Name: visualizing dna damage repair proteins in patient-derived ovarian cancer organoids via immunofluorescence assays
Uploaded: 2023-02-24T14:20:00
Description: Watch this Scientific Journal Video about Visualizing DNA Damage Repair Proteins in Patient-Derived Ovarian Cancer Organoids via Immunofluorescence Assays at JoVE.com

We are grateful for the guidance of Pavel Lobachevsky, PhD in establishing this protocol. We&#39;d also like to acknowledge Washington University&#39;s School of Medicine in St. Louis&#39;s Department of Obstetrics and Gynecology and Division of Gynecologic Oncology, Washington University&#39;s Dean&#39;s Scholar Program, Gynecologic Oncology Group Foundation, and the Reproductive Scientist Development Program for their support of this project.

Tumor tissue and ascites were obtained after obtaining patient consent as part of a gynecologic oncology biorepository that was approved by the Washington University in St. Louis Institutional Review Board (IRB). Patients were included if they had advanced stage high-grade serous ovarian cancer (HGSOC). All procedures were performed at room temperature on the bench unless otherwise specified. All reagents were prepared at room temperature (unless otherwise indicated) and stored at 4 &#176;C.
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<ol>
	<li>Lheureux, S., Gourley, C., Vergote, I., Oza, A. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Epithelial+ovarian+cancer.">Epithelial ovarian cancer.</a> Lancet Oncology. 393 (10177), 1240-1253 (2019).</li><li>Tew, W. P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=PARP+inhibitors+in+the+management+of+ovarian+cancer:+ASCO+guideline.">PARP inhibitors in the management of ovarian cancer: ASCO guideline.</a> Journal of Clinical Oncology. 38 (30), 3468-3493 (2020).</li><li>Tomasova, K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=DNA+repair+and+ovarian+carcinogenesis:+impact+on+risk,+prognosis+and+therapy+outcome.">DNA repair and ovarian carcinogenesis: impact on risk, prognosis and therapy outcome.</a> Cancers. 12 (7), 1713 (2020).</li><li>Mukhopadhyay, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Development+of+a+functional+assay+for+homologous+recombination+status+in+primary+cultures+of+epithelial+ovarian+tumor+and+correlation+with+sensitivity+to+poly(ADP-Ribose)+polymerase+inhibitors.">Development of a functional assay for homologous recombination status in primary cultures of epithelial ovarian tumor and correlation with sensitivity to poly(ADP-Ribose) polymerase inhibitors.</a> Clinical Cancer Research. 16 (8), 2344-2351 (2010).</li><li>Graeser, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+marker+of+homologous+recombination+predicts+pathologic+complete+response+to+neoadjuvant+chemotherapy+in+primary+breast+cancer.">A marker of homologous recombination predicts pathologic complete response to neoadjuvant chemotherapy in primary breast cancer.</a> Clinical Cancer Research. 16 (24), 6159-6168 (2010).</li><li>Hill, S. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Prediction+of+DNA+repair+inhibitor+response+in+short-term+patient-derived+ovarian+cancer+organoids.">Prediction of DNA repair inhibitor response in short-term patient-derived ovarian cancer organoids.</a> Cancer Discovery. 8 (11), 1404-1421 (2018).</li><li>Naipal, K. A. T., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Functional+ex+vivo+assay+to+select+homologous+recombination-deficient+breast+tumors+for+PARP+inhibitor+treatment.">Functional ex vivo assay to select homologous recombination-deficient breast tumors for PARP inhibitor treatment.</a> Clinical Cancer Research. 20 (18), 4816-4826 (2014).</li><li>Tumiati, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+functional+homologous+recombination+assay+predicts+primary+chemotherapy+response+and+long-term+survival+in+ovarian+cancer+patients.">A functional homologous recombination assay predicts primary chemotherapy response and long-term survival in ovarian cancer patients.</a> Clinical Cancer Research. 24 (18), 4482-4493 (2018).</li><li>Mukhopadhyay, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Clinicopathological+features+of+homologous+recombination-deficient+epithelial+ovarian+cancers:+sensitivity+to+PARP+inhibitors,+platinum,+and+survival.">Clinicopathological features of homologous recombination-deficient epithelial ovarian cancers: sensitivity to PARP inhibitors, platinum, and survival.</a> Cancer Research. 72 (22), 5675-5682 (2012).</li><li>Johnson, S. W., Laub, P. B., Beesley, J. S., Ozols, R. F., Hamilton, T. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Increased+platinum-DNA+damage+tolerance+is+associated+with+cisplatin+resistance+and+cross-resistance+to+various+chemotherapeutic+agents+in+unrelated+human+ovarian+cancer+cell+lines.">Increased platinum-DNA damage tolerance is associated with cisplatin resistance and cross-resistance to various chemotherapeutic agents in unrelated human ovarian cancer cell lines.</a> Cancer Research. 57 (5), 850-856 (1997).</li><li>Stefanou, D. T., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Aberrant+DNA+damage+response+pathways+may+predict+the+outcome+of+platinum+chemotherapy+in+ovarian+cancer.">Aberrant DNA damage response pathways may predict the outcome of platinum chemotherapy in ovarian cancer.</a> PLoS One. 10 (2), 0117654 (2015).</li><li>Helleday, T., Petermann, E., Lundin, C., Hodgson, B., Sharma, R. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=DNA+repair+pathways+as+targets+for+cancer+therapy.">DNA repair pathways as targets for cancer therapy.</a> Nature Reviews Cancer. 8 (3), 193-204 (2008).</li><li>Ivashkevich, A., Redon, C. E., Nakamura, A. J., Martin, R. F., Martin, O. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Use+of+the+&#947;-H2AX+assay+to+monitor+DNA+damage+and+repair+in+translational+cancer+research.">Use of the &#947;-H2AX assay to monitor DNA damage and repair in translational cancer research.</a> Cancer Letters. 327 (1-2), 123-133 (2012).</li><li>Fuh, K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Homologous+recombination+deficiency+real-time+clinical+assays,+ready+or+not.">Homologous recombination deficiency real-time clinical assays, ready or not.</a> Gynecologic Oncology. 159 (3), 877-886 (2020).</li><li>Cong, K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Replication+gaps+are+a+key+determinant+of+PARP+inhibitor+synthetic+lethality+with+BRCA+deficiency.">Replication gaps are a key determinant of PARP inhibitor synthetic lethality with BRCA deficiency.</a> Molecular Cell. 81 (15), 3128-3144 (2021).</li><li>Lee, E. K., Matulonis, U. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=PARP+inhibitor+resistance+mechanisms+and+implications+for+post-progression+combination+therapies.">PARP inhibitor resistance mechanisms and implications for post-progression combination therapies.</a> Cancers. 12 (8), 2054 (2020).</li><li>Panzarino, N. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Replication+gaps+underlie+BRCA+deficiency+and+therapy+response.">Replication gaps underlie BRCA deficiency and therapy response.</a> Cancer Research. 81 (5), 1388-1397 (2021).</li><li>Yee, C., Dickson, K. A., Muntasir, M. N., Ma, Y., Marsh, D. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Three-dimensional+modelling+of+ovarian+cancer:+from+cell+lines+to+organoids+for+discovery+and+personalized+medicine.">Three-dimensional modelling of ovarian cancer: from cell lines to organoids for discovery and personalized medicine.</a> Frontiers in Bioengineering and Biotechnology. 10, 836984 (2022).</li><li>Regan, J. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Immunofluorescence+staining+of+colorectal+cancer+patient-derived+organoids.">Immunofluorescence staining of colorectal cancer patient-derived organoids.</a> Methods Cell Biology. 171, 163-171 (2022).</li><li>Graham, O., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Generation+and+culturing+of+high-grade+serous+ovarian+cancer+patient+derived+organoids.">Generation and culturing of high-grade serous ovarian cancer patient derived organoids.</a> Journal of Visualized Experiments. (191), (2023).</li><li>Jakl, L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Validation+of+JCountPro+software+for+efficient+assessment+of+ionizing+radiation-induced+foci+in+human+lymphocytes.">Validation of JCountPro software for efficient assessment of ionizing radiation-induced foci in human lymphocytes.</a> International Journal of Radiation Biology. 92 (12), 766-773 (2016).</li><li>Mullen, M. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=GAS6/AXL+inhibition+enhances+ovarian+cancer+sensitivity+to+chemotherapy+and+PARP+inhibition+through+increased+DNA+damage+and+enhanced+replication+stress.">GAS6/AXL inhibition enhances ovarian cancer sensitivity to chemotherapy and PARP inhibition through increased DNA damage and enhanced replication stress.</a> Molecular Cancer Research. 20 (2), 265-279 (2022).</li><li>van Ineveld, R. L., Ariese, H. C. R., Wehrens, E. J., Dekkers, J. F., Rios, A. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Single-cell+resolution+three-dimensional+imaging+of+intact+organoids.">Single-cell resolution three-dimensional imaging of intact organoids.</a> Journal of Visualized Experiments. (160), e60709 (2020).</li><li>Dekkers, J. F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=High-resolution+3D+imaging+of+fixed+and+cleared+organoids.">High-resolution 3D imaging of fixed and cleared organoids.</a> Nature Protocols. 14 (6), 1756-1771 (2019).</li><li>O'Rourke, K. P., Dow, L. E., Lowe, S. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Immunofluorescent+staining+of+mouse+intestinal+stem+cells.">Immunofluorescent staining of mouse intestinal stem cells.</a> Bio Protocols. 6 (4), 1732 (2016).</li><li>Nwani, N. G., Sima, L. E., Nieves-Neira, W., Matei, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Targeting+the+microenvironment+in+high+grade+serous+ovarian+cancer.">Targeting the microenvironment in high grade serous ovarian cancer.</a> Cancers. 10 (8), 266 (2018).</li><li>Ghoneum, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Exploring+the+clinical+value+of+tumor+microenvironment+in+platinum-resistant+ovarian+cancer.">Exploring the clinical value of tumor microenvironment in platinum-resistant ovarian cancer.</a> Seminars in Cancer Biology. 77, 83-98 (2021).</li><li>Yang, Y., Yang, Y., Yang, J., Zhao, X., Wei, X. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Tumor+microenvironment+in+ovarian+cancer:+function+and+therapeutic+strategy.">Tumor microenvironment in ovarian cancer: function and therapeutic strategy.</a> Frontiers in Cell and Developmental Biology. 8, 758 (2020).</li><li>van de Wetering, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Prospective+derivation+of+a+living+organoid+biobank+of+colorectal+cancer+patients.">Prospective derivation of a living organoid biobank of colorectal cancer patients.</a> Cell. 161 (4), 933-945 (2015).</li><li>Broutier, L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Human+primary+liver+cancer-derived+organoid+cultures+for+disease+modeling+and+drug+screening.">Human primary liver cancer-derived organoid cultures for disease modeling and drug screening.</a> Nature Medicine. 23 (12), 1424-1435 (2017).</li><li>Drost, J., Clevers, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Organoids+in+cancer+research.">Organoids in cancer research.</a> Nature Reviews Cancer. 18 (7), 407-418 (2018).</li><li>Cybulla, E., Vindigni, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Leveraging+the+replication+stress+response+to+optimize+cancer+therapy.">Leveraging the replication stress response to optimize cancer therapy.</a> Nature Reviews. , (2022).</li></ol>

The DNA damage response plays an integral role in both the development of ovarian cancer and chemotherapy resistance. Therefore, a thorough understanding of DNA repair mechanisms is imperative. Here, a methodology is presented to study DNA damage repair proteins in 3D, intact organoids. A reproducible, reliable protocol is developed utilizing hallmark antibodies to evaluate DNA damage, homologous recombination, non-homologous end joining, and replication stress. Importantly, these methods are validated using genetically ...

Ovarian cancer is the leading cause of death due to gynecologic malignancy. The majority of patients are treated with DNA-damaging drugs such as carboplatin, and those with homologous recombination repair (HRR)-deficient tumors can be given poly (ADP-ribose) polymerase (PARP) inhibitors1,2. However, most patients develop resistance to these therapies and die within 5 years of diagnosis. Dysregulation of the DNA damage response (DDR) has been associated with the development of ovarian cancer and both chemotherapy and PARP inhibitor resistance3. Thus, study of the DDR is imperative in understanding the pathophysiology of ovarian cancer, potential biomarkers, and novel targeted therapies.
Current methods to evaluate the DDR utilize immunofluorescence (IF), as this allows for the accurate identification and localization of DNA damage proteins and nucleotide analogs. Once there is a double-stranded break (DSB) in the DNA, the histone protein H2AX is rapidly phosphorylated, forming a focus where DNA damage repair proteins congregate4. This phosphorylation can be easily identified utilizing IF; in fact, the &#611;-H2AX assay has commonly been employed to confirm the induction of a DSB5,6,7,8,9. Increased DNA damage has been associated with platinum sensitivity and efficacy of DNA damaging agents10,11,12, and &#611;-H2AX has been proposed as a biomarker associated with chemotherapy response in other cancer treatments13. Upon a DSB, a cell proficient in HRR performs a series of events that leads to BRCA1 and BRCA2 recruiting RAD51 to replace replication protein A (RPA) and bind to the DNA. HRR repair uses a DNA template to faithfully repair the DSB. However, when tumors are deficient in HRR, they rely on alternative repair pathways such as non-homologous end joining (NHEJ). NHEJ is known to be error-prone and creates a high mutational burden on the cell, which uses 53BP1 as a positive regulator14. These DNA damage proteins can all be accurately identified as foci using IF. In addition to staining for proteins, IF can be used to study fork protection and single-stranded DNA gap formation. The ability to have stable forks has been correlated with platinum response, and recently, gap assays have shown the potential to predict the response to PARP inhibitors6,15,16,17. Therefore, staining for the nucleotide analogs after introduction into the genome is another way to study the DDR.
To date, evaluation of the DDR in ovarian cancer has been largely limited to homogenous 2D cell lines that do not recapitulate the clonal heterogeneity, microenvironment, or architecture of in vivo tumors18,19. Recent research suggests organoids are superior to 2D cell lines in studying complex biologic processes such as DDR mechanisms6. The present methodology evaluates RAD51, &#611;-H2AX, 53BP1, RPA, and geminin in PDOs. These methods assess the intact organoid and allow for the study of DDR mechanisms in a setting more similar to the in vivo tumor microenvironment. Together with confocal microscopy and automated foci counting, this methodology can aid in understanding the DDR pathway in ovarian cancer and personalizing treatment plans for patients.

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		<tr>
			<td>1x phosphate buffered saline with calcium and magnesium (PBS++)</td>
			<td>Sigma</td>
			<td>14-040-133</td>
			<td></td>
		</tr>
		<tr>
			<td>1x phosphate buffered saline without calcium and magnesium (PBS)</td>
			<td>Fisher Scientific&#160;</td>
			<td>ICN1860454</td>
			<td></td>
		</tr>
		<tr>
			<td>Ant-53BP1 Antibody&#160;</td>
			<td>BD Biosciences</td>
			<td>612522</td>
			<td>diluted to 1:500 in staining buffer</td>
		</tr>
		<tr>
			<td>Ant-Geminin Antibody&#160;</td>
			<td>Abcam</td>
			<td>ab104306</td>
			<td>diluted to 1:200 in staining buffer</td>
		</tr>
		<tr>
			<td>Anti-Geminin Antibody&#160;</td>
			<td>ProteinTech</td>
			<td>10802-1-AP</td>
			<td>diluted to 1:400 in staining buffer</td>
		</tr>
		<tr>
			<td>Anti-RAD51 Antibody&#160;</td>
			<td>Abcam</td>
			<td>ab133534</td>
			<td>diluted to 1:1000 in staining buffer</td>
		</tr>
		<tr>
			<td>Anti-yH2AX Antibody&#160;</td>
			<td>Millipore-Sigma</td>
			<td>05-636</td>
			<td>diluted to 1:500 in staining buffer</td>
		</tr>
		<tr>
			<td>Ant-phospho-RPA32 (S4/S8) Antibody</td>
			<td>Bethyl Laboratories&#160;</td>
			<td>A300-245A-M</td>
			<td>diluted to 1:200 in staining buffer</td>
		</tr>
		<tr>
			<td>Bovine Serum Albumin (BSA)</td>
			<td>Fisher Scientific&#160;</td>
			<td>BP1605 100</td>
			<td></td>
		</tr>
		<tr>
			<td>Centrifuge; Sorvall St 16R Centrifuge</td>
			<td>Thermo Scientific&#160;</td>
			<td>75004240</td>
			<td></td>
		</tr>
		<tr>
			<td>Confocal Microscope, Leica SP5 confocal system DMI4000</td>
			<td>Leica&#160;</td>
			<td>389584</td>
			<td></td>
		</tr>
		<tr>
			<td>Conical Tubes, 15 mL</td>
			<td>Corning&#160;</td>
			<td>14-959-53A</td>
			<td></td>
		</tr>
		<tr>
			<td>Countess 3 FL Automated Cell Counter (Cell Counting Machine)&#160;</td>
			<td>Thermo Scientific&#160;</td>
			<td>AMQAF2000</td>
			<td></td>
		</tr>
		<tr>
			<td>Countess Cell Counting Chamber Slides</td>
			<td>Thermo Scientific&#160;</td>
			<td>C10228</td>
			<td></td>
		</tr>
		<tr>
			<td>Cover Slip</td>
			<td>LA Colors</td>
			<td></td>
			<td>Any clear nail polish will suffice</td>
		</tr>
		<tr>
			<td>Cultrex&#160;RGF Basement Membrane Extract, Type 2</td>
			<td>&#160;R&#38;D Systems&#160;</td>
			<td>3533-010-02</td>
			<td>Could probably use Matrigel or other BME Matrix&#160;</td>
		</tr>
		<tr>
			<td>DAPI&#160;</td>
			<td>Thermo Scientific&#160;</td>
			<td>&#160;R37606</td>
			<td>NucBlue Fixed Cell ReadyProbes Reagent, Diluted in 1x PBS&#160;</td>
		</tr>
		<tr>
			<td>Glycine&#160;</td>
			<td>Fisher Scientific&#160;</td>
			<td>NC0756056</td>
			<td></td>
		</tr>
		<tr>
			<td>JCountPro</td>
			<td>JCountPro</td>
			<td></td>
			<td>For access to the software, Email: jcountpro@gmail.com&#160;</td>
		</tr>
		<tr>
			<td>Microcentrifuge Tubes&#160;</td>
			<td>Fisher Scientific&#160;</td>
			<td>07-000-243</td>
			<td></td>
		</tr>
		<tr>
			<td>Nail Polish&#160;</td>
			<td>StatLab</td>
			<td>SL102450</td>
			<td></td>
		</tr>
		<tr>
			<td>Parafomraldehyde (PFA), 2%&#160;</td>
			<td>Electron Microscopy Sciences&#160;</td>
			<td>157-4</td>
			<td>Dilute to 4% PFA in PBS++ to obtain 2% PFA</td>
		</tr>
		<tr>
			<td>Permeabilization Buffer</td>
			<td>Made in Lab</td>
			<td></td>
			<td>0.2% X-100 Triton in PBS++&#160;</td>
		</tr>
		<tr>
			<td>Pipette</td>
			<td>Rainin</td>
			<td>17014382</td>
			<td></td>
		</tr>
		<tr>
			<td>Pipette Tips&#160;</td>
			<td>Rainin&#160;</td>
			<td>17014967</td>
			<td></td>
		</tr>
		<tr>
			<td>ProLong Gold Antifade Mountant</td>
			<td>Thermo Scientific&#160;</td>
			<td>&#160;P36930</td>
			<td></td>
		</tr>
		<tr>
			<td>Staining Buffer&#160;</td>
			<td>Made in Lab</td>
			<td></td>
			<td>0.5% BSA, 0.15% Glycine, 0.1% X-100 Triton in PBS++&#160;</td>
		</tr>
		<tr>
			<td>Thermo Scientific Nunc Lab-Tek II Chamber Slide System&#160;</td>
			<td>Thermo Scientific&#160;</td>
			<td>12-565-8</td>
			<td></td>
		</tr>
		<tr>
			<td>Triton X-100</td>
			<td>Sigma-Alderich&#160;</td>
			<td>11332481001</td>
			<td></td>
		</tr>
		<tr>
			<td>Trypan Blue Solution, 0.4%</td>
			<td>Thermo Scientific&#160;</td>
			<td>15250061</td>
			<td></td>
		</tr>
		<tr>
			<td>TrypLE Express</td>
			<td>Invitrogen</td>
			<td>12604013</td>
			<td>animal origin-free, recombinant enzyme</td>
		</tr>
		<tr>
			<td>X-RAD 320 Biological Irradiator&#160;</td>
			<td>Precision X-Ray Irradiation&#160;</td>
			<td>X-RAD320</td>
			<td></td>
		</tr>
	</tbody>
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visualizing dna damage repair proteins in patient-derived ovarian cancer organoids via immunofluorescence assays

Immunofluorescence is one of the most widely used techniques to visualize target antigens with high sensitivity and specificity, allowing for the accurate identification and localization of proteins, glycans, and small molecules. While this technique is well-established in two-dimensional (2D) cell culture, less is known about its use in three-dimensional (3D) cell models. Ovarian cancer organoids are 3D tumor models that recapitulate tumor cell clonal heterogeneity, the tumor microenvironment, and cell-cell and cell-matrix interactions. Thus, they are superior to cell lines for the evaluation of drug sensitivity and functional biomarkers. Therefore, the ability to utilize immunofluorescence on primary ovarian cancer organoids is extremely beneficial in understanding the biology of this cancer. The current study describes the technique of immunofluorescence to detect DNA damage repair proteins in high-grade serous patient-derived ovarian cancer organoids (PDOs). After exposing the PDOs to ionizing radiation, immunofluorescence is performed on intact organoids to evaluate nuclear proteins as foci. Images are collected using z-stack imaging on confocal microscopy and analyzed using automated foci counting software. The described methods allow for the analysis of temporal and special recruitment of DNA damage repair proteins and colocalization of these proteins with cell-cycle markers.

The presented protocol can successfully stain, visualize, and quantify nuclear DNA damage repair proteins in organoids. This technique was used to stain and evaluate PDOs both before and after irradiation. PDOs were exposed to 10 Gy of radiation and evaluated for the following biomarkers: &#611;-H2AX (Figure 1), a marker of DNA damage; RAD51 (Figure 2), a marker for HRR; 53BP1, a marker of NHEJ; RPA, a marker of replication stress (Figure 3<...

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Visualizing DNA Damage Repair Proteins in Patient-Derived Ovarian Cancer Organoids via Immunofluorescence Assays

The present protocol describes methods for evaluating DNA damage repair proteins in patient-derived ovarian cancer organoids. Included here are comprehensive plating and staining methods, as well as detailed, objective quantification procedures.

Visualizing DNA Damage Repair Proteins in Patient-Derived Ovarian Cancer Organoids via Immunofluorescence Assays

Immunofluorescence is one of the most widely used techniques to visualize target antigens with high sensitivity and specificity, allowing for the accurate ...

The study of the DNA damage response is necessary in understanding the pathophysiology of ovarian cancer potential biomarkers in novel targeted therapy. This technique allows for the sample to stay intact and allows the examination of antigens in their location of action. This protocol is quick and can be adapted to any antigen amenable to immunofluorescence.This method gives insight into ovarian cancer and DNA damage repair processes involved in chemotherapeutic and PARP inhibitor resistance. These methods can be applied to other areas of study involving the use of 3D cultures and organoids. To begin, aspirate the media from the irradiated and incubated organoids without disrupting the 3D matrix.Then wash with 300 microliters of PBS. Fix the organoids in 300 microliters of 2%paraformaldehyde for 10 minutes. After fixing, wash the organoids with 300 microliters of staining buffer and place them on a shaker for five minutes.Then permeabilize the organoid by gently adding 300 microliters of permeabilization buffer. After 20 minutes of incubation, remove the buffer and wash with 300 microliters of staining buffer. Place the organoids on a shaker for five minutes.Next, add 300 microliters of staining buffer to block the permeabilization step. Place on the shaker for 30 minutes and aspirate the staining buffer using a pipette. Then add 300 microliters of primary antibodies diluted in staining buffer.Incubate at four degrees Celsius for 16 hours. After incubation, remove the primary antibody solution. Perform three washes with 300 microliters of staining buffer for five minutes each on the shaker.Add 300 microliters of secondary antibody solution diluted in staining buffer, and incubate for one hour in the dark. After one hour, aspirate the secondary antibody solution and add 300 microliters of diluted DAPI. Place on the shaker for five minutes.Perform three washes with 300 microliters of staining buffer for five minutes each on the shaker. Remove the staining buffer and detach the chambers using the removal kit included with the chamber slides. Cut the tip of a P200 pipette tip and use this to add mounting medium to cover each well containing an organoid tab.Place a cover slip over the specimen while avoiding bubbles. Take clear nail polish and paint it onto the sides of the cover glass to seal the slide. Let it harden for one hour and then place it at 20 degrees Celsius.Acquire images using a confocal microscope using a 63X objective with immersion oil. Using this protocol, patient derived ovarian cancer organoids were stained for DNA damage repair proteins before and after irradiation, and evaluated for biomarkers such as gamma H2AX, a marker of DNA damage, and RAD51, a marker for homologous recombination repair. RPA, a marker of replication stress, 53BP1, a marker of non-homologous enjoining, and Geminin, a GS2 phase cell cycle marker were also evaluated using this technique.The BME tabs tend to depolymerize, so paying close attention after fixing and aspirating is vital. Analyzing the antigens to determine the organoids damage and the ability to mount a DNA damage response could help assist in the evaluation of chemotherapeutic resistance.

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Research

JoVE Journal

Cancer Research

Evaluating In Vitro DNA Damage Using Comet Assay

DNA damage is a common phenomenon for each cell during its lifespan, and is defined as an alteration of the chemical structure of genomic DNA. Cancer therapies, such as radio- and chemotherapy, introduce enormous amount of additional DNA damage, leading to cell cycle arrest and apoptosis to limit cancer progression. Quantitative assessment of DNA damage during experimental cancer therapy is a key step to justify the effectiveness of a genotoxic agent. In this study, we focus on a single cell electrophoresis assay, also known as the comet assay, which can quantify single and double-strand DNA breaks in vitro. The comet assay is a DNA damage quantification method that is efficient and easy to perform, and has low time/budget demands and high reproducibility. Here, we highlight the utility of the comet assay for a preclinical study by evaluating the genotoxic effect of olaparib/temozolomide combination therapy to U251 glioma cells.

Evaluating In Vitro DNA Damage Using Comet Assay

The comet assay is an efficient method to detect DNA damage including single and double-stranded DNA breaks. We describe alkaline and neutral comet assays to measure DNA damage in cancer cells to evaluate the therapeutic effect of chemotherapy.

DNA damage is a common phenomenon for each cell during its lifespan, and is defined as an alteration of the chemical structure of genomic DNA. Cancer ...

Characterizing DNA Repair Processes at Transient and Long-lasting Double-strand DNA Breaks by Immunofluorescence Microscopy

The repair of double-stranded breaks (DSBs) in DNA is a highly coordinated process, necessitating the formation and resolution of multi-protein repair complexes. This process is regulated by a myriad of proteins that promote the association and disassociation of proteins to these lesions. Thanks in large part to the ability to perform functional screens of a vast library of proteins, there is a greater appreciation of the genes necessary for the double-strand DNA break repair. Often knockout or chemical inhibitor screens identify proteins involved in repair processes by using increased toxicity as a marker for a protein that is required for DSB repair. Although useful for identifying novel cellular proteins involved in maintaining genome fidelity, functional analysis requires the determination of whether the protein of interest promotes localization, formation, or resolution of repair complexes. 
The accumulation of repair proteins can be readily detected as distinct nuclear foci by immunofluorescence microscopy. Thus, association and disassociation of these proteins at sites of DNA damage can be accessed by observing these nuclear foci at representative intervals after the induction of double-strand DNA breaks. This approach can also identify mis-localized repair factor proteins, if repair defects do not simultaneously occur with incomplete delays in repair. In this scenario, long-lasting double-strand DNA breaks can be engineered by expressing a rare cutting endonuclease (e.g., I-SceI) in cells where the recognition site for the said enzyme has been integrated into the cellular genome. The resulting lesion is particularly hard to resolve as faithful repair will reintroduce the enzyme's recognition site, prompting another round of cleavage. As a result, differences in the kinetics of repair are eliminated. If repair complexes are not formed, localization has been impeded. This protocol describes the methodology necessary to identify changes in repair kinetics as well as repair protein localization.

Repair of double-strand DNA breaks is a dynamic process, requiring not only formation of repair complexes at the breaks, but also their resolution after the lesion is addressed. Here, we use immunofluorescence microscopy for transient and long-lasting double-stranded breaks as a tool to dissect this genome maintenance mechanism.

The repair of double-stranded breaks (DSBs) in DNA is a highly coordinated process, necessitating the formation and resolution of multi-protein repair ...

Immunofluorescence Imaging of DNA Damage and Repair Foci in Human Colon Cancer Cells

The purpose of the manuscript is to provide a step-by-step protocol for performing immunofluorescence microscopy to study the radiation-induced DNA damage response induced by neutron-gamma mixed-beam used in boron neutron capture therapy (BNCT). Specifically, the proposed methodology is applied for the detection of repair proteins activation which can be visualized as foci using antibodies specific to DNA double-strand breaks (DNA-DSBs). DNA repair foci were assessed by immunofluorescence in colon cancer cells (HCT-116) after irradiation with the neutron-mixed beam. DNA-DSBs are the most genotoxic lesions and are repaired in mammalian cells by two major pathways: non-homologous end-joining pathway (NHEJ) and homologous recombination repair (HRR). The frequencies of foci, immunochemically stained, for commonly used markers in radiobiology like &#947;-H2AX, 53BP1 are associated with DNA-DSB number and are considered as efficient and sensitive markers for monitoring the induction and repair of DNA-DSBs. It was established that &#947;-H2AX foci attract repair proteins, leading to a higher concentration of repair factors near a DSB. To monitor DNA damage at the cellular level, immunofluorescence analysis for the presence of DNA-PKcs representative repair protein foci from the NHEJ pathway and Rad52 from the HRR pathway was planned. We have developed and introduced a reliable immunofluorescence staining protocol for the detection of radiation-induced DNA damage response with antibodies specific for repair factors from NHEJ and HRR pathways and observed radiation-induced foci (RIF). The proposed methodology can be used for investigating repair protein that is highly activated in the case of neutron-mixed beam radiation, thereby indicating the dominance of the repair pathway.

Radiation-induced DNA damage response activated by neutron mixed-beam used in boron neutron capture therapy (BNCT) has not been fully established. This protocol provides a step-by-step procedure to detect radiation-induced foci (RIF) of repair proteins by immunofluorescence staining in human colon cancer cell lines after irradiation with the neutron-mixed beam.

The purpose of the manuscript is to provide a step-by-step protocol for performing immunofluorescence microscopy to study the radiation-induced DNA damage ...

High-Throughput In Vitro Assay using Patient-Derived Tumor Organoids

Patient-derived tumor organoids (PDOs) are expected to be a preclinical cancer model with better reproducibility of disease than traditional cell culture models. PDOs have been successfully generated from a variety of human tumors to recapitulate the architecture and function of tumor tissue accurately and efficiently. However, PDOs are unsuitable for an in vitro high-throughput assay system (HTS) or cell analysis using 96-well or 384-well plates when evaluating anticancer drugs because they are heterogeneous in size and form large clusters in culture. These cultures and assays use extracellular matrices, such as Matrigel, to create tumor tissue scaffolds. Therefore, PDOs have a low throughput and high cost, and it has been difficult to develop a suitable assay system. To address this issue, a simpler and more accurate HTS was established using PDOs to evaluate the potency of anticancer drugs and immunotherapy. An in vitro HTS was created that uses PDOs established from solid tumors cultured in 384-well plates. An HTS was also developed for assessment of antibody-dependent cellular cytotoxicity activity to represent the immune response using PDOs cultured in 96-well plates.

High-Throughput In Vitro Assay using Patient-Derived Tumor Organoids

A highly accurate in vitro high-throughput assay system was developed to evaluate anticancer drugs using patient-derived tumor organoids (PDOs), similar to cancer tissues but are unsuitable for in vitro high-throughput assay systems with 96-well and 384-well plates.

Patient-derived tumor organoids (PDOs) are expected to be a preclinical cancer model with better reproducibility of disease than traditional cell culture ...

Profiling Sensitivity to Targeted Therapies in EGFR-Mutant NSCLC Patient-Derived Organoids

Novel 3D cancer organoid cultures derived from clinical patient specimens represent an important model system to evaluate intratumor heterogeneity and treatment response to targeted inhibitors in cancer. Pioneering work in gastrointestinal and pancreatic cancers has highlighted the promise of patient-derived organoids (PDOs) as a patient-proximate culture system, with an increasing number of models emerging. Similarly, work in other cancer types has focused on establishing organoid models and optimizing culture protocols. Notably, 3D cancer organoid models maintain the genetic complexity of original tumor specimens and thus translate tumor-derived sequencing data into treatment with genetically informed targeted therapies in an experimental setting. Further, PDOs might foster the evaluation of rational combination treatments to overcome resistance-associated adaptation of tumors in the future. The latter focuses on intense research efforts in non-small-cell lung cancer (NSCLC), as resistance development ultimately limits the treatment success of targeted inhibitors. An early assessment of therapeutically targetable mechanisms using NSCLC PDOs could help inform rational combination treatments. This manuscript describes a standardized protocol for the cell culture plate-based assessment of drug sensitivities to targeted inhibitors in NSCLC-derived 3D PDOs, with potential adaptability to combinational treatments and other treatment modalities.

This protocol describes a standardized evaluation of drug sensitivities to targeted signaling inhibitors in NSCLC patient-derived organoid models.

Novel 3D cancer organoid cultures derived from clinical patient specimens represent an important model system to evaluate intratumor heterogeneity and ...

Generation and Culturing of High-Grade Serous Ovarian Cancer Patient-Derived Organoids

Organoids are 3D dynamic tumor models that can be grown successfully from patient-derived ovarian tumor tissue, ascites, or pleural fluid and aid in the discovery of novel therapeutics and predictive biomarkers for ovarian cancer. These models recapitulate clonal heterogeneity, the tumor microenvironment, and cell-cell and cell-matrix interactions. Additionally, they have been shown to match the primary tumor morphologically, cytologically, immunohistochemically, and genetically. Thus, organoids facilitate research on tumor cells and the tumor microenvironment and are superior to cell lines. The present protocol describes distinct methods to generate patient-derived ovarian cancer organoids from patient tumors, ascites, and pleural fluid samples with a higher than 97% success rate. The patient samples are separated into cellular suspensions by both mechanical and enzymatic digestion. The cells are then plated utilizing a basement membrane extract (BME) and are supported with optimized growth media containing supplements specific to the culturing of high-grade serous ovarian cancer (HGSOC). After forming initial organoids, the PDOs can sustain long-term culture, including passaging for expansion for subsequent experiments.

Patient-derived organoids (PDO) are a three-dimensional (3D) culture that can mimic the tumor environment in vitro. In high-grade serous ovarian cancer, PDOs represent a model to study novel biomarkers and therapeutics.

Organoids are 3D dynamic tumor models that can be grown successfully from patient-derived ovarian tumor tissue, ascites, or pleural fluid and aid in the ...

Quantifying Replication Stress in Ovarian Cancer Cells Using Single-Stranded DNA Immunofluorescence

Replication stress is a hallmark of several ovarian cancers. Replication stress can emerge from multiple sources, including double-strand breaks, transcription-replication conflicts, or amplified oncogenes, inevitably resulting in the generation of single-stranded DNA (ssDNA). Quantifying ssDNA, therefore, presents an opportunity to assess the level of replication stress in different cell types and under various DNA-damaging conditions or treatments. Emerging evidence also suggests that ssDNA can be a predictor of responses to chemotherapeutic drugs that target DNA repair. Here, we describe a detailed immunofluorescence-based methodology to quantify ssDNA. This methodology involves labeling the genome with a thymidine analog, followed by the antibody-based detection of the analog at the chromatin under non-denaturing conditions. Stretches of ssDNA can be visualized as foci under a fluorescence microscope. The number and intensity of the foci directly co-relate with the level of ssDNA present in the nucleus. We also describe an automated pipeline to quantify the ssDNA signal. The method is rapid and reproducible. Furthermore, the simplicity of this methodology makes it amenable to high-throughput applications such as drug and genetic screens.

Here, we describe an immunofluorescence-based method to quantify the levels of single-stranded DNA in cells. This efficient and reproducible method can be utilized to examine replication stress, a common feature in several ovarian cancers. Additionally, this assay is compatible with an automated analysis pipeline, which further increases its efficiency.

Replication stress is a hallmark of several ovarian cancers. Replication stress can emerge from multiple sources, including double-strand breaks, ...

Establishment and Culture of Patient-Derived Breast Organoids

Breast cancer is a complex disease that has been classified into several different histological and molecular subtypes. Patient-derived breast tumor organoids developed in our laboratory consist of a mix of multiple tumor-derived cell populations, and thus represent a better approximation of tumor cell diversity and milieu than the established 2D cancer cell lines. Organoids serve as an ideal in vitro model, allowing for cell-extracellular matrix interactions, known to play an important role in cell-cell interactions and cancer progression. Patient-derived organoids also have advantages over mouse models as they are of human origin. Furthermore, they have been shown to recapitulate the genomic, transcriptomic as well as metabolic heterogeneity of patient tumors; thus, they are capable of representing tumor complexity as well as patient diversity. As a result, they are poised to provide more accurate insights into target discovery and validation and drug sensitivity assays. In this protocol, we provide a detailed demonstration of how patient-derived breast organoids are established from resected breast tumors (cancer organoids) or reductive mammoplasty-derived breast tissue (normal organoids). This is followed by a comprehensive account of 3D organoid culture, expansion, passaging, freezing, as well as thawing of patient-derived breast organoid cultures.

A detailed protocol is provided here for establishing human breast organoids from patient-derived breast tumor resections or normal breast tissue. The protocol provides comprehensive step-by-step instructions for culturing, freezing, and thawing human patient-derived breast organoids.

Breast cancer is a complex disease that has been classified into several different histological and molecular subtypes. Patient-derived breast tumor ...

Ovarian Cancer Patient-Derived Organoid Models for Pre-Clinical Drug Testing

Ovarian cancer is a fatal gynecologic cancer and the fifth leading cause of cancer death among women in the United States. Developing new drug treatments is crucial to advancing healthcare and improving patient outcomes. Organoids are in-vitro three-dimensional multicellular miniature organs. Patient-derived organoid (PDO) models of ovarian cancer may be optimal for drug screening because they more accurately recapitulate tissues of interest than two-dimensional cell culture models and are inexpensive compared to patient-derived xenografts. In addition, ovarian cancer PDOs mimic the variable tumor microenvironment and genetic background typically observed in ovarian cancer. Here, a method is described that can be used to test conventional and novel drugs on PDOs derived from ovarian cancer tissue and ascites. A luminescence-based adenosine triphosphate (ATP) assay is used to measure viability, growth rate, and drug sensitivity. Drug screens in PDOs can be completed in 7-10 days, depending on the rate of organoid formation and drug treatments.

We present a protocol that can be used to conduct therapeutic drug testing with patient-derived ovarian cancer organoids.

Ovarian cancer is a fatal gynecologic cancer and the fifth leading cause of cancer death among women in the United States. Developing new drug treatments ...

Automated Kinetic Imaging for Drug Assessment in Patient-Derived Tumor Organoids

Multiplexed Live-Cell Imaging for Drug Responses in Patient-Derived Organoid Models of Cancer

Patient-derived organoid (PDO) models of cancer are a multifunctional research system that better recapitulates human disease as compared to cancer cell lines. PDO models can be generated by culturing patient tumor cells in extracellular basement membrane extracts (BME) and plating them as three-dimensional domes. However, commercially available reagents that have been optimized for phenotypic assays in monolayer cultures often are not compatible with BME. Herein, we describe a method to plate PDO models and assess drug effects using an automated live-cell imaging system. In addition, we apply fluorescent dyes that are compatible with kinetic measurements to quantify cell health and apoptosis simultaneously. Image capture can be customized to occur at regular time intervals over several days. Users can analyze drug effects in individual Z-plane images or a Z Projection of serial images from multiple focal planes. Using masking, specific parameters of interest are calculated, such as PDO number, area, and fluorescence intensity. We provide proof-of-concept data demonstrating the effect of cytotoxic agents on cell health, apoptosis, and viability. This automated kinetic imaging platform can be expanded to other phenotypic readouts to understand diverse therapeutic effects in PDO models of cancer.

Author Spotlight: Developing Multiplexed Kinetic Assays for Organoid-Based Drug Response Analysis

Patient-derived tumor organoids are a sophisticated model system for basic and translational research. This methods article details the use of multiplexed fluorescent live-cell imaging for simultaneous kinetic assessment of different organoid phenotypes.

Patient-derived organoid (PDO) models of cancer are a multifunctional research system that better recapitulates human disease as compared to cancer cell ...