Assessment of Consistency in Assignment of Severe (Grade 3) Squamous Metaplasia to Human Bulbar Conjunctiva Impression Cytology Cell Samples

Cell heterogeneity, rather than the cell storage solution, affects the behavior of mesenchymal stem cells in vitro and in vivo

Background

Mesenchymal stem cells (MSCs) have to be expanded in vitro to reach a sufficient cell dose for the treatment of various diseases. During the process of expansion, some obstacles remain to be overcome. The purpose of this study was to investigate the effects of storage solutions and heterogeneity on the behavior of MSCs in vitro and in vivo.

Methods

Umbilical cord MSCs (UC-MSCs) of similar sizes within normal ranges were suspended in three different storage solutions, phosphate buffer solution, normal saline, and Dulbecco’s modified Eagle medium. Then, the ultrastructure, viability, and safety of these cells were compared. Other two UC-MSC populations of different sizes were categorized based on their mean diameters. The ultrastructure, proliferation, immunosuppression, hepatic differentiation potential, and number of senescent cells were investigated and compared. The survival rates of mice after the infusion of UC-MSCs of different sizes were compared.

Results

For UC-MSCs suspended in different storage solutions, the cell apoptosis rates, ultrastructure, and survival rates of mice were similar, and no differences were observed. Cells with a diameter of 19.14 ± 4.89 μm were categorized as the larger UC-MSC population, and cells with a diameter of 15.58 ± 3.81 μm were categorized as the smaller population. The mean diameter of the larger UC-MSC population was significantly larger than that of the smaller UC-MSC population (p < 0.01). Smaller UC-MSCs had more powerful proliferation and immunosuppressive potential and a higher nucleus-cytoplasm ratio than those of large UC-MSCs. The number of cells positive for β-galactosidase staining was higher in the larger UC-MSC population than in the smaller UC-MSC population. The survival rates of mice receiving 1 × 10⁶ or 2 × 10⁶ smaller UC-MSCs were 100%, both of which were higher than those of mice receiving the same amounts of larger UC-MSCs (p < 0.01). The cause of mouse death was explored and it was found that some larger UC-MSCs accumulated in the pulmonary capillary in dead mice.

Conclusion

Different storage solutions showed no significant effects on cell behavior, whereas heterogeneity was quite prevalent in MSC populations and might limit cells application. Hence, it is necessary to establish a more precise standardization for culture-expanded MSCs.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13287-021-02450-2.

Assessment of goblet cell size and density in relation to epithelial cell (multi)layering on conjunctival impression cytology samples

PURPOSE

To assess goblet cell size and numbers in relation to the extent of multilayering of conjunctival impression cytology (CIC) samples as a basis for reducing variability in image selection for goblet cell density (GCD) estimates.

METHODS

CIC was undertaken immediately postmortem off the superior bulbar conjunctiva of healthy young adult rabbits onto Millicell-CM Biopore filter units. After fixation with buffered glutaraldehyde and Giemsa staining, two × 200 images were selected from each sample representative of either slight multilayering or substantial multilayering, projected at × 1000, an overlay of the outlines of the goblet cells was made, and their dimensions and areas were measured.

RESULTS

From measures of 4918 goblet cells, the average value (+/- SD) for the longest dimension was 17.7 ± 6.4 μm and 14.6 ± 5.3 μm for the shortest dimension. The GCD values ranged from 210 to 2069/mm², with a mean of 1074 ± 601/mm², but was lower for slightly multilayered images (at 537 ± 239 cells/mm ) compared with multilayered regions (at 1612 ± 601 cells/mm²; p < 0.001). The measured areas ranged from 72 to 491 μm², with average values from any particular image ranging from 110 to 370 μm², which were inversely correlated with the estimated GCD (Spearman's rho = - 0.722, p < 0.05).

CONCLUSIONS

Larger goblet cells but in fewer numbers were predictably found across the filter surface where there were fewer layers of cells and vice versa. This difference could be considered in selection of images for counts of goblet cells from CIC specimens.

Goblet cell density estimate differences in impression cytology samples varies with different magnification of images

PURPOSE

To assess the impact of using different microscope magnifications for the goblet cell density (GCD) estimates from conjunctival impression cytology (CIC) samples from healthy individuals METHODS: In a prospective study, CIC specimens were collected from the superior bulbar conjunctiva (12 o'clock, 5mm from limbus) of 20 adult subjects (average age 22 years) onto Millicell-CM membranes and Giemsa stained. A region from each CIC filter containing reasonably high numbers of goblet cells was imaged by light microscopy at a final magnification of 400X and then the same region assessed at 200X and then 100X. The images were enlarged, the goblet cells marked and counted and GCD values/sq mm calculated.

RESULTS

The mean GCD estimates at 400X magnification, 200X and 100X were 644±180, 405±72 and 365±81 cells/sq mm respectively, and these values were statistically different (p<0.001).

CONCLUSIONS

As a result of non-uniform distribution, a strategy to select a 400X high power microscope field (HPF) that appears to include a moderate number of goblet cells will have a probability (by at least 20:1) that the GCD estimates will likely be higher compared to those at 200X or 100X, and the probability for higher GCD values is at least 15:1 comparing assessments made at 200X to 100X. Investigators should use only one magnification, with that of a medium power field (200X final magnification) likely being the most useful.

Biomarkers of ocular surface disease using impression cytology

Impression cytology (IC) is a technique which permits the retrieval of the outermost layer of ocular surface cells via the use of various types of filters. It is a minimally invasive method of evaluating human conjunctival epithelial cell morphology in the diagnosis of dry eye disease, a common and distressing disorder associated with ageing, contact lens wear, autoimmune disorders and refractive (LASIK) surgery. IC may also be utilized in the diagnosis of other ocular diseases, such as keratoconus and thyroid orbitopathy. More recently, IC has been utilized for the subsequent investigation of gene and protein expression of conjunctival cells in order to identify novel diagnostic biomarkers and to further our understanding of the mechanisms underlying ocular surface disease. This review will therefore examine the literature concerning the role of IC in identifying cellular markers of eye disease, systemic diseases with ocular involvement and potential novel therapeutic targets.

Giemsa-based cytological assessment of area, shape and nucleus:cytoplasm ratio of goblet cells of rabbit bulbar conjunctiva

Goblet cells were visualized in impression cytology specimens from bulbar conjunctiva of the rabbit eye using Giemsa staining. Highly magnified images were used to generate outlines of the goblet cells and their characteristic eccentric nuclei. Using sets of 10 cells from 15 cytology specimens, I found that the longest dimension of the goblet cells averaged 16.7 ± 2.3 μm, the shortest dimension averaged 14.4 ± 1.8 μm and the nucleus averaged 6.3 ± 0.8 μm. The goblet cells were ellipsoid in shape and the longest:shortest cell dimension ratio averaged 1.169 ± 0.091. The goblet cell areas ranged from 108 to 338 μm² (average 193 ± 50 μm²). The area could be predicted reliably from the longest and shortest dimensions (r² = 0.903). The areas of goblet cell nuclei were 15-58 μm² (average 33 ± μm²) and the nucleus:cytoplasm area fraction was predictably greater in smaller goblet cells and less in the larger goblet cells (Spearman correlation = 0.817). The nuclei were estimated to occupy an average of 9.5% of the cell volume. The differences in size, shape and nucleus:cytoplasm ratio may reflect differences in goblet cell maturation.