1
|
Chang S, Krzyzanowska H, Bowden AK. Label-Free Optical Technologies to Enhance Noninvasive Endoscopic Imaging of Early-Stage Cancers. ANNUAL REVIEW OF ANALYTICAL CHEMISTRY (PALO ALTO, CALIF.) 2024; 17:289-311. [PMID: 38424030 DOI: 10.1146/annurev-anchem-061622-014208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
White light endoscopic imaging allows for the examination of internal human organs and is essential in the detection and treatment of early-stage cancers. To facilitate diagnosis of precancerous changes and early-stage cancers, label-free optical technologies that provide enhanced malignancy-specific contrast and depth information have been extensively researched. The rapid development of technology in the past two decades has enabled integration of these optical technologies into clinical endoscopy. In recent years, the significant advantages of using these adjunct optical devices have been shown, suggesting readiness for clinical translation. In this review, we provide an overview of the working principles and miniaturization considerations and summarize the clinical and preclinical demonstrations of several such techniques for early-stage cancer detection. We also offer an outlook for the integration of multiple technologies and the use of computer-aided diagnosis in clinical endoscopy.
Collapse
Affiliation(s)
- Shuang Chang
- 1Vanderbilt Biophotonics Center, Vanderbilt University, Nashville, Tennessee, USA;
- 2Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - Halina Krzyzanowska
- 1Vanderbilt Biophotonics Center, Vanderbilt University, Nashville, Tennessee, USA;
- 2Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - Audrey K Bowden
- 1Vanderbilt Biophotonics Center, Vanderbilt University, Nashville, Tennessee, USA;
- 2Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
- 3Department of Electrical and Computer Engineering, Vanderbilt University, Nashville, Tennessee, USA
| |
Collapse
|
2
|
Boktor M, Tweel JED, Ecclestone BR, Ye JA, Fieguth P, Haji Reza P. Multi-channel feature extraction for virtual histological staining of photon absorption remote sensing images. Sci Rep 2024; 14:2009. [PMID: 38263394 PMCID: PMC10805725 DOI: 10.1038/s41598-024-52588-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 01/20/2024] [Indexed: 01/25/2024] Open
Abstract
Accurate and fast histological staining is crucial in histopathology, impacting diagnostic precision and reliability. Traditional staining methods are time-consuming and subjective, causing delays in diagnosis. Digital pathology plays a vital role in advancing and optimizing histology processes to improve efficiency and reduce turnaround times. This study introduces a novel deep learning-based framework for virtual histological staining using photon absorption remote sensing (PARS) images. By extracting features from PARS time-resolved signals using a variant of the K-means method, valuable multi-modal information is captured. The proposed multi-channel cycleGAN model expands on the traditional cycleGAN framework, allowing the inclusion of additional features. Experimental results reveal that specific combinations of features outperform the conventional channels by improving the labeling of tissue structures prior to model training. Applied to human skin and mouse brain tissue, the results underscore the significance of choosing the optimal combination of features, as it reveals a substantial visual and quantitative concurrence between the virtually stained and the gold standard chemically stained hematoxylin and eosin images, surpassing the performance of other feature combinations. Accurate virtual staining is valuable for reliable diagnostic information, aiding pathologists in disease classification, grading, and treatment planning. This study aims to advance label-free histological imaging and opens doors for intraoperative microscopy applications.
Collapse
Affiliation(s)
- Marian Boktor
- PhotoMedicine Labs, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada
- Vision and Image Processing Lab, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada
| | - James E D Tweel
- PhotoMedicine Labs, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada
- illumiSonics Inc., 22 King Street South, Suite 300, Waterloo, ON, N2J 1N8, Canada
| | - Benjamin R Ecclestone
- PhotoMedicine Labs, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada
- illumiSonics Inc., 22 King Street South, Suite 300, Waterloo, ON, N2J 1N8, Canada
| | - Jennifer Ai Ye
- Vision and Image Processing Lab, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada
| | - Paul Fieguth
- Vision and Image Processing Lab, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada
| | - Parsin Haji Reza
- PhotoMedicine Labs, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada.
| |
Collapse
|
3
|
Chang S, Yang J, Novoseltseva A, Abdelhakeem A, Hyman M, Fu X, Li C, Chen S, Augustinack JC, Magnain C, Fischl B, Mckee AC, Boas DA, Chen IA, Wang H. Multi-Scale Label-Free Human Brain Imaging with Integrated Serial Sectioning Polarization Sensitive Optical Coherence Tomography and Two-Photon Microscopy. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2303381. [PMID: 37882348 PMCID: PMC10724383 DOI: 10.1002/advs.202303381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 08/29/2023] [Indexed: 10/27/2023]
Abstract
The study of aging and neurodegenerative processes in the human brain requires a comprehensive understanding of cytoarchitectonic, myeloarchitectonic, and vascular structures. Recent computational advances have enabled volumetric reconstruction of the human brain using thousands of stained slices, however, tissue distortions and loss resulting from standard histological processing have hindered deformation-free reconstruction. Here, the authors describe an integrated serial sectioning polarization-sensitive optical coherence tomography (PSOCT) and two photon microscopy (2PM) system to provide label-free multi-contrast imaging of intact brain structures, including scattering, birefringence, and autofluorescence of human brain tissue. The authors demonstrate high-throughput reconstruction of 4 × 4 × 2cm3 sample blocks and simple registration between PSOCT and 2PM images that enable comprehensive analysis of myelin content, vascular structure, and cellular information. The high-resolution 2PM images provide microscopic validation and enrichment of the cellular information provided by the PSOCT optical properties on the same sample, revealing the densely packed fibers, capillaries, and lipofuscin-filled cell bodies in the cortex and white matter. It is shown that the imaging system enables quantitative characterization of various pathological features in aging process, including myelin degradation, lipofuscin accumulation, and microvascular changes, which opens up numerous opportunities in the study of neurodegenerative diseases in the future.
Collapse
Affiliation(s)
- Shuaibin Chang
- Department of Electrical and Computer EngineeringBoston University8 St Mary's StBoston02215USA
| | - Jiarui Yang
- Department of Biomedical EngineeringBoston University44 Cummington MallBoston02215USA
| | - Anna Novoseltseva
- Department of Biomedical EngineeringBoston University44 Cummington MallBoston02215USA
| | - Ayman Abdelhakeem
- Department of Electrical and Computer EngineeringBoston University8 St Mary's StBoston02215USA
| | - Mackenzie Hyman
- Department of Biomedical EngineeringBoston University44 Cummington MallBoston02215USA
| | - Xinlei Fu
- Department of Mechanical EngineeringThe Chinese University of Hong KongHong Kong999077China
| | - Chenglin Li
- Department of Mechanical EngineeringThe Chinese University of Hong KongHong Kong999077China
| | - Shih‐Chi Chen
- Department of Mechanical EngineeringThe Chinese University of Hong KongHong Kong999077China
| | - Jean C. Augustinack
- Department of RadiologyMassachusetts General HospitalA.A. Martinos Center for Biomedical Imaging13th StreetBoston02129USA
| | - Caroline Magnain
- Department of RadiologyMassachusetts General HospitalA.A. Martinos Center for Biomedical Imaging13th StreetBoston02129USA
| | - Bruce Fischl
- Department of RadiologyMassachusetts General HospitalA.A. Martinos Center for Biomedical Imaging13th StreetBoston02129USA
| | - Ann C. Mckee
- VA Boston Healthcare SystemU.S. Department of Veteran AffairsBoston02132USA
- Boston University Chobanian and Avedisian School of MedicineBoston University Alzheimer's Disease Research Center and CTE CenterBoston02118USA
- Department of NeurologyBoston University Chobanian and Avedisian School of MedicineBoston02118USA
- Department of Pathology and Laboratory MedicineBoston University Chobanian and Avedisian School of MedicineBoston02118USA
- VA Bedford Healthcare SystemU.S. Department of Veteran AffairsBedfordMA01730‐1114USA
| | - David A. Boas
- Department of Electrical and Computer EngineeringBoston University8 St Mary's StBoston02215USA
- Department of Biomedical EngineeringBoston University44 Cummington MallBoston02215USA
| | - Ichun Anderson Chen
- Department of Biomedical EngineeringBoston University44 Cummington MallBoston02215USA
| | - Hui Wang
- Department of RadiologyMassachusetts General HospitalA.A. Martinos Center for Biomedical Imaging13th StreetBoston02129USA
| |
Collapse
|
4
|
Chang S, Yang J, Novoseltseva A, Fu X, Li C, Chen SC, Augustinack JC, Magnain C, Fischl B, Mckee AC, Boas DA, Chen IA, Wang H. Multi-Scale Label-free Human Brain Imaging with Integrated Serial Sectioning Polarization Sensitive Optical Coherence Tomography and Two-Photon Microscopy. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.05.22.541785. [PMID: 37293092 PMCID: PMC10245911 DOI: 10.1101/2023.05.22.541785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The study of neurodegenerative processes in the human brain requires a comprehensive understanding of cytoarchitectonic, myeloarchitectonic, and vascular structures. Recent computational advances have enabled volumetric reconstruction of the human brain using thousands of stained slices, however, tissue distortions and loss resulting from standard histological processing have hindered deformation-free reconstruction of the human brain. The development of a multi-scale and volumetric human brain imaging technique that can measure intact brain structure would be a major technical advance. Here, we describe the development of integrated serial sectioning Polarization Sensitive Optical Coherence Tomography (PSOCT) and Two Photon Microscopy (2PM) to provide label-free multi-contrast imaging, including scattering, birefringence and autofluorescence of human brain tissue. We demonstrate that high-throughput reconstruction of 4×4×2cm3 sample blocks and simple registration of PSOCT and 2PM images enable comprehensive analysis of myelin content, vascular structure, and cellular information. We show that 2μm in-plane resolution 2PM images provide microscopic validation and enrichment of the cellular information provided by the PSOCT optical property maps on the same sample, revealing the sophisticated capillary networks and lipofuscin filled cell bodies across the cortical layers. Our method is applicable to the study of a variety of pathological processes, including demyelination, cell loss, and microvascular changes in neurodegenerative diseases such as Alzheimer's disease (AD) and Chronic Traumatic Encephalopathy (CTE).
Collapse
Affiliation(s)
- Shuaibin Chang
- Department of Electrical and Computer Engineering, Boston University, 8 St Mary’s St, Boston 02215, USA
| | - Jiarui Yang
- Department of Biomedical Engineering, Boston University, 44 Cummington Mall, Boston 02215, USA
| | - Anna Novoseltseva
- Department of Biomedical Engineering, Boston University, 44 Cummington Mall, Boston 02215, USA
| | - Xinlei Fu
- The Chinese University of Hong Kong, Department of Mechanical Engineering, Hong Kong Special Administrative Region, China
| | - Chenglin Li
- The Chinese University of Hong Kong, Department of Mechanical Engineering, Hong Kong Special Administrative Region, China
| | - Shih-Chi Chen
- The Chinese University of Hong Kong, Department of Mechanical Engineering, Hong Kong Special Administrative Region, China
| | - Jean C. Augustinack
- Department of Radiology, Massachusetts General Hospital, A.A. Martinos Center for Biomedical Imaging, 13th Street, Boston 02129, USA
| | - Caroline Magnain
- Department of Radiology, Massachusetts General Hospital, A.A. Martinos Center for Biomedical Imaging, 13th Street, Boston 02129, USA
| | - Bruce Fischl
- Department of Radiology, Massachusetts General Hospital, A.A. Martinos Center for Biomedical Imaging, 13th Street, Boston 02129, USA
| | - Ann C. Mckee
- VA Boston Healthcare System, U.S. Department of Veteran Affairs
- Boston University Chobanian and Avedisian School of Medicine, Boston University Alzheimer’s Disease Research Center and CTE Center
- Department of Neurology, Boston University Chobanian and Avedisian School of Medicine
- Department of Pathology and Laboratory Medicine, Boston University Chobanian and Avedisian School of Medicine
- VA Bedford Healthcare System, U.S. Department of Veteran Affairs, Bedford, MA, USA
| | - David A. Boas
- Department of Electrical and Computer Engineering, Boston University, 8 St Mary’s St, Boston 02215, USA
- Department of Biomedical Engineering, Boston University, 44 Cummington Mall, Boston 02215, USA
| | - Ichun Anderson Chen
- Department of Biomedical Engineering, Boston University, 44 Cummington Mall, Boston 02215, USA
| | - Hui Wang
- Department of Radiology, Massachusetts General Hospital, A.A. Martinos Center for Biomedical Imaging, 13th Street, Boston 02129, USA
| |
Collapse
|
5
|
Shah VS, Hou J, Vinarsky V, Xu J, Surve MV, Lin CP, Rajagopal J. Autofluorescence imaging permits label-free cell type assignment and reveals the dynamic formation of airway secretory cell associated antigen passages (SAPs). eLife 2023; 12:e84375. [PMID: 36994985 PMCID: PMC10154029 DOI: 10.7554/elife.84375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 03/29/2023] [Indexed: 03/31/2023] Open
Abstract
The specific functional properties of a tissue are distributed amongst its component cell types. The various cells act coherently, as an ensemble, in order to execute a physiologic response. Modern approaches for identifying and dissecting novel physiologic mechanisms would benefit from an ability to identify specific cell types in live tissues that could then be imaged in real time. Current techniques require the use of fluorescent genetic reporters that are not only cumbersome, but which only allow the study of three or four cell types at a time. We report a non-invasive imaging modality that capitalizes on the endogenous autofluorescence signatures of the metabolic cofactors NAD(P)H and FAD. By marrying morphological characteristics with autofluorescence signatures, all seven of the airway epithelial cell types can be distinguished simultaneously in mouse tracheal explants in real time. Furthermore, we find that this methodology for direct cell type-specific identification avoids pitfalls associated with the use of ostensibly cell type-specific markers that are, in fact, altered by clinically relevant physiologic stimuli. Finally, we utilize this methodology to interrogate real-time physiology and identify dynamic secretory cell associated antigen passages (SAPs) that form in response to cholinergic stimulus. The identical process has been well documented in the intestine where the dynamic formation of SAPs and goblet cell associated antigen passages (GAPs) enable luminal antigen sampling. Airway secretory cells with SAPs are frequently juxtaposed to antigen presenting cells, suggesting that airway SAPs, like their intestinal counterparts, not only sample antigen but convey their cargo for immune cell processing.
Collapse
Affiliation(s)
- Viral S Shah
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Massachusetts General HospitalBostonUnited States
- Center for Regenerative Medicine, Massachusetts General HospitalBostonUnited States
| | - Jue Hou
- Advanced Microscopy Program, Center for Systems Biology and Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical SchoolBostonUnited States
| | - Vladimir Vinarsky
- Center for Regenerative Medicine, Massachusetts General HospitalBostonUnited States
| | - Jiajie Xu
- Center for Regenerative Medicine, Massachusetts General HospitalBostonUnited States
| | - Manalee V Surve
- Center for Regenerative Medicine, Massachusetts General HospitalBostonUnited States
| | - Charles P Lin
- Advanced Microscopy Program, Center for Systems Biology and Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical SchoolBostonUnited States
| | - Jayaraj Rajagopal
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Massachusetts General HospitalBostonUnited States
- Center for Regenerative Medicine, Massachusetts General HospitalBostonUnited States
- Harvard Stem Cell InstituteCambridgeUnited States
- Klarman Cell Observatory, Broad InstituteCambridgeUnited States
| |
Collapse
|
6
|
Quansah E, Gardey E, Ramoji A, Meyer-Zedler T, Goehrig B, Heutelbeck A, Hoeppener S, Schmitt M, Waldner M, Stallmach A, Popp J. Intestinal epithelial barrier integrity investigated by label-free techniques in ulcerative colitis patients. Sci Rep 2023; 13:2681. [PMID: 36792686 PMCID: PMC9931702 DOI: 10.1038/s41598-023-29649-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 02/08/2023] [Indexed: 02/17/2023] Open
Abstract
The intestinal epithelial barrier, among other compartments such as the mucosal immune system, contributes to the maintenance of intestinal homeostasis. Therefore, any disturbance within the epithelial layer could lead to intestinal permeability and promote mucosal inflammation. Considering that disintegration of the intestinal epithelial barrier is a key element in the etiology of ulcerative colitis, further assessment of barrier integrity could contribute to a better understanding of the role of epithelial barrier defects in ulcerative colitis (UC), one major form of chronic inflammatory bowel disease. Herein, we employ fast, non-destructive, and label-free non-linear methods, namely coherent anti-Stokes Raman scattering (CARS), second harmonic generation (SHG), two-photon excited fluorescence (TPEF), and two-photon fluorescence lifetime imaging (2P-FLIM), to assess the morpho-chemical contributions leading to the dysfunction of the epithelial barrier. For the first time, the formation of epithelial barrier gaps was directly visualized, without sophisticated data analysis procedures, by the 3D analysis of the colonic mucosa from severely inflamed UC patients. The results were compared with histopathological and immunofluorescence images and validated using transmission electron microscopy (TEM) to indicate structural alterations of the apical junction complex as the underlying cause for the formation of the epithelial barrier gaps. Our findings suggest the potential advantage of non-linear multimodal imaging is to give precise, detailed, and direct visualization of the epithelial barrier in the gastrointestinal tract, which can be combined with a fiber probe for future endomicroscopy measurements during real-time in vivo imaging.
Collapse
Affiliation(s)
- Elsie Quansah
- Institute of Physical Chemistry and Abbe Center of Photonics (IPC), Member of the Leibniz Centre for Photonics in Infection Research (LPI), Friedrich Schiller University Jena, Helmholtzweg 4, 07743, Jena, Germany
- Leibniz Institute of Photonic Technology (IPHT), Member of Leibniz Health Technologies, Member of the Leibniz Centre for Photonics in Infection Research (LPI), Albert-Einstein-Straße 9, 07745, Jena, Germany
| | - Elena Gardey
- Department of Internal Medicine IV (Gastroenterology, Hepatology, Infectious Diseases and Interdisciplinary Endoscopy), Jena University Hospital, Friedrich Schiller University Jena, Am Klinikum 1, 07747, Jena, Germany
- Friedrich Schiller University Jena, Jena Center for Soft Matter (JCSM), Philosophenweg 7, 07743, Jena, Germany
| | - Anuradha Ramoji
- Institute of Physical Chemistry and Abbe Center of Photonics (IPC), Member of the Leibniz Centre for Photonics in Infection Research (LPI), Friedrich Schiller University Jena, Helmholtzweg 4, 07743, Jena, Germany.
- Leibniz Institute of Photonic Technology (IPHT), Member of Leibniz Health Technologies, Member of the Leibniz Centre for Photonics in Infection Research (LPI), Albert-Einstein-Straße 9, 07745, Jena, Germany.
- Jena University Hospital, Center for Sepsis Control and Care (CSCC), Friedrich Schiller University Jena, Erlanger Allee 101, 07747, Jena, Germany.
| | - Tobias Meyer-Zedler
- Institute of Physical Chemistry and Abbe Center of Photonics (IPC), Member of the Leibniz Centre for Photonics in Infection Research (LPI), Friedrich Schiller University Jena, Helmholtzweg 4, 07743, Jena, Germany
- Leibniz Institute of Photonic Technology (IPHT), Member of Leibniz Health Technologies, Member of the Leibniz Centre for Photonics in Infection Research (LPI), Albert-Einstein-Straße 9, 07745, Jena, Germany
| | - Bianca Goehrig
- Institute for Occupational, Social, and Environmental Medicine, Jena University Hospital, Friedrich Schiller University Jena, Am Klinikum 1, 07747, Jena, Germany
| | - Astrid Heutelbeck
- Institute for Occupational, Social, and Environmental Medicine, Jena University Hospital, Friedrich Schiller University Jena, Am Klinikum 1, 07747, Jena, Germany
| | - Stephanie Hoeppener
- Friedrich Schiller University Jena, Jena Center for Soft Matter (JCSM), Philosophenweg 7, 07743, Jena, Germany
- Laboratory of Organic and Macromolecular Chemistry (IOMC), Friedrich Schiller University Jena, Humboldtstraße 10, 07743, Jena, Germany
| | - Michael Schmitt
- Institute of Physical Chemistry and Abbe Center of Photonics (IPC), Member of the Leibniz Centre for Photonics in Infection Research (LPI), Friedrich Schiller University Jena, Helmholtzweg 4, 07743, Jena, Germany
- Leibniz Institute of Photonic Technology (IPHT), Member of Leibniz Health Technologies, Member of the Leibniz Centre for Photonics in Infection Research (LPI), Albert-Einstein-Straße 9, 07745, Jena, Germany
| | - Maximillian Waldner
- Department of Medicine, University of Erlangen-Nuremberg, 91054, Erlangen, Germany
| | - Andreas Stallmach
- Department of Internal Medicine IV (Gastroenterology, Hepatology, Infectious Diseases and Interdisciplinary Endoscopy), Jena University Hospital, Friedrich Schiller University Jena, Am Klinikum 1, 07747, Jena, Germany
- Friedrich Schiller University Jena, Jena Center for Soft Matter (JCSM), Philosophenweg 7, 07743, Jena, Germany
| | - Jürgen Popp
- Institute of Physical Chemistry and Abbe Center of Photonics (IPC), Member of the Leibniz Centre for Photonics in Infection Research (LPI), Friedrich Schiller University Jena, Helmholtzweg 4, 07743, Jena, Germany
- Leibniz Institute of Photonic Technology (IPHT), Member of Leibniz Health Technologies, Member of the Leibniz Centre for Photonics in Infection Research (LPI), Albert-Einstein-Straße 9, 07745, Jena, Germany
| |
Collapse
|
7
|
Popowski KD, Moatti A, Scull G, Silkstone D, Lutz H, López de Juan Abad B, George A, Belcher E, Zhu D, Mei X, Cheng X, Cislo M, Ghodsi A, Cai Y, Huang K, Li J, Brown AC, Greenbaum A, Dinh PUC, Cheng K. Inhalable dry powder mRNA vaccines based on extracellular vesicles. MATTER 2022; 5:2960-2974. [PMID: 35847197 PMCID: PMC9272513 DOI: 10.1016/j.matt.2022.06.012] [Citation(s) in RCA: 76] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 04/29/2022] [Accepted: 06/07/2022] [Indexed: 05/10/2023]
Abstract
Respiratory diseases are a global burden, with millions of deaths attributed to pulmonary illnesses and dysfunctions. Therapeutics have been developed, but they present major limitations regarding pulmonary bioavailability and product stability. To circumvent such limitations, we developed room-temperature-stable inhalable lung-derived extracellular vesicles or exosomes (Lung-Exos) as mRNA and protein drug carriers. Compared with standard synthetic nanoparticle liposomes (Lipos), Lung-Exos exhibited superior distribution to the bronchioles and parenchyma and are deliverable to the lungs of rodents and nonhuman primates (NHPs) by dry powder inhalation. In a vaccine application, severe acute respiratory coronavirus 2 (SARS-CoV-2) spike (S) protein encoding mRNA-loaded Lung-Exos (S-Exos) elicited greater immunoglobulin G (IgG) and secretory IgA (SIgA) responses than its loaded liposome (S-Lipo) counterpart. Importantly, S-Exos remained functional at room-temperature storage for one month. Our results suggest that extracellular vesicles can serve as an inhaled mRNA drug-delivery system that is superior to synthetic liposomes.
Collapse
Affiliation(s)
- Kristen D Popowski
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, NC 27607, USA
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC 27607, USA
| | - Adele Moatti
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC 27607, USA
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Raleigh/Chapel Hill, NC 27607/27599, USA
| | - Grant Scull
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC 27607, USA
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Raleigh/Chapel Hill, NC 27607/27599, USA
| | - Dylan Silkstone
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC 27607, USA
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Raleigh/Chapel Hill, NC 27607/27599, USA
| | - Halle Lutz
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, NC 27607, USA
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC 27607, USA
| | - Blanca López de Juan Abad
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, NC 27607, USA
| | - Arianna George
- Department of Molecular and Structural Biochemistry, North Carolina State University, Raleigh, NC 27695, USA
- Department of Biological Sciences, North Carolina State University, Raleigh, NC 27695, USA
| | - Elizabeth Belcher
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Raleigh/Chapel Hill, NC 27607/27599, USA
| | - Dashuai Zhu
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, NC 27607, USA
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC 27607, USA
| | - Xuan Mei
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, NC 27607, USA
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC 27607, USA
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Raleigh/Chapel Hill, NC 27607/27599, USA
| | - Xiao Cheng
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, NC 27607, USA
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Raleigh/Chapel Hill, NC 27607/27599, USA
| | - Megan Cislo
- Department of Biological Sciences, North Carolina State University, Raleigh, NC 27695, USA
- Department of Food, Bioprocessing, and Nutrition Sciences, North Carolina State University, Raleigh, NC 27695, USA
| | - Asma Ghodsi
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, NC 27607, USA
| | - Yuheng Cai
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC 27607, USA
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Raleigh/Chapel Hill, NC 27607/27599, USA
| | - Ke Huang
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, NC 27607, USA
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC 27607, USA
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Raleigh/Chapel Hill, NC 27607/27599, USA
| | - Junlang Li
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, NC 27607, USA
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Raleigh/Chapel Hill, NC 27607/27599, USA
| | - Ashley C Brown
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC 27607, USA
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Raleigh/Chapel Hill, NC 27607/27599, USA
| | - Alon Greenbaum
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC 27607, USA
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Raleigh/Chapel Hill, NC 27607/27599, USA
| | - Phuong-Uyen C Dinh
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, NC 27607, USA
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC 27607, USA
| | - Ke Cheng
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, NC 27607, USA
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC 27607, USA
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Raleigh/Chapel Hill, NC 27607/27599, USA
- Division of Pharmacoengineering and Molecular Pharmaceutics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| |
Collapse
|
8
|
Virtual histological staining of label-free total absorption photoacoustic remote sensing (TA-PARS). Sci Rep 2022; 12:10296. [PMID: 35717539 PMCID: PMC9206643 DOI: 10.1038/s41598-022-14042-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/31/2022] [Indexed: 01/21/2023] Open
Abstract
Histopathological visualizations are a pillar of modern medicine and biological research. Surgical oncology relies exclusively on post-operative histology to determine definitive surgical success and guide adjuvant treatments. The current histology workflow is based on bright-field microscopic assessment of histochemical stained tissues and has some major limitations. For example, the preparation of stained specimens for brightfield assessment requires lengthy sample processing, delaying interventions for days or even weeks. Therefore, there is a pressing need for improved histopathology methods. In this paper, we present a deep-learning-based approach for virtual label-free histochemical staining of total-absorption photoacoustic remote sensing (TA-PARS) images of unstained tissue. TA-PARS provides an array of directly measured label-free contrasts such as scattering and total absorption (radiative and non-radiative), ideal for developing H&E colorizations without the need to infer arbitrary tissue structures. We use a Pix2Pix generative adversarial network to develop visualizations analogous to H&E staining from label-free TA-PARS images. Thin sections of human skin tissue were first virtually stained with the TA-PARS, then were chemically stained with H&E producing a one-to-one comparison between the virtual and chemical staining. The one-to-one matched virtually- and chemically- stained images exhibit high concordance validating the digital colorization of the TA-PARS images against the gold standard H&E. TA-PARS images were reviewed by four dermatologic pathologists who confirmed they are of diagnostic quality, and that resolution, contrast, and color permitted interpretation as if they were H&E. The presented approach paves the way for the development of TA-PARS slide-free histological imaging, which promises to dramatically reduce the time from specimen resection to histological imaging.
Collapse
|
9
|
Kohlfaerber T, Pieper M, Münter M, Holzhausen C, Ahrens M, Idel C, Bruchhage KL, Leichtle A, König P, Hüttmann G, Schulz-Hildebrandt H. Dynamic microscopic optical coherence tomography to visualize the morphological and functional micro-anatomy of the airways. BIOMEDICAL OPTICS EXPRESS 2022; 13:3211-3223. [PMID: 35781952 PMCID: PMC9208592 DOI: 10.1364/boe.456104] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/03/2022] [Accepted: 04/19/2022] [Indexed: 06/15/2023]
Abstract
In the imaging of airway tissue, optical coherence tomography (OCT) provides cross-sectional images of tissue structures, shows cilia movement and mucus secretion, but does not provide sufficient contrast to differentiate individual cells. By using fast sequences of microscopic resolution OCT (mOCT) images, OCT can use small signal fluctuations to overcome lack in contrast and speckle noise. In this way, OCT visualizes airway morphology on a cellular level and allows the tracking of the dynamic behavior of immune cells, as well as mucus transport and secretion. Here, we demonstrate that mOCT, by using temporal tissue fluctuation as contrast (dynamic mOCT), provides the possibility to study physiological and pathological tissue processes in vivo.
Collapse
Affiliation(s)
- Tabea Kohlfaerber
- Medizinisches Laserzentrum Lübeck GmbH, Peter-Monnik-Weg 4, 23562 Lübeck, Germany
| | - Mario Pieper
- University of Lübeck, Institute of Anatomy, Ratzeburger Allee 160, 23562 Lübeck, Germany
- Airway Research Center North Member of the German Center for Lung Research, DZL, 22927 Großhansdorf, Germany
| | - Michael Münter
- University of Lübeck, Institute of Biomedical Optics, Peter-Monnik-Weg 4, 23562 Lübeck, Germany
| | - Cornelia Holzhausen
- University of Lübeck, Institute of Anatomy, Ratzeburger Allee 160, 23562 Lübeck, Germany
| | - Martin Ahrens
- Airway Research Center North Member of the German Center for Lung Research, DZL, 22927 Großhansdorf, Germany
- University of Lübeck, Institute of Biomedical Optics, Peter-Monnik-Weg 4, 23562 Lübeck, Germany
| | - Christian Idel
- University Hospital Schleswig-Holstein, ENT Clinics, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Karl-Ludwig Bruchhage
- University Hospital Schleswig-Holstein, ENT Clinics, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Anke Leichtle
- University Hospital Schleswig-Holstein, ENT Clinics, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Peter König
- University of Lübeck, Institute of Anatomy, Ratzeburger Allee 160, 23562 Lübeck, Germany
- Airway Research Center North Member of the German Center for Lung Research, DZL, 22927 Großhansdorf, Germany
| | - Gereon Hüttmann
- Medizinisches Laserzentrum Lübeck GmbH, Peter-Monnik-Weg 4, 23562 Lübeck, Germany
- University of Lübeck, Institute of Anatomy, Ratzeburger Allee 160, 23562 Lübeck, Germany
- Airway Research Center North Member of the German Center for Lung Research, DZL, 22927 Großhansdorf, Germany
- Center of Brain, Behavior and Metabolism (CBBM), University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany
| | - Hinnerk Schulz-Hildebrandt
- Medizinisches Laserzentrum Lübeck GmbH, Peter-Monnik-Weg 4, 23562 Lübeck, Germany
- University of Lübeck, Institute of Anatomy, Ratzeburger Allee 160, 23562 Lübeck, Germany
- Airway Research Center North Member of the German Center for Lung Research, DZL, 22927 Großhansdorf, Germany
| |
Collapse
|
10
|
Hollenhorst MI, Nandigama R, Evers SB, Gamayun I, Abdel Wadood N, Salah A, Pieper M, Wyatt A, Stukalov A, Gebhardt A, Nadolni W, Burow W, Herr C, Beisswenger C, Kusumakshi S, Ectors F, Kichko TI, Hübner L, Reeh P, Munder A, Wienhold SM, Witzenrath M, Bals R, Flockerzi V, Gudermann T, Bischoff M, Lipp P, Zierler S, Chubanov V, Pichlmair A, König P, Boehm U, Krasteva-Christ G. Bitter taste signaling in tracheal epithelial brush cells elicits innate immune responses to bacterial infection. J Clin Invest 2022; 132:150951. [PMID: 35503420 PMCID: PMC9246383 DOI: 10.1172/jci150951] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 04/29/2022] [Indexed: 11/17/2022] Open
Abstract
Constant exposure of the airways to inhaled pathogens requires efficient early immune responses protecting against infections. How bacteria on the epithelial surface are detected and first-line protective mechanisms are initiated are not well understood. We have recently shown that tracheal brush cells (BCs) express functional taste receptors. Here we report that bitter taste signaling in murine BCs induces neurogenic inflammation. We demonstrate that BC signaling stimulates adjacent sensory nerve endings in the trachea to release the neuropeptides CGRP and substance P that mediate plasma extravasation, neutrophil recruitment, and diapedesis. Moreover, we show that bitter tasting quorum-sensing molecules from Pseudomonas aeruginosa activate tracheal BCs. BC signaling depends on the key taste transduction gene Trpm5, triggers secretion of immune mediators, among them the most abundant member of the complement system, and is needed to combat P. aeruginosa infections. Our data provide functional insight into first-line defense mechanisms against bacterial infections of the lung.
Collapse
Affiliation(s)
| | - Rajender Nandigama
- Institute of Anatomy and Cell Biology, Julius-Maximilians-University, Würzburg, Germany
| | - Saskia B Evers
- Institute of Anatomy and Cell Biology, Saarland University, Homburg, Germany
| | - Igor Gamayun
- Institute for Experimental and Clinical Pharmacology and Toxicology, Saarland University, Homburg, Germany
| | - Noran Abdel Wadood
- Institute of Anatomy and Cell Biology, Saarland University, Homburg, Germany
| | - Alaa Salah
- Institute of Anatomy and Cell Biology, Saarland University, Homburg, Germany
| | - Mario Pieper
- Institute of Anatomy, University of Luebeck, Luebeck, Germany
| | - Amanda Wyatt
- Institute for Experimental and Clinical Pharmacology and Toxicology, Saarland University, Homburg, Germany
| | - Alexey Stukalov
- Immunopathology of Virus Infection Laboratory, Institute of Virology, Technical University of Munich, Munich, Germany
| | - Anna Gebhardt
- Immunopathology of Virus Infection Laboratory, Institute of Virology, Technical University of Munich, Munich, Germany
| | - Wiebke Nadolni
- Walther-Straub-Institute for Pharmacology and Toxicology, Ludwig-Maximilians-University, Munich, Germany
| | - Wera Burow
- Institute of Anatomy and Cell Biology, Julius-Maximilians-University, Würzburg, Germany
| | - Christian Herr
- Department of Internal Medicine V, Saarland University Hospital, Homburg, Germany
| | | | - Soumya Kusumakshi
- Institute for Experimental and Clinical Pharmacology and Toxicology, Saarland University, Homburg, Germany
| | - Fabien Ectors
- FARAH Mammalian Transgenics Platform, Liège University, Liège, Belgium
| | - Tatjana I Kichko
- Institute of Physiology and Pathophysiology, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Lisa Hübner
- Institute of Anatomy and Cell Biology, Julius-Maximilians-University, Würzburg, Germany
| | - Peter Reeh
- Institute of Physiology and Pathophysiology, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Antje Munder
- Clinic for Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany
| | - Sandra-Maria Wienhold
- Department of Infectious Diseases and Respiratory Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Martin Witzenrath
- Department of Infectious Diseases and Respiratory Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Robert Bals
- Department of Internal Medicine V, Saarland University Hospital, Homburg, Germany
| | - Veit Flockerzi
- Institute for Experimental and Clinical Pharmacology and Toxicology, Saarland University, Homburg, Germany
| | - Thomas Gudermann
- Walther-Straub-Institute for Pharmacology and Toxicology, Ludwig-Maximilians-University, Munich, Germany
| | - Markus Bischoff
- Institute for Medical Microbiology and Hygiene, Saarland University, Homburg, Germany
| | - Peter Lipp
- Institute for Molecular Cell Biology, Saarland University, Homburg, Germany
| | - Susanna Zierler
- Walther-Straub-Institute for Pharmacology and Toxicology, Ludwig-Maximilians-University, Munich, Germany
| | - Vladimir Chubanov
- Walther-Straub-Institute for Pharmacology and Toxicology, Ludwig-Maximilians-University, Munich, Germany
| | - Andreas Pichlmair
- Immunopathology of Virus Infection Laboratory, Institute of Virology, Technical University of Munich, Munich, Germany
| | - Peter König
- Institute of Anatomy, University of Luebeck, Luebeck, Germany
| | - Ulrich Boehm
- Institute for Experimental and Clinical Pharmacology and Toxicology, Saarland University, Homburg, Germany
| | | |
Collapse
|
11
|
Hsu M, Laaker C, Madrid A, Herbath M, Choi YH, Sandor M, Fabry Z. Neuroinflammation creates an immune regulatory niche at the meningeal lymphatic vasculature near the cribriform plate. Nat Immunol 2022; 23:581-593. [PMID: 35347285 PMCID: PMC8989656 DOI: 10.1038/s41590-022-01158-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 02/12/2022] [Indexed: 12/29/2022]
Abstract
Meningeal lymphatics near the cribriform plate undergo lymphangiogenesis during neuroinflammation to drain excess fluid. Here, we hypothesized that lymphangiogenic vessels may acquire an altered phenotype to regulate immunity. Using single-cell RNA sequencing of meningeal lymphatics near the cribriform plate from healthy and experimental autoimmune encephalomyelitis in the C57BL/6 model, we report that neuroinflammation induces the upregulation of genes involved in antigen presentation such as major histocompatibility complex class II, adhesion molecules including vascular cell adhesion protein 1 and immunoregulatory molecules such as programmed cell death 1 ligand 1, where many of these changes are mediated by interferon-γ. The inflamed lymphatics retain CD11c+ cells and CD4 T cells where they capture and present antigen, creating an immunoregulatory niche that represents an underappreciated interface in the regulation of neuroinflammation. We also found discontinuity of the arachnoid membrane near the cribriform plate, which provides unrestricted access to the cerebrospinal fluid. These findings highlight a previously unknown function of local meningeal lymphatics in regulating immunity that has only previously been characterized in draining lymph nodes.
Collapse
Affiliation(s)
- Martin Hsu
- Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI, USA
| | - Collin Laaker
- Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI, USA
| | - Andy Madrid
- Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI, USA
| | - Melinda Herbath
- Department of Pathology and Laboratory Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Yun Hwa Choi
- School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA
| | - Matyas Sandor
- Department of Pathology and Laboratory Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Zsuzsanna Fabry
- Department of Pathology and Laboratory Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA.
| |
Collapse
|
12
|
Yao Y, Sprott RF, Ritzmann F, Grißmer A, Langer F, Herr C, Meier C, Bals R, Beisswenger C, Tschernig T. Human bronchospheres – A mirror of bronchiolar surfaces? TRANSLATIONAL RESEARCH IN ANATOMY 2022. [DOI: 10.1016/j.tria.2022.100169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
|
13
|
Membrane curvature and connective fiber alignment in guinea pig round window membrane. Acta Biomater 2021; 136:343-362. [PMID: 34563725 DOI: 10.1016/j.actbio.2021.09.036] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 09/14/2021] [Accepted: 09/17/2021] [Indexed: 11/23/2022]
Abstract
The round window membrane (RWM) covers an opening between the perilymph fluid-filled inner ear space and the air-filled middle ear space. As the only non-osseous barrier between these two spaces, the RWM is an ideal candidate for aspiration of perilymph for diagnostics purposes and delivery of medication for treatment of inner ear disorders. Routine access across the RWM requires the development of new surgical tools whose design can only be optimized with a thorough understanding of the RWM's structure and properties. The RWM possesses a layer of collagen and elastic fibers so characterization of the distribution and orientation of these fibers is essential. Confocal and two-photon microscopy were conducted on intact RWMs in a guinea pig model to characterize the distribution of collagen and elastic fibers. The fibers were imaged via second-harmonic-generation, autofluorescence, and Rhodamine B staining. Quantitative analyses of both fiber orientation and geometrical properties of the RWM uncovered a significant correlation between mean fiber orientations and directions of zero curvature in some portions of the RWM, with an even more significant correlation between the mean fiber orientations and linear distance along the RWM in a direction approximately parallel to the cochlear axis. The measured mean fiber directions and dispersions can be incorporated into a generalized structure tensor for use in the development of continuum anisotropic mechanical constitutive models that in turn will enable optimization of surgical tools to access the cochlea. STATEMENT OF SIGNIFICANCE: The Round Window Membrane (RWM) is the only non-osseous barrier separating the middle and inner ear spaces, and thus is an ideal portal for medical access to the cochlea. An understanding of RWM structure and mechanical response is necessary to optimize the design of surgical tools for this purpose. The RWM geometry and the connective fiber orientation and dispersion are measured via confocal and 2-photon microscopy. A region of the RWM geometry is characterized as a hyperbolic paraboloid and another region as a tapered parabolic cylinder. Predominant fiber directions correlate well with directions of zero curvature in the hyperbolic paraboloid region. Overall fiber directions correlate well with position along a line approximately parallel to the central axis of the cochlea's spiral.
Collapse
|
14
|
Cleland NRW, Al-Juboori SI, Dobrinskikh E, Bruce KD. Altered substrate metabolism in neurodegenerative disease: new insights from metabolic imaging. J Neuroinflammation 2021; 18:248. [PMID: 34711251 PMCID: PMC8555332 DOI: 10.1186/s12974-021-02305-w] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/21/2021] [Indexed: 12/13/2022] Open
Abstract
Neurodegenerative diseases (NDs), such as Alzheimer's disease (AD), Parkinson's disease (PD) and multiple sclerosis (MS), are relatively common and devastating neurological disorders. For example, there are 6 million individuals living with AD in the United States, a number that is projected to grow to 14 million by the year 2030. Importantly, AD, PD and MS are all characterized by the lack of a true disease-modifying therapy that is able to reverse or halt disease progression. In addition, the existing standard of care for most NDs only addresses the symptoms of the disease. Therefore, alternative strategies that target mechanisms underlying the neuropathogenesis of disease are much needed. Recent studies have indicated that metabolic alterations in neurons and glia are commonly observed in AD, PD and MS and lead to changes in cell function that can either precede or protect against disease onset and progression. Specifically, single-cell RNAseq studies have shown that AD progression is tightly linked to the metabolic phenotype of microglia, the key immune effector cells of the brain. However, these analyses involve removing cells from their native environment and performing measurements in vitro, influencing metabolic status. Therefore, technical approaches that can accurately assess cell-specific metabolism in situ have the potential to be transformative to our understanding of the mechanisms driving AD. Here, we review our current understanding of metabolism in both neurons and glia during homeostasis and disease. We also evaluate recent advances in metabolic imaging, and discuss how emerging modalities, such as fluorescence lifetime imaging microscopy (FLIM) have the potential to determine how metabolic perturbations may drive the progression of NDs. Finally, we propose that the temporal, regional, and cell-specific characterization of brain metabolism afforded by FLIM will be a critical first step in the rational design of metabolism-focused interventions that delay or even prevent NDs.
Collapse
Affiliation(s)
- Nicholas R W Cleland
- Endocrinology, Metabolism and Diabetes, Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, USA
- School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, USA
| | - Saif I Al-Juboori
- Section of Neonatology, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, USA
| | - Evgenia Dobrinskikh
- Section of Neonatology, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, USA
- Division of Pulmonary Sciences and Critical Care, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, USA
| | - Kimberley D Bruce
- Endocrinology, Metabolism and Diabetes, Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, USA.
| |
Collapse
|
15
|
Jones JD, Rodriguez MR, Quinn KP. Automated Extraction of Skin Wound Healing Biomarkers From In Vivo Label-Free Multiphoton Microscopy Using Convolutional Neural Networks. Lasers Surg Med 2021; 53:1086-1095. [PMID: 33442889 PMCID: PMC8275674 DOI: 10.1002/lsm.23375] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 12/06/2020] [Accepted: 12/23/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND OBJECTIVES Histological analysis is a gold standard technique for studying impaired skin wound healing. Label-free multiphoton microscopy (MPM) can provide natural image contrast similar to histological sections and quantitative metabolic information using NADH and FAD autofluorescence. However, MPM analysis requires time-intensive manual segmentation of specific wound tissue regions limiting the practicality and usage of the technology for monitoring wounds. The goal of this study was to train a series of convolutional neural networks (CNNs) to segment MPM images of skin wounds to automate image processing and quantification of wound geometry and metabolism. STUDY DESIGN/MATERIALS AND METHODS Two CNNs with a 4-layer U-Net architecture were trained to segment unstained skin wound tissue sections and in vivo z-stacks of the wound edge. The wound section CNN used 380 distinct MPM images while the in vivo CNN used 5,848 with both image sets being randomly distributed to training, validation, and test sets following a 70%, 20%, and 10% split. The accuracy of each network was evaluated on the test set of images, and the effectiveness of automated measurement of wound geometry and optical redox ratio were compared with hand traced outputs of six unstained wound sections and 69 wound edge z-stacks from eight mice. RESULTS The MPM wound section CNN had an overall accuracy of 92.83%. Measurements of epidermal/dermal thickness, wound depth, wound width, and % re-epithelialization were within 10% error when evaluated on six full wound sections from days 3, 5, and 10 post-wounding that were not included in the training set. The in vivo wound z-stack CNN had an overall accuracy of 89.66% and was able to isolate the wound edge epithelium in z-stacks from eight mice across post-wound time points to quantify the optical redox ratio within 5% of what was recorded by manual segmentations. CONCLUSION The CNNs trained and presented in this study can accurately segment MPM imaged wound sections and in vivo z-stacks to enable automated and rapid calculation of wound geometry and metabolism. Although MPM is a noninvasive imaging modality well suited to imaging living wound tissue, its use has been limited by time-intensive user segmentation. The use of CNNs for automated image segmentation demonstrate that it is possible for MPM to deliver near real-time quantitative readouts of tissue structure and function. Lasers Surg. Med. © 2021 Wiley Periodicals LLC.
Collapse
Affiliation(s)
- Jake D. Jones
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, AR, USA
| | - Marcos R. Rodriguez
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, AR, USA
| | - Kyle P. Quinn
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, AR, USA
| |
Collapse
|
16
|
Checa M, Millan-Solsona R, Mares AG, Pujals S, Gomila G. Fast Label-Free Nanoscale Composition Mapping of Eukaryotic Cells Via Scanning Dielectric Force Volume Microscopy and Machine Learning. SMALL METHODS 2021; 5:e2100279. [PMID: 34928004 DOI: 10.1002/smtd.202100279] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 04/28/2021] [Indexed: 06/14/2023]
Abstract
Mapping the biochemical composition of eukaryotic cells without the use of exogenous labels is a long-sought objective in cell biology. Recently, it has been shown that composition maps on dry single bacterial cells with nanoscale spatial resolution can be inferred from quantitative nanoscale dielectric constant maps obtained with the scanning dielectric microscope. Here, it is shown that this approach can also be applied to the much more challenging case of fixed and dry eukaryotic cells, which are highly heterogeneous and show micrometric topographic variations. More importantly, it is demonstrated that the main bottleneck of the technique (the long computation times required to extract the nanoscale dielectric constant maps) can be shortcut by using supervised neural networks, decreasing them from weeks to seconds in a wokstation computer. This easy-to-use data-driven approach opens the door for in situ and on-the-fly label free nanoscale composition mapping of eukaryotic cells with scanning dielectric microscopy.
Collapse
Affiliation(s)
- Martí Checa
- Nanoscale Bioelectrical Characterization Group, Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology (BIST), Carrer Baldiri i Reixac 11-15, Barcelona, 08028, Spain
| | - Ruben Millan-Solsona
- Nanoscale Bioelectrical Characterization Group, Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology (BIST), Carrer Baldiri i Reixac 11-15, Barcelona, 08028, Spain
- Departament d'Enginyeria Electrònica i Biomèdica, Universitat de Barcelona, Carrer Martí i Franquès 1, Barcelona, 08028, Spain
| | - Adrianna Glinkowska Mares
- Nanoscopy for Nanomedicine Group, Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology (BIST), Carrer Baldiri i Reixac 11-15, Barcelona, 08028, Spain
| | - Silvia Pujals
- Departament d'Enginyeria Electrònica i Biomèdica, Universitat de Barcelona, Carrer Martí i Franquès 1, Barcelona, 08028, Spain
- Nanoscopy for Nanomedicine Group, Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology (BIST), Carrer Baldiri i Reixac 11-15, Barcelona, 08028, Spain
| | - Gabriel Gomila
- Nanoscale Bioelectrical Characterization Group, Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology (BIST), Carrer Baldiri i Reixac 11-15, Barcelona, 08028, Spain
- Departament d'Enginyeria Electrònica i Biomèdica, Universitat de Barcelona, Carrer Martí i Franquès 1, Barcelona, 08028, Spain
| |
Collapse
|
17
|
The IL-10GFP (VeRT-X) mouse strain is not suitable for the detection of IL-10 production by granulocytes during lung inflammation. PLoS One 2021; 16:e0247895. [PMID: 33979348 PMCID: PMC8115804 DOI: 10.1371/journal.pone.0247895] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 04/27/2021] [Indexed: 11/19/2022] Open
Abstract
The clear and unequivocal identification of immune effector functions is essential to understand immune responses. The cytokine IL-10 is a critical immune regulator and was shown, for example, to limit pathology during various lung diseases. However, the clear identification of IL-10-producing cells is challenging and, therefore, reporter mouse lines were developed to facilitate their detection. Several such reporter lines utilize GFP, including the IL-10GFP (VeRT-X) reporter strain studied here. In line with previous reports, we found that this IL-10GFP line faithfully reports on the IL-10 production of lymphoid cells. However, we show that the IL-10GFP reporter is not suitable to analyse IL-10 production of myeloid cells during inflammation. During inflammation, the autofluorescence of myeloid cells increased to an extent that entirely masked the IL-10-specific GFP-signal. Our data illustrate a general and important technical caveat using GFP-reporter lines for the analysis of myeloid cells and suggest that previous reports on effector functions of myeloid cells using such GFP-based reporters might require re-evaluation.
Collapse
|
18
|
Belanger MC, Anbaei P, Dunn AF, Kinman AW, Pompano RR. Spatially Resolved Analytical Chemistry in Intact, Living Tissues. Anal Chem 2020; 92:15255-15262. [PMID: 33201681 PMCID: PMC7864589 DOI: 10.1021/acs.analchem.0c03625] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Tissues are an exciting frontier for bioanalytical chemistry, one in which spatial distribution is just as important as total content. Intact tissue preserves the native cellular and molecular organization and the cell-cell contacts found in vivo. Live tissue, in particular, offers the potential to analyze dynamic events in a spatially resolved manner, leading to fundamental biological insights and translational discoveries. In this Perspective, we provide a tutorial on the four fundamental challenges for the bioanalytical chemist working in living tissue samples as well as best practices for mitigating them. The challenges include (i) the complexity of the sample matrix, which contributes myriad interfering species and causes nonspecific binding of reagents; (ii) hindered delivery and mixing; (iii) the need to maintain physiological conditions; and (iv) tissue reactivity. This framework is relevant to a variety of methods for spatially resolved chemical analysis, including optical imaging, inserted sensors and probes such as electrodes, and surface analyses such as sensing arrays. The discussion focuses primarily on ex vivo tissues, though many considerations are relevant in vivo as well. Our goal is to convey the exciting potential of analytical chemistry to contribute to understanding the functions of live, intact tissues.
Collapse
Affiliation(s)
- Maura C. Belanger
- Department of Chemistry, University of Virginia, PO BOX 400319, Charlottesville, VA 22904
| | - Parastoo Anbaei
- Department of Chemistry, University of Virginia, PO BOX 400319, Charlottesville, VA 22904
| | - Austin F. Dunn
- Department of Chemistry, University of Virginia, PO BOX 400319, Charlottesville, VA 22904
| | - Andrew W.L. Kinman
- Department of Chemistry, University of Virginia, PO BOX 400319, Charlottesville, VA 22904
| | - Rebecca R. Pompano
- Department of Chemistry, University of Virginia, PO BOX 400319, Charlottesville, VA 22904
| |
Collapse
|
19
|
Fu Y, Liu X, Wang Y, He Y, Feng G, Wu H, Zheng C, Li P, Gan H. Miniaturized integrating sphere light sources based on LEDs for radiance responsivity calibration of optical imaging microscopes. OPTICS EXPRESS 2020; 28:32199-32213. [PMID: 33115182 DOI: 10.1364/oe.403899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 09/20/2020] [Indexed: 06/11/2023]
Abstract
LED-based integrating sphere light sources (LED-ISLSs) in the size of typical microscope slides were developed to calibrate the radiance responsivity of optical imaging microscopes. Each LED-ISLS consists of a miniaturized integrating sphere with a diameter of 4 mm, an LED chip integrated on a printed circuit board, and a thin circular aperture with a diameter of 1 mm as the exit port. The non-uniformity of the radiant exitance of the LED-ISLSs was evaluated to be 0.8%. The normal radiance of the LED-ISLSs in the range of (5∼69) W m-2 sr-1 was measured with a standard uncertainty of 1.3% using two precision apertures and a standard silicon photodetector whose spectral responsivity is traceable to an absolute cryogenic radiometer. The LED-ISLSs were applied to calibrate the radiance responsivity of a home-built optical imaging microscope with a standard uncertainty of 2.6∼2.9%. The LED-ISLSs offer a practical way to calibrate the radiance responsivity of various optical imaging microscopes for results comparison and information exchange.
Collapse
|
20
|
Regulatory T cells suppress Th17 cell Ca 2+ signaling in the spinal cord during murine autoimmune neuroinflammation. Proc Natl Acad Sci U S A 2020; 117:20088-20099. [PMID: 32732436 PMCID: PMC7443932 DOI: 10.1073/pnas.2006895117] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
T lymphocyte motility and interaction dynamics with other immune cells are vital determinants of immune responses. Regulatory T (Treg) cells prevent autoimmune disorders by suppressing excessive lymphocyte activity, but how interstitial motility patterns of Treg cells limit neuroinflammation is not well understood. We used two-photon microscopy to elucidate the spatial organization, motility characteristics, and interactions of endogenous Treg and Th17 cells together with antigen-presenting cells (APCs) within the spinal cord leptomeninges in experimental autoimmune encephalomyelitis (EAE), an animal model of multiple sclerosis. Th17 cells arrive before the onset of clinical symptoms, distribute uniformly during the peak, and decline in numbers during later stages of EAE. In contrast, Treg cells arrive after Th17 cells and persist during the chronic phase. Th17 cells meander widely, interact with APCs, and exhibit cytosolic Ca2+ transients and elevated basal Ca2+ levels before the arrival of Treg cells. In contrast, Treg cells adopt a confined, repetitive-scanning motility while contacting APCs. These locally confined but highly motile Treg cells limit Th17 cells from accessing APCs and suppress Th17 cell Ca2+ signaling by a mechanism that is upstream of store-operated Ca2+ entry. Finally, Treg cell depletion increases APC numbers in the spinal cord and exaggerates ongoing neuroinflammation. Our results point to fundamental differences in motility characteristics between Th17 and Treg cells in the inflamed spinal cord and reveal three potential cellular mechanisms by which Treg cells regulate Th17 cell effector functions: reduction of APC density, limiting access of Th17 cells to APCs, and suppression of Th17 Ca2+ signaling.
Collapse
|
21
|
Rakhymzhan A, Reuter L, Raspe R, Bremer D, Günther R, Leben R, Heidelin J, Andresen V, Cheremukhin S, Schulz-Hildebrandt H, Bixel MG, Adams RH, Radbruch H, Hüttmann G, Hauser AE, Niesner RA. Coregistered Spectral Optical Coherence Tomography and Two-Photon Microscopy for Multimodal Near-Instantaneous Deep-Tissue Imaging. Cytometry A 2020; 97:515-527. [PMID: 32293804 DOI: 10.1002/cyto.a.24012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/17/2020] [Accepted: 03/19/2020] [Indexed: 12/23/2022]
Abstract
Two-photon microscopy (2PM) has brought unique insight into the mechanisms underlying immune system dynamics and function since it enables monitoring of cellular motility and communication in complex systems within their genuine environment-the living organism. However, use of 2PM in clinical settings is limited. In contrast, optical coherence tomography (OCT), a noninvasive label-free diagnostic imaging method, which allows monitoring morphologic changes of large tissue regions in vivo, has found broad application in the clinic. Here we developed a combined multimodal technology to achieve near-instantaneous coregistered OCT, 2PM, and second harmonic generation (SHG) imaging over large volumes (up to 1,000 × 1,000 × 300 μm3 ) of tendons and other tissue compartments in mouse paws, as well as in mouse lymph nodes, spleens, and femurs. Using our multimodal imaging approach, we found differences in macrophage cell shape and motility behavior depending on whether they are located in tendons or in the surrounding tissue compartments of the mouse paw. The cellular shape of tissue-resident macrophages, indicative for their role in tissue, correlated with the supramolecular organization of collagen as revealed by SHG and OCT. Hence, the here-presented approach of coregistered OCT and 2PM has the potential to link specific cellular phenotypes and functions (as revealed by 2PM) to tissue morphology (as highlighted by OCT) and thus, to build a bridge between basic research knowledge and clinical observations. © 2020 The Authors. Cytometry Part A published by Wiley Periodicals, Inc. on behalf of International Society for Advancement of Cytometry.
Collapse
Affiliation(s)
- Asylkhan Rakhymzhan
- Biophysical Analytics, Deutsches Rheumaforschungszentrum (DRFZ), Berlin, Germany
| | - Lucie Reuter
- Biophysical Analytics, Deutsches Rheumaforschungszentrum (DRFZ), Berlin, Germany
| | - Raphael Raspe
- Immundynamics, Deutsches Rheumaforschungszentrum (DRFZ), Berlin, Germany.,Immundynamics and Intravital Microscopy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Daniel Bremer
- Biophysical Analytics, Deutsches Rheumaforschungszentrum (DRFZ), Berlin, Germany
| | - Robert Günther
- Biophysical Analytics, Deutsches Rheumaforschungszentrum (DRFZ), Berlin, Germany.,Immundynamics, Deutsches Rheumaforschungszentrum (DRFZ), Berlin, Germany
| | - Ruth Leben
- Biophysical Analytics, Deutsches Rheumaforschungszentrum (DRFZ), Berlin, Germany
| | - Judith Heidelin
- LaVision BioTec-A Miltenyi Biotec Company, Bielefeld, Germany
| | - Volker Andresen
- LaVision BioTec-A Miltenyi Biotec Company, Bielefeld, Germany
| | | | | | - Maria G Bixel
- Max-Plank-Institut for Molecular Biomedicine, Tissue Morphogenesis, Münster, Germany
| | - Ralf H Adams
- Max-Plank-Institut for Molecular Biomedicine, Tissue Morphogenesis, Münster, Germany
| | - Helena Radbruch
- Institute for Neuropathology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Gereon Hüttmann
- Institute of Biomedical Optics, University of Lübeck, Lübeck, Germany.,Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Lübeck, Germany
| | - Anja E Hauser
- Immundynamics, Deutsches Rheumaforschungszentrum (DRFZ), Berlin, Germany.,Immundynamics and Intravital Microscopy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Raluca A Niesner
- Biophysical Analytics, Deutsches Rheumaforschungszentrum (DRFZ), Berlin, Germany.,Dynamic and Functional in vivo Imaging, Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| |
Collapse
|
22
|
Bardet SM, Cortese J, Blanc R, Mounayer C, Rouchaud A. Multiphoton microscopy for pre-clinical evaluation of flow-diverter stents for treating aneurysms. J Neuroradiol 2020; 48:200-206. [PMID: 32205257 DOI: 10.1016/j.neurad.2020.03.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 03/09/2020] [Accepted: 03/10/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Conventional histological analyses are the gold standard for the study of aneurysms and vascular pathologies in pre-clinical research. Over the past decade, in vivo and ex vivo imaging using multiphoton microscopy have emerged as powerful pre-clinical tools for detailed tissue analyses that can assess morphology, the extracellular matrix (ECM), cell density and vascularisation. Multiphoton microscopy allows for deeper tissue penetration with minor phototoxicity. OBJECTIVE The present study aimed to demonstrate the current status of multimodality imaging, including multiphoton microscopy, for detailed analyses of neo-endothelialisation and ECM evolution after flow-diverter stent (FDS) treatment in an experimental rabbit model of aneurysms. METHODS Multiphoton microscopy tools for assessing autofluorescence and second harmonic generation (SHG) signals from biological tissues were used to evaluate the endovascular treatment of intracranial aneurysms in an animal model of aneurysms (pig, rabbit). Results from multiphoton microscopy were compared to those from standard histology, electronic and bright field microscopy. CONCLUSIONS The present study describes novel evaluation modes based on multiphoton microscopy for visualising tissue morphology (e.g., collagen, elastin, and cells) to qualify and quantify the extent of neo-intimal formation of covered arteries and device integration into the arterial wall using a rabbit model of intracranial aneurysms treated with FDS.
Collapse
Affiliation(s)
- Sylvia M Bardet
- University of Limoges, 123, avenue Albert-Thomas, XLIM UMR CNRS 7252, 87060 Limoges, France.
| | - Jonathan Cortese
- Bichat University Hospital, INSERM U1148-LVTS, Paris, France; Bicetre Hospital, Department of Interventional Neuroradiology, Paris, France
| | - Raphaël Blanc
- Department of Interventional Neuroradiology, Fondation Ophtalmologique Adolphe-de-Rothschild, Paris, France
| | - Charbel Mounayer
- University of Limoges, 123, avenue Albert-Thomas, XLIM UMR CNRS 7252, 87060 Limoges, France; University Hospital, Department of Interventional Neuroradiology, Limoges, France
| | - Aymeric Rouchaud
- University of Limoges, 123, avenue Albert-Thomas, XLIM UMR CNRS 7252, 87060 Limoges, France; University Hospital, Department of Interventional Neuroradiology, Limoges, France.
| |
Collapse
|
23
|
Nguyen WNT, Jacobsen EA, Finney CAM, Colarusso P, Patel KD. Intravital imaging of eosinophils: Unwrapping the enigma. J Leukoc Biol 2020; 108:83-91. [PMID: 32170880 DOI: 10.1002/jlb.3hr0220-396r] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 02/16/2020] [Accepted: 02/20/2020] [Indexed: 12/12/2022] Open
Abstract
Eosinophils are traditionally associated with allergic and parasitic inflammation. More recently, eosinophils have also been shown to have roles in diverse processes including development, intestinal health, thymic selection, and B-cell survival with the majority of these insights being derived from murine models and in vitro assays. Despite this, tools to measure the dynamic activity of eosinophils in situ have been lacking. Intravital microscopy is a powerful tool that enables direct visualization of leukocytes and their dynamic behavior in real-time in a wide range of processes in both health and disease. Until recently eosinophil researchers have not been able to take full advantage of this technology due to a lack of tools such as genetically encoded reporter mice. This mini-review examines the history of intravital microscopy with a focus on eosinophils. The development and use of eosinophil-specific Cre (EoCre) mice to create GFP and tdTomato fluorescent reporter animals is also described. Genetically encoded eosinophil reporter mice combined with intravital microscopy provide a powerful tool to add to the toolbox of technologies that will help us unravel the mysteries still surrounding this cell.
Collapse
Affiliation(s)
- William N T Nguyen
- Departments of Physiology and Pharmacology, University of Calgary, Calgary, Alberta, Canada
| | - Elizabeth A Jacobsen
- Division of Allergy and Clinical Immunology, Mayo Clinic Arizona, Scottsdale, Arizona, USA
| | - Constance A M Finney
- Department of Biological Sciences, Faculty of Science, University of Calgary, Calgary, Alberta, Canada
| | - Pina Colarusso
- Departments of Physiology and Pharmacology, University of Calgary, Calgary, Alberta, Canada
| | - Kamala D Patel
- Departments of Physiology and Pharmacology, University of Calgary, Calgary, Alberta, Canada.,Biochemistry and Molecular Biology, Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
24
|
Jones JD, Ramser HE, Woessner AE, Veves A, Quinn KP. Quantifying Age-Related Changes in Skin Wound Metabolism Using In Vivo Multiphoton Microscopy. Adv Wound Care (New Rochelle) 2020; 9:90-102. [PMID: 31993251 PMCID: PMC6985773 DOI: 10.1089/wound.2019.1030] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 07/28/2019] [Indexed: 12/27/2022] Open
Abstract
Objective: The elderly are at high risk for developing chronic skin wounds, but the effects of intrinsic aging on skin healing are difficult to isolate due to common comorbidities like diabetes. Our objective is to use multiphoton microscopy (MPM) to find endogenous, noninvasive biomarkers to differentiate changes in skin wound healing metabolism between young and aged mice in vivo. Approach: We utilized MPM to monitor skin metabolism at the edge of full-thickness, excisional wounds in 24- and 4-month-old mice of both sexes for 10 days. MPM can assess quantitative biomarkers of cellular metabolism in vivo by utilizing autofluorescence from the cofactors nicotinamide adenine dinucleotide (NADH) and flavin adenine dinucleotide (FAD). Results: An optical redox ratio of FAD/(NADH+FAD) autofluorescence and NADH fluorescence lifetime imaging revealed dynamic changes in keratinocyte function during healing. Aged female mice demonstrated an attenuation of keratinocyte proliferation during wound healing detectable optically through a higher redox ratio and longer NADH fluorescence lifetime. By measuring the correlation between NADH lifetime and the optical redox ratio at each day, we also demonstrate sensitivity to the proliferative phase of wound healing. Innovation: Label-free MPM was used to longitudinally monitor individual wounds in vivo, which revealed age-dependent differences in wound metabolism. Conclusion: These results indicate in vivo MPM can provide quantitative biomarkers of age-related delays in healing, which can be used in the future to provide patient-specific wound care.
Collapse
Affiliation(s)
- Jake D. Jones
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, Arkansas
| | - Hallie E. Ramser
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, Arkansas
| | - Alan E. Woessner
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, Arkansas
| | - Aristidis Veves
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Kyle P. Quinn
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, Arkansas
| |
Collapse
|
25
|
Park Y, Yoo J, Kang MH, Kwon W, Joo J. Photoluminescent and biodegradable porous silicon nanoparticles for biomedical imaging. J Mater Chem B 2019; 7:6271-6292. [DOI: 10.1039/c9tb01042d] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A set of unique properties including biodegradability, intrinsic photoluminescence, and mesoporous structure allows porous silicon nanoparticles to address current challenges of translational nanomedicine, especially in biomedical imaging.
Collapse
Affiliation(s)
- Yoonsang Park
- Department of Chemical Engineering
- Pohang University of Science and Technology (POSTECH)
- Pohang 37673
- Republic of Korea
| | - Jounghyun Yoo
- Department of Chemical Engineering
- Pohang University of Science and Technology (POSTECH)
- Pohang 37673
- Republic of Korea
| | - Myoung-Hee Kang
- Department of Biomedical Engineering
- School of Life Sciences
- Ulsan National Institute of Science and Technology (UNIST)
- Ulsan 44919
- Republic of Korea
| | - Woosung Kwon
- Department of Chemical and Biological Engineering
- Sookmyung Women's University
- Seoul 04310
- Republic of Korea
| | - Jinmyoung Joo
- Department of Biomedical Engineering
- School of Life Sciences
- Ulsan National Institute of Science and Technology (UNIST)
- Ulsan 44919
- Republic of Korea
| |
Collapse
|
26
|
Jones JD, Ramser HE, Woessner AE, Quinn KP. In vivo multiphoton microscopy detects longitudinal metabolic changes associated with delayed skin wound healing. Commun Biol 2018; 1:198. [PMID: 30480099 PMCID: PMC6242983 DOI: 10.1038/s42003-018-0206-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 10/26/2018] [Indexed: 01/08/2023] Open
Abstract
Chronic wounds are difficult to diagnose and characterize due to a lack of quantitative biomarkers. Label-free multiphoton microscopy has emerged as a useful imaging modality capable of quantifying changes in cellular metabolism using an optical redox ratio of FAD/(NADH+FAD) autofluorescence. However, the utility of an optical redox ratio for long-term in vivo monitoring of tissue metabolism has not been robustly evaluated. In this study, we demonstrate how multiphoton microscopy can be used to monitor changes in the metabolism of individual full-thickness skin wounds in vivo. 3D optical redox ratio maps and NADH fluorescence lifetime images identify differences between diabetic and control mice during the re-epithelialization of wounds. These metabolic changes are associated with a transient increase in keratinocyte proliferation at the wound edge. Our study demonstrates that high-resolution, non-invasive autofluorescence imaging can be performed in vivo and that optical redox ratios can serve as quantitative optical biomarkers of impaired wound healing.
Collapse
Affiliation(s)
- Jake D Jones
- Department of Biomedical Engineering, University of Arkansas, 123 John A. White Jr. Engineering Hall, Fayetteville, AR, 72701, USA
| | - Hallie E Ramser
- Department of Biomedical Engineering, University of Arkansas, 123 John A. White Jr. Engineering Hall, Fayetteville, AR, 72701, USA
| | - Alan E Woessner
- Department of Biomedical Engineering, University of Arkansas, 123 John A. White Jr. Engineering Hall, Fayetteville, AR, 72701, USA
| | - Kyle P Quinn
- Department of Biomedical Engineering, University of Arkansas, 123 John A. White Jr. Engineering Hall, Fayetteville, AR, 72701, USA.
| |
Collapse
|
27
|
Veres TZ. Visualizing immune responses of the airway mucosa. Cell Immunol 2018; 350:103865. [PMID: 30297084 DOI: 10.1016/j.cellimm.2018.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 05/03/2018] [Accepted: 10/01/2018] [Indexed: 12/19/2022]
Abstract
The airway mucosa is the primary tissue site exposed to inhaled particulate matter, which includes pathogens and allergens. While most inhaled particles are eliminated from the airways via mucociliary clearance, some pathogens may penetrate the mucosal epithelial barrier and an effective activation of the mucosal immune system is required to prevent further pathogen spread. Similarly, inhaled environmental allergens may induce an aberrant activation of immune cells in the airway mucosa, causing allergic airway disease. During the last years, several investigators employed advanced microscopic imaging on both intravital and tissue explant preparations to observe the dynamic behavior of various immune cells within their complex tissue environment. In the respiratory tract, most imaging studies focused on immune responses of the alveolar compartment in the lung periphery. However, equally important immunological events occur more proximally in the mucosa of the conducting airways, both during infection and allergic responses, calling for a more detailed imaging analysis also at this site. In this review, I will outline the technical challenges of designing microscopic imaging experiments in the conducting airways and summarize our recent efforts in understanding airway mucosal immune cell dynamics in steady-state conditions, during infection and allergy.
Collapse
Affiliation(s)
- Tibor Z Veres
- Lymphocyte Biology Section, Laboratory of Immune System Biology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, United States; MediCity Research Laboratory, University of Turku, Turku 20520, Finland.
| |
Collapse
|
28
|
Schaefer PM, Kalinina S, Rueck A, von Arnim CAF, von Einem B. NADH Autofluorescence-A Marker on its Way to Boost Bioenergetic Research. Cytometry A 2018; 95:34-46. [PMID: 30211978 DOI: 10.1002/cyto.a.23597] [Citation(s) in RCA: 107] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 07/20/2018] [Accepted: 08/04/2018] [Indexed: 12/20/2022]
Abstract
More than 60 years ago, the idea was introduced that NADH autofluorescence could be used as a marker of cellular redox state and indirectly also of cellular energy metabolism. Fluorescence lifetime imaging microscopy of NADH autofluorescence offers a marker-free readout of the mitochondrial function of cells in their natural microenvironment and allows different pools of NADH to be distinguished within a cell. Despite its many advantages in terms of spatial resolution and in vivo applicability, this technique still requires improvement in order to be fully useful in bioenergetics research. In the present review, we give a summary of technical and biological challenges that have so far limited the spread of this powerful technology. To help overcome these challenges, we provide a comprehensible overview of biological applications of NADH imaging, along with a detailed summary of valid imaging approaches that may be used to tackle many biological questions. This review is meant to provide all scientists interested in bioenergetics with support on how to embed successfully NADH imaging in their research. © 2018 International Society for Advancement of Cytometry.
Collapse
Affiliation(s)
| | - Sviatlana Kalinina
- Core Facility Confocal and Multiphoton Microscopy, Ulm University, Ulm, Germany
| | - Angelika Rueck
- Core Facility Confocal and Multiphoton Microscopy, Ulm University, Ulm, Germany
| | - Christine A F von Arnim
- Department of Neurology, Ulm University, Ulm, Germany.,Clinic for Neurogeriatrics and Neurological Rehabilitation, University- and Rehabilitation Hospital Ulm, Ulm, Germany
| | | |
Collapse
|
29
|
Imaging of Murine Whole Lung Fibrosis by Large Scale 3D Microscopy aided by Tissue Optical Clearing. Sci Rep 2018; 8:13348. [PMID: 30190498 PMCID: PMC6127188 DOI: 10.1038/s41598-018-31182-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 07/31/2018] [Indexed: 12/28/2022] Open
Abstract
Pulmonary fibrosis, characterized by excessive collagen deposition in the lungs, comprises a key and debilitating component of chronic lung diseases. Methods are lacking for the direct visualization of fibrillar collagen throughout the whole murine lung, a capability that would aid the understanding of lung fibrosis. We combined an optimized organ-level optical clearing (OC) approach with large-scale, label-free multiphoton microscopy (MPM) and second harmonic generation microscopy (SHGM) to reveal the complete network of fibrillar collagen in whole murine lungs. An innate inflammation-driven model based on repetitive poly(I:C) challenge was evaluated. Following OC, mosaic MPM/SHGM imaging with 3D reconstruction and whole organ quantitative analysis revealed significant differences in collagen deposition between PBS and poly(I:C) treated lungs. Airway specific analysis in whole lung acquisitions revealed significant sub-epithelial fibrosis evident throughout the proximal conductive and distal airways with higher collagen deposition in the poly(I:C) group vs PBS group. This study establishes a new, powerful approach based on OC and MPM/SHGM imaging for 3D analysis of lung fibrosis with macroscopic views of lung pathology based on microscopy and providing a new way to analyze the whole lung while avoiding regional sampling bias.
Collapse
|
30
|
Palomino-Segura M, Virgilio T, Morone D, Pizzagalli DU, Gonzalez SF. Imaging Cell Interaction in Tracheal Mucosa During Influenza Virus Infection Using Two-photon Intravital Microscopy. J Vis Exp 2018:58355. [PMID: 30176018 PMCID: PMC6128112 DOI: 10.3791/58355] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
The analysis of cell-cell or cell-pathogen interaction in vivo is an important tool to understand the dynamics of the immune response to infection. Two-photon intravital microscopy (2P-IVM) allows the observation of cell interactions in deep tissue in living animals, while minimizing the photobleaching generated during image acquisition. To date, different models for 2P-IVM of lymphoid and non-lymphoid organs have been described. However, imaging of respiratory organs remains a challenge due to the movement associated with the breathing cycle of the animal. Here, we describe a protocol to visualize in vivo immune cell interactions in the trachea of mice infected with influenza virus using 2P-IVM. To this purpose, we developed a custom imaging platform, which included the surgical exposure and intubation of the trachea, followed by the acquisition of dynamic images of neutrophils and dendritic cells (DC) in the mucosal epithelium. Additionally, we detailed the steps needed to perform influenza intranasal infection and flow cytometric analysis of immune cells in the trachea. Finally, we analyzed neutrophil and DC motility as well as their interactions during the course of a movie. This protocol allows for the generation of stable and bright 4D images necessary for the assessment of cell-cell interactions in the trachea.
Collapse
Affiliation(s)
- Miguel Palomino-Segura
- Faculty of Biomedical Sciences, Institute for Research in Biomedicine, Università della Svizzera italiana (USI); Graduate School of Cellular and Molecular Sciences, Faculty of Medicine, University of Bern
| | - Tommaso Virgilio
- Faculty of Biomedical Sciences, Institute for Research in Biomedicine, Università della Svizzera italiana (USI); Graduate School of Cellular and Molecular Sciences, Faculty of Medicine, University of Bern
| | - Diego Morone
- Faculty of Biomedical Sciences, Institute for Research in Biomedicine, Università della Svizzera italiana (USI)
| | - Diego U Pizzagalli
- Faculty of Biomedical Sciences, Institute for Research in Biomedicine, Università della Svizzera italiana (USI); Institute of Computational Science, Università della Svizzera italiana (USI)
| | - Santiago F Gonzalez
- Faculty of Biomedical Sciences, Institute for Research in Biomedicine, Università della Svizzera italiana (USI);
| |
Collapse
|
31
|
Bhattacharjee S, Satwaha S, Thornton K, Scholz D. Label-Free Imaging and Optical Characterization of Tissues Based on Autofluorescence. ACS OMEGA 2018; 3:5926-5930. [PMID: 30023932 PMCID: PMC6044981 DOI: 10.1021/acsomega.8b00678] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Accepted: 05/23/2018] [Indexed: 06/08/2023]
Abstract
Attaining capability of label-free optical characterization of tissues will offer methodological advancement and possibilities for early clinical detection, which is of paramount importance in treating patients under clinical setups, for example, cancer. Here, we demonstrate the potential of autofluorescence exhibited by tissues as an enabling microscopic strategy to achieve high-resolution imagery data offering a wealth of clinically relevant information including possibility of three-dimensional rendering. Furthermore, we elucidate the use of analytic tools to extract numerical read-outs from such data with further implications in histopathology, pharmaceutics, toxicology, and screening purposes. This study summarizes the results obtained through a systematic autofluorescence-based investigation on murine and porcine gut tissues with an example of applying the technique in nanotoxicology. The study provides with a methodological roadmap toward developing a fast, effective, and robust platform enabling in-depth optical characterization of tissues.
Collapse
Affiliation(s)
- Sourav Bhattacharjee
- School of Veterinary Medicine and Conway Institute of Biomolecular
and Biomedical
Research, University College Dublin (UCD), Belfield, Dublin 4, Ireland
| | - Simran Satwaha
- School
of Life Sciences, Pharmacy and Chemistry, Kingston University, London, U.K.
| | - Kevin Thornton
- School of Veterinary Medicine and Conway Institute of Biomolecular
and Biomedical
Research, University College Dublin (UCD), Belfield, Dublin 4, Ireland
| | - Dimitri Scholz
- School of Veterinary Medicine and Conway Institute of Biomolecular
and Biomedical
Research, University College Dublin (UCD), Belfield, Dublin 4, Ireland
| |
Collapse
|
32
|
Sorensen EW, Lian J, Ozga AJ, Miyabe Y, Ji SW, Bromley SK, Mempel TR, Luster AD. CXCL10 stabilizes T cell-brain endothelial cell adhesion leading to the induction of cerebral malaria. JCI Insight 2018; 3:98911. [PMID: 29669942 PMCID: PMC5931132 DOI: 10.1172/jci.insight.98911] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 03/14/2018] [Indexed: 01/12/2023] Open
Abstract
Malaria remains one of the world's most significant human infectious diseases and cerebral malaria (CM) is its most deadly complication. CM pathogenesis remains incompletely understood, hindering the development of therapeutics to prevent this lethal complication. Elevated levels of the chemokine CXCL10 are a biomarker for CM, and CXCL10 and its receptor CXCR3 are required for experimental CM (ECM) in mice, but their role has remained unclear. Using multiphoton intravital microscopy, CXCR3 receptor- and ligand-deficient mice and bone marrow chimeric mice, we demonstrate a key role for endothelial cell-produced CXCL10 in inducing the firm adhesion of T cells and preventing their cell detachment from the brain vasculature. Using a CXCL9 and CXCL10 dual-CXCR3-ligand reporter mouse, we found that CXCL10 was strongly induced in the brain endothelium as early as 4 days after infection, while CXCL9 and CXCL10 expression was found in inflammatory monocytes and monocyte-derived DCs within the blood vasculature on day 8. The induction of both CXCL9 and CXCL10 was completely dependent on IFN-γ receptor signaling. These data demonstrate that IFN-γ-induced, endothelium-derived CXCL10 plays a critical role in mediating the T cell-endothelial cell adhesive events that initiate the inflammatory cascade that injures the endothelium and induces the development of ECM.
Collapse
|
33
|
Kretschmer S, Pieper M, Klinger A, Hüttmann G, König P. Imaging of Wound Closure of Small Epithelial Lesions in the Mouse Trachea. THE AMERICAN JOURNAL OF PATHOLOGY 2017; 187:2451-2460. [DOI: 10.1016/j.ajpath.2017.07.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 06/26/2017] [Accepted: 07/13/2017] [Indexed: 12/28/2022]
|
34
|
Intubation-free in vivo imaging of the tracheal mucosa using two-photon microscopy. Sci Rep 2017; 7:694. [PMID: 28386104 PMCID: PMC5429620 DOI: 10.1038/s41598-017-00769-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 03/09/2017] [Indexed: 01/08/2023] Open
Abstract
The mucosal layer of conducting airways is the primary tissue exposed to inhaled microorganisms, allergens and pollutants. We developed an in vivo two-photon microscopic approach that allows performing dynamic imaging studies in the mouse trachea, which is a commonly used in vivo model of human small-diameter bronchi. By providing stabilized access to the tracheal mucosa without intubation, our setup uniquely allows dynamic in vivo imaging of mucociliary clearance and steady-state immune cell behavior within the complex airway mucosal tissue.
Collapse
|
35
|
Hocke AC, Suttorp N, Hippenstiel S. Human lung ex vivo infection models. Cell Tissue Res 2016; 367:511-524. [PMID: 27999962 PMCID: PMC7087833 DOI: 10.1007/s00441-016-2546-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 11/24/2016] [Indexed: 12/21/2022]
Abstract
Pneumonia is counted among the leading causes of death worldwide. Viruses, bacteria and pathogen-related molecules interact with cells present in the human alveolus by numerous, yet poorly understood ways. Traditional cell culture models little reflect the cellular composition, matrix complexity and three-dimensional architecture of the human lung. Integrative animal models suffer from species differences, which are of particular importance for the investigation of zoonotic lung diseases. The use of cultured ex vivo infected human lung tissue may overcome some of these limitations and complement traditional models. The present review gives an overview of common bacterial lung infections, such as pneumococcal infection and of widely neglected pathogens modeled in ex vivo infected lung tissue. The role of ex vivo infected lung tissue for the investigation of emerging viral zoonosis including influenza A virus and Middle East respiratory syndrome coronavirus is discussed. Finally, further directions for the elaboration of such models are revealed. Overall, the introduced models represent meaningful and robust methods to investigate principles of pathogen-host interaction in original human lung tissue.
Collapse
Affiliation(s)
- Andreas C Hocke
- Department of Internal Medicine/Infectious Diseases and Pulmonary Medicine, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Norbert Suttorp
- Department of Internal Medicine/Infectious Diseases and Pulmonary Medicine, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Stefan Hippenstiel
- Department of Internal Medicine/Infectious Diseases and Pulmonary Medicine, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
| |
Collapse
|