskinesia25 or viral infection, which intestinal organoids cannot.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>Nasal brush</td>
			<td>Medical Packaging CYB1</td>
			<td>CYB-1</td>
			<td>Length: 8 inches, width approximately 7 mm</td>
		</tr>
		<tr>
			<td>Large-Orifice Pipette Tips</td>
			<td>ThermoFisher Scientific</td>
			<td>02-707-141</td>
			<td>Large bore pipette tips</td>
		</tr>
		<tr>
			<td>Accutase</td>
			<td>ThermoFisher Scientific</td>
			<td>A1110501</td>
			<td>Cell detachment solution</td>
		</tr>
		<tr>
			<td>0.05% trypsin -EDTA</td>
			<td>Gibco</td>
			<td>25300-054</td>
			<td></td>
		</tr>
		<tr>
			<td>Trypsin inhibitor from soybean</td>
			<td>Sigma</td>
			<td>T6522</td>
			<td>Working solution: 1mg/mL in 1XDPBS</td>
		</tr>
		<tr>
			<td>Matrigel matrix</td>
			<td>Corning</td>
			<td>356255</td>
			<td>Extracellular matrix (EM)</td>
		</tr>
		<tr>
			<td>&#181;-Slide Angiogenesis</td>
			<td>Ibidi</td>
			<td>81506</td>
			<td>15-well slide</td>
		</tr>
		<tr>
			<td>24-Well Transwell</td>
			<td>Corning</td>
			<td>7200154</td>
			<td>Culture insert</td>
		</tr>
		<tr>
			<td>Chambered Coverglass</td>
			<td>ThermoFisher Scientific</td>
			<td>155409</td>
			<td>8-well glass-bottom chamber slides</td>
		</tr>
		<tr>
			<td>Cell-Tak Cell and Tissue Adhesive</td>
			<td>ThermoFisher Scientific</td>
			<td>354240</td>
			<td>Cell adhesive</td>
		</tr>
		<tr>
			<td>Paraformaldehyde</td>
			<td>Electron Microscopy Sciences</td>
			<td>50980487</td>
			<td></td>
		</tr>
		<tr>
			<td>Triton X-100</td>
			<td>Alfa Aesar</td>
			<td>A16046</td>
			<td></td>
		</tr>
		<tr>
			<td>BSA</td>
			<td>ThermoFisher Scientific</td>
			<td>BP1600-100</td>
			<td></td>
		</tr>
		<tr>
			<td>NucBlue</td>
			<td>ThermoFisher Scientific</td>
			<td>R37605</td>
			<td>DAPI</td>
		</tr>
		<tr>
			<td>Eclipse Ts2-FL (Inverted Routine Microscope)</td>
			<td>Nikon</td>
			<td></td>
			<td>Inverted epi-fluorescence microscope or bright-field microscope</td>
		</tr>
		<tr>
			<td>Nikon A1R-HD25</td>
			<td>Nikon</td>
			<td></td>
			<td>Confocal microscope</td>
		</tr>
		<tr>
			<td>NIS Elements- Basic Research</td>
			<td>Nikon</td>
			<td></td>
			<td>manual imaging analysis software</td>
		</tr>
		<tr>
			<td>Histogel</td>
			<td>ThermoFisher Scientific</td>
			<td>HG-4000-012</td>
			<td></td>
		</tr>
		<tr>
			<td>Disposable Base Molds</td>
			<td>ThermoFisher Scientific</td>
			<td>41-740</td>
			<td></td>
		</tr>
		<tr>
			<td>Lionheart FX</td>
			<td>BioTek</td>
			<td>BTLFX</td>
			<td>Automated image system</td>
		</tr>
		<tr>
			<td>Lionheart Cover</td>
			<td>BioTek</td>
			<td>BT1450009</td>
			<td>Environmental Control Lid</td>
		</tr>
		<tr>
			<td>Humidity Chamber</td>
			<td>BioTek</td>
			<td>BT1450006</td>
			<td>Stage insert (environmental chamber)</td>
		</tr>
		<tr>
			<td>Gas Controller for CO2 and O2</td>
			<td>BioTek</td>
			<td>BT1210013</td>
			<td>Gas controller</td>
		</tr>
		<tr>
			<td>Microplate/Slide Stage Insert</td>
			<td>BioTek</td>
			<td>BT1450527</td>
			<td>Slide holder</td>
		</tr>
		<tr>
			<td>Gen5 Imaging Prime Software</td>
			<td>BioTek</td>
			<td>BTGEN5IPRIM</td>
			<td>Automated imaging analysis software</td>
		</tr>
		<tr>
			<td>4x Phase Contrast Objective</td>
			<td>BioTek</td>
			<td>BT1320515</td>
			<td></td>
		</tr>
		<tr>
			<td>10x Phase Contrast Objective</td>
			<td>BioTek</td>
			<td>BT1320516</td>
			<td></td>
		</tr>
		<tr>
			<td>LED Cube</td>
			<td>BioTek</td>
			<td>BT1225007</td>
			<td></td>
		</tr>
		<tr>
			<td>Filter Cube (DAPI)</td>
			<td>BioTek</td>
			<td>BT1225100</td>
			<td>DAPI</td>
		</tr>
		<tr>
			<td>CFTRinh-172</td>
			<td>Selleck Chemicals</td>
			<td>S7139</td>
			<td></td>
		</tr>
		<tr>
			<td>Forskolin</td>
			<td>Sigma</td>
			<td>F6886</td>
			<td></td>
		</tr>
		<tr>
			<td>IBMX</td>
			<td>Sigma</td>
			<td>I5879</td>
			<td></td>
		</tr>
		<tr>
			<td>Expansion Media</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>DMEM</td>
			<td>ThermoFisher Scientific</td>
			<td>11965</td>
			<td></td>
		</tr>
		<tr>
			<td>F12 Nutrient mix</td>
			<td>ThermoFisher Scientific</td>
			<td>11765</td>
			<td></td>
		</tr>
		<tr>
			<td>Fetal Bovine Serum</td>
			<td>ThermoFisher Scientific</td>
			<td>&#160;16140-071</td>
			<td></td>
		</tr>
		<tr>
			<td>Penicillin/Streptomycin</td>
			<td>ThermoFisher Scientific</td>
			<td>&#160;15-140-122</td>
			<td></td>
		</tr>
		<tr>
			<td>Cholera Toxin</td>
			<td>Sigma</td>
			<td>&#160;C8052</td>
			<td></td>
		</tr>
		<tr>
			<td>Epidermal Growth Factor (EGF)</td>
			<td>ThermoFisher Scientific</td>
			<td>&#160;PHG0314</td>
			<td></td>
		</tr>
		<tr>
			<td>Hydrocortisone (HC)</td>
			<td>Sigma</td>
			<td>&#160;H0888</td>
			<td></td>
		</tr>
		<tr>
			<td>Insulin</td>
			<td>Sigma</td>
			<td>&#160;I9278</td>
			<td></td>
		</tr>
		<tr>
			<td>Adenine</td>
			<td>Sigma</td>
			<td>&#160;A2786</td>
			<td></td>
		</tr>
		<tr>
			<td>Y-27632</td>
			<td>Stemgent</td>
			<td>&#160;04-0012-02</td>
			<td></td>
		</tr>
		<tr>
			<td>Antibiotic Media</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Ceftazidime</td>
			<td>Alfa Aesar</td>
			<td>&#160;J66460-03</td>
			<td></td>
		</tr>
		<tr>
			<td>Tobramycin</td>
			<td>Alfa Aesar</td>
			<td>&#160;J67340</td>
			<td></td>
		</tr>
		<tr>
			<td>Vancomycin</td>
			<td>Alfa Aesar</td>
			<td>&#160;J67251</td>
			<td></td>
		</tr>
		<tr>
			<td>Amphotericin B</td>
			<td>Sigma</td>
			<td>&#160;A2942</td>
			<td></td>
		</tr>
		<tr>
			<td>Differentiation Media</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>DMEM/F-12 (1:1)</td>
			<td>ThermoFisher Scientific</td>
			<td>&#160;11330-32</td>
			<td></td>
		</tr>
		<tr>
			<td>Ultroser-G</td>
			<td>Pall</td>
			<td>&#160;15950-017</td>
			<td></td>
		</tr>
		<tr>
			<td>Fetal Clone II</td>
			<td>Hyclone</td>
			<td>&#160;SH30066.03</td>
			<td></td>
		</tr>
		<tr>
			<td>Bovine Brain Extract</td>
			<td>Lonza</td>
			<td>&#160;CC-4098</td>
			<td></td>
		</tr>
		<tr>
			<td>Insulin</td>
			<td>Sigma</td>
			<td>&#160;I-9278</td>
			<td></td>
		</tr>
		<tr>
			<td>Hydrocortisone</td>
			<td>Sigma</td>
			<td>&#160;H-0888</td>
			<td></td>
		</tr>
		<tr>
			<td>Triiodothyronine</td>
			<td>Sigma</td>
			<td>&#160;T-6397</td>
			<td></td>
		</tr>
		<tr>
			<td>Transferrin</td>
			<td>Sigma</td>
			<td>&#160;T-0665</td>
			<td></td>
		</tr>
		<tr>
			<td>Ethanolamine</td>
			<td>Sigma</td>
			<td>&#160;E-0135</td>
			<td></td>
		</tr>
		<tr>
			<td>Epinephrine</td>
			<td>Sigma</td>
			<td>E-4250</td>
			<td></td>
		</tr>
		<tr>
			<td>O-Phosphorylethanolamine</td>
			<td>Sigma</td>
			<td>P-0503</td>
			<td></td>
		</tr>
		<tr>
			<td>Retinoic Acid</td>
			<td>Sigma</td>
			<td>R-2625</td>
			<td></td>
		</tr>
		<tr>
			<td>Primary antibodies</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Human CFTR antibody</td>
			<td>R&#38;D Systems</td>
			<td>MAB1660</td>
			<td>Dilution: 100x</td>
		</tr>
		<tr>
			<td>ZO-1 antibody</td>
			<td>Thermo Fisher</td>
			<td>MA3-39100-A647</td>
			<td>Dilution: 1000x</td>
		</tr>
		<tr>
			<td>Anti-MUC5B antibody</td>
			<td>Sigma</td>
			<td>HPA008246</td>
			<td>Dilution: 100x</td>
		</tr>
		<tr>
			<td>Anti-acetylated tubulin</td>
			<td>Sigma</td>
			<td>T7451</td>
			<td>Dilution: 100x</td>
		</tr>
		<tr>
			<td>Anti-beta IV Tubulin antibody</td>
			<td>Abcam</td>
			<td>Ab11315</td>
			<td>Dilution: 100x</td>
		</tr>
		<tr>
			<td>Secondary antibodies</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Donkey anti-Mouse IgG (H+L), Alexa Fluor 488</td>
			<td>Invitrogen</td>
			<td>A21202</td>
			<td>Dilution: 2000x</td>
		</tr>
		<tr>
			<td>Donkey anti-Rabbit IgG (H+L), Alexa Fluor 594</td>
			<td>Invitrogen</td>
			<td>A21207</td>
			<td>Dilution: 2000x</td>
		</tr>
	</tbody>
</table>

culture and imaging of human nasal epithelial organoids

Individualized therapy for cystic fibrosis (CF) patients can be achieved with an in vitro disease model to understand baseline Cystic Fibrosis Transmembrane conductance Regulator (CFTR) activity and restoration from small molecule compounds. Our group recently focused on establishing a well-differentiated organoid model directly derived from primary human nasal epithelial cells (HNE). Histology of sectioned organoids, whole-mount immunofluorescent staining, and imaging (using confocal microscopy, immunofluorescent microscopy, and bright field) are essential to characterize organoids and confirm epithelial differentiation in preparation for functional assays. Furthermore, HNE organoids produce lumens of varying sizes that correlate with CFTR activity, distinguishing between CF and non-CF organoids. In this manuscript, the methodology for culturing HNE organoids are described in detail, focusing on the assessment of differentiation using the imaging modalities, including the measurement of baseline lumen area (a method of CFTR activity measurement in organoids that any laboratory with a microscope can employ) as well as the developed automated approach to a functional assay (which requires more specialized equipment).

HNEs expansion is essential for a thriving organoid culture. HNEs from a successful sample collection should expand to over 70% confluence around 10 days. An example of successful and unsuccessful samples is shown in Figure 1A and Figure 1B, respectively. The cells must be discarded if they cannot reach 70% confluence by 14 days after co-culture with irradiated 3T3 cells. Any contaminated cells are to be immediately discarded if unable to rescue...

Watch this Scientific Journal Video about Culture and Imaging of Human Nasal Epithelial Organoids at JoVE.com

Culture and Imaging of Human Nasal Epithelial Organoids

A detailed protocol is presented here to describe an in vitro organoid model from human nasal epithelial cells. The protocol has options for measurements requiring standard laboratory equipment, with additional possibilities for specialized equipment and software.

Individualized therapy for cystic fibrosis (CF) patients can be achieved with an in vitro disease model to understand baseline Cystic Fibrosis ...

Individualized therapy for cystic fibrosis patients can be achieved by an in vitro disease model to understand the CFTR activity at baseline. Human nasal epithelial organoids, or HNE organoids, produce lumens of varying sizes that correlate with the CFTR activity, distinguishing between CF and non-CF organoids. Here, we have described a methodology for culturing and imaging these HNE organoids in detail.Dysfunctional epithelial ion transport, particularly that of chloride and bicarbonate, results in a decreased volume of the epithelial lining fluids. This also affects the mucus secretions leading to mucostasis and obstruction. Therefore, our HNE model has been developed for various applications, depending on the investigator's experimental design and resources.Apart from assessing CFTR activity at baseline or in response to therapeutics, this technique can also be applied to other diseases involving epithelial cell function, especially epithelial cell fluid transport. These methods were developed primarily for use in cystic fibrosis studies. Other studies evaluating the airway epithelia, such as primary ciliary dyskinesia, may also find these methods helpful.These techniques require attention to detail and precision. They also require careful observation to ensure that the initial expansion of cells is appropriate. Monitor all cultures every day, and the success will be more likely.To begin, dissociate the nasal brush biopsy into 8 milliters of RPMI media in a 15 milliliter conical tube by passing the cytology brush several times through a one milliliter large-bore pipette tip. Centrifuge the cells at 500 times g for five minutes at four degrees Celsius. Discard the supernatant and then re-suspend the cell pellet in three milliliters of cell detachment solution.Incubate at room temperature for 16 minutes to digest. Use five milliliters of the expansion media to wash the cells twice. Then, add them to a T75 flask, pre-seeded with irradiated, inactivated, and 50 to 60%confluent 3T3 fibroblasts.Allow the cells to co-culture and expand in the expansion media for 7 to 14 days. If antibiotics were introduced for cells derived from patients with cystic fibrosis, the media should be replaced with antibiotic-free expansion media after the initial three days of culture, and can continue changing media every two days until 80%confluent. Wash the cells with 1x DPBS.Then, add 1.5 milliliters of 0.05%trypsin-EDTA into the T75 flask and incubate for four minutes at 37 degrees Celsius to remove the irradiated and inactivated 3T3 fibroblast from the culture. Rinse the T75 flask with 1x DPBS twice to thoroughly wash away any remaining 3T3 fibroblasts. Add 1.5 milliliters of 0.05%trypsin-EDTA into the T75 flask and incubate for 10 minutes at 37 degrees Celsius to detach HNEs.Neutralize the trypsin with soybean trypsin inhibitor at a one-to-one ratio. Centrifuge the cells at 500 times gi for five minutes. Then, discard the supernatant and wash the cells with five milliliters of expansion media once.The cells are now ready for seeding to grow organoids. Thaw the organoid culture extracellular matrix or ECM overnight at four degrees Celsius. Cool the 15-well angiogenesis slides overnight at the same temperature.Next, cool the pipette tips to four degrees Celsius. Coat the slides with five microliters of cold 100%ECM on ice. Place them into a cell culture incubator at 37 degrees Celsius for at least 30 minutes for consolidation.Count the HNEs harvested from co-culture using a hemocytometer. Then, dilute the cells to 500 cells per microliters in total number, with 20%ECM diluted by differentiation media on ice. Take the ECM coated slides out of the incubator and seed five microliters of the cold cell ECM mixture into each of the wells.Transfer the slides immediately into a culture incubator at 37 degrees Celsius for an hour to consolidate the cell ECM mixture. After that, take the slides out of the incubator and feed the cells into each well of the 15-well angiogenesis slides with 50 microliters of the differentiation media. Return the slide into the culture incubator at 37 degrees Celsius, changing the media every other day until the organoids are ready for further experiments.Pre-treat the 8-well glass-bottom chamber slides with cell adhesive for 30 minutes. Discard the solution and air-dry the wells for another 30 minutes. Next, discard the media from the top of the ECM and then add 50 microliters of the cold 1x PBS into each well of the 15-well slides on ice.Pipette up and down three to five times using 200 microliters of the large-bore pipette tip. Dispense the solution onto the center of a well of the 8-well chamber slides. Remove the excess liquid immediately from the wells by a fine-tip pipette.Then, place the chamber slide into a 37 degree Celsius incubator for 40 minutes to enhance the organoid adhering to the glass bottom. After 40 minutes, gently wash the organoids with 1x PBS twice and fix them with 300 microliters of 4%paraformaldehyde in each well for 30 minutes set room temperature. Wash twice with 1x PBS and store the organoids in 1x PBS set four degrees Celsius for immunostaining for up to two weeks.To harvest the organoids for histological studies, remove the media from the culture and add 50 microliters of cold one 1x PBS into each well of the slides on ice. Pipette up and down three to five times using a 200 microliter large-bore pipette tip. Combine all the solutions from the 15-well slide or culture inserts into a 15 milliliter conical tube on ice.Adjust the total solution volume in the tube to 10 milliliters by adding cold 1x PBS. Centrifuge the tube at four degrees Celsius, 300 times g for five minutes. Then, aspirate out the supernatant and add 60 microliters of warm histogel to mix with the organoid pellet using a 200 microliter large-bore pipette tip.Transfer the suspension immediately to a histology mold. After consolidating the histogel at room temperature, put the mold block into 4%paraformaldehyde for fixation overnight at four degrees Celsius. Open the software and right click at the bottom of the screen.Then, select Analysis Controls, followed by Automated Measurement Results. Open the organoid image and select 5 to 10 organoids with visible lumens. Hold right click on the image to open the menu and select Polygonal ROI to outline the full organoid to obtain the organoid's total surface area.Then, outline the lumen to obtain the lumen area. Repeat this for the remaining organoids in the well, and all the wells in the assay. Finally, export the data to Excel.Divide the lumen area by the total surface area and average all the organoids from the sample to get the Baseline Lumen Ratio. The bright field images represent HNEs from a successful and unsuccessful samples collection. The HNEs grow well in a large cluster.In contrast, the HNEs grow poorly in two small clusters surrounding the irradiated 3T3 cells. Organoids in the 15-well slide have more precise and sharper images than those in the culture insert. Besides this, no significant morphological difference was observed in these two culture methods.Non-CF organoids typically have a larger lumen and more fluid than CF organoids. The HNE staining in organoids from a non-CF, F508del/F508del subject, and the immunofluorescent staining of cilia in an organoid are shown in these images. The cilia stained with acetylated-tubulin, FITC labeled secondary antibody, and the nuclei labeled with DAPI are shown here.Maximum projection images of the two representative organoids by whole-mount immunofluorescent staining and their corresponding three-dimensional reconstruction images are shown here. Mucus and cilia within the lumen of the organoids are shown. The graphical images represent the forskolin-induced swelling assay to test CFTR function on the primary nasal epithelial cells.A representative forskolin dose-response experiment of non-CF volunteers is shown here. FSK dose-response is compared with average fractional change at one hour, versus at eight hours, which suggests that the eight hours assay can produce a more significant swelling difference among different FSK doses than those at one hour. The area under the curve can show a minor difference in swelling compared to average fractional change at eight hours.While attempting this procedure, keep in mind that organoids will be lost during the collection, fixation and staining process. So, meticulous care must be taken during each step and sufficient starting numbers must be obtained to ensure success. Growing organoids in culture inserts can help in this regard, as these techniques are developed.Here, we have used commercially available reagents and supplies to facilitate expansion to other investigators. A functional assay was also developed that used common microscope techniques and more specialized equipment.

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