This protocol describes a method for morphometric analysis of neuromuscular junctions by combined confocal and STED microscopy that is used to quantify pathological changes in mouse models of SMA and ColQ-related CMS.
Neuromuscular junctions (NMJs) are highly specialized synapses between lower motor neurons and skeletal muscle fibers that play an essential role in the transmission of molecules from the nervous system to voluntary muscles, leading to contraction. They are affected in many human diseases, including inherited neuromuscular disorders such as Duchenne muscular dystrophy (DMD), congenital myasthenic syndromes (CMS), spinal muscular atrophy (SMA), and amyotrophic lateral sclerosis (ALS). Therefore, monitoring the morphology of neuromuscular junctions and their alterations in disease mouse models represents a valuable tool for pathological studies and preclinical assessment of therapeutic approaches. Here, methods for labeling and analyzing the three-dimensional (3D) morphology of the pre- and postsynaptic parts of motor endplates from murine teased muscle fibers are described. The procedures to prepare samples and measure NMJ volume, area, tortuosity and axon terminal morphology/occupancy by confocal imaging, and the distance between postsynaptic junctional folds and acetylcholine receptor (AChR) stripe width by super-resolution stimulated emission depletion (STED) microscopy are detailed. Alterations in these NMJ parameters are illustrated in mutant mice affected by SMA and CMS.
The neuromuscular junction (NMJ) is a complex structure composed of a motor axon terminal, a perisynaptic Schwann cell, and a skeletal myofiber portion involved in the transmission of chemical information and coupling of lower motor neuron activity to muscle contraction. In mammals, the morphology of the neuromuscular junction changes during development, adopting a typical pretzel-like shape after maturation, with differences in shape and complexity between species, and shows some degree of plasticity in response to physiological processes such as exercise or aging1,2,3,4. The postsynaptic motor endplate forms membrane invaginations named junctional folds, where the upper part containing acetylcholine receptors (AChR) is in close contact with the presynaptic terminal axon branch5.
Morphological and functional changes in neuromuscular junctions contribute to the pathophysiology of several neurodegenerative disorders such as spinal muscular atrophy (SMA) and amyotrophic lateral sclerosis (ALS), myopathies like Duchenne muscular dystrophy (DMD), congenital myasthenic syndromes (CMS), myasthenia gravis (MG) and centronuclear myopathies (CNM), and aging-associated sarcopenia3,6,7,8,9,10,11,12. In these diseases, NMJ structural alterations such as endplate fragmentation, reduced postsynaptic junctional fold size and/or denervation are observed. The pathology of NMJs can be a primary or early event during disease progression or appear more lately as a secondary event contributing to the clinical manifestations. In any case, monitoring the morphology of NMJs in animal models of these diseases represents a valuable parameter to study pathological changes and assess the efficacy of potential treatments.
The morphology of neuromuscular junctions is usually analyzed by techniques using confocal microscopy2,13,14,15 or electron microscopy5,16, with their inherent limitations such as resolution or technical difficulties, respectively. More recently, super-resolution microscopy was also used to visualize particular regions of the NMJ, such as presynaptic active zones or AChR distribution on the postsynaptic membrane16,17,18, as an alternative or complementary approach to ultrastructural analysis by electron microscopy.
This protocol aims to provide a detailed and reproducible method to assess NMJ morphological parameters by combining fluorescence confocal and stimulated emission depletion (STED) microscopy. Important features of the presynaptic and postsynaptic endplates, such as volume, area, relative tortuosity, AChR stripe width, and axon terminal distribution in innervated teased muscle fibers of mouse gastrocnemius and tibialis anterior were quantified in the context of normal and diseased conditions. In particular, NMJ defects were exemplified in the Smn2B/- mouse model of spinal muscular atrophy, a neuromuscular disease with motor neuron degeneration caused by mutations in the SMN1 gene11,19, and in a collagen-like tail subunit of asymmetric acetylcholinesterase knockout (ColQDex2/Dex2 or ColQ-KO) mice, as a model of the congenital myasthenic syndrome20,21,22.
Care and manipulation of mice were performed according to national and European legislation on animal experimentation and approved by the institutional ethical committee. Males and females of Smn2B/- (C57Bl/6J background) and ColQDex2/Dex2 (B6D2F1/J background) mice at 3- and 6-weeks of age, respectively, were used in the study.
1. Euthanasia of mice and dissection of muscles: tibialis anterior and gastrocnemius
2. Immunostaining
3. Image acquisition
4. Image analysis- confocal microscopy
NOTE: All images were processed with computers using Microsoft Windows 10 professional operating system.
5. Image analysis- STED microscopy
NOTE: Image processing was performed with the offline software of the STED microscope manufacturer.
6. Experimental design and statistical tests
In order to facilitate the morphological analysis of neuromuscular junctions at the pre- and postsynaptic level in a reproducible manner, a workflow was developed from muscle harvesting to imaging and quantification using the microscope software and ImageJ custom macros (Figure 1). To exemplify the utility of this protocol, the morphology of NMJs in two mouse models of genetic disorders, Smn2B/- and ColQDex2/Dex2 mice affected by spinal muscular atrophy (SMA) and a congenital myasthenic syndrome (CMS) form, respectively, were evaluated and data were compared to age-matched control littermates.
The NMJ structure was assessed from tibialis anterior and gastrocnemius muscles of 3- and 6-week-old Smn2B/- (C57Bl/6 background) and ColQDex2/Dex2 (B6D2F1/J background) mice, respectively, when signs of the disease are already present in these animals. At 3 weeks of age, Smn2B/- mice show signs of delayed skeletal muscle development and denervation, such as NMJ atrophy and loss35,36. CMS mice have a primary pathology in NMJs and manifest a reduction in body weight from the first week of life and marked muscle weakness20 (data not shown). As shown in Figure 2A, the postsynaptic motor endplate labeled with fluorescent α-bungarotoxin appeared smaller and/or fragmented in mutants of the two mouse lines by confocal microscopy. Quantification of NMJ Z-stacks using this customized ImageJ macros revealed marked decreases in endplate volume, maximum intensity projection (MIP), and relative tortuosity in both SMA and CMS mice compared to controls, as signs of NMJ maturation defects32 (Figure 2B–D). Postsynaptic endplate volume and MIP were decreased in diseased animals (fold-change of 2.7 and 2.0 for volume, and 2.5 and 2.0 for MIP, in Smn2B/- and ColQDex2/Dex2 mice, respectively). The relative tortuosity was also smaller in SMN and ColQ deficient muscles than WT (16.97% ± 1.33% in SMA versus 48.84% ± 5.90% WT mice, and 13.29% ± 2.79% in CMS versus 30.20% ± 4.44% control mice). In addition, the quantification of the distribution of presynaptic axon terminal branches using the ImageJ custom macro revealed an altered pattern in neurofilament M distribution in the two animal models, with increased immunolabelling (84.65% ± 0.32% versus 16.57% ± 2.03% and 23.64% ± 2.78% versus 18.77% ± 1.73% in Smn2B/- and ColQDex2/Dex2 mice compared to controls, respectively) (Figure 3A-D). By SV2 staining, a 43% reduction in the occupancy ratio, i.e., percent of AChR-containing regions with adjacent nerve terminal active zones, was also observed in Smn2B/- mice (49.36% ± 3.76% in SMA versus 85.69% ± 2.34% WT mice) (Figure 3E,F). This NMJ parameter was also calculated in GA of ColQDex2/Dex2 mutants, but no statistically significant difference was found compared to control littermates (data not shown).
We further analyzed postsynaptic membrane characteristics by quantifying the distance between junctional folds and the width of AChR stripes, which are located at the crest of these folds, in ColQ-deficient muscle using super-resolution stimulated emission depletion (STED) microscopy. As shown in Figure 4, the aspect of these structures can be clearly visualized by fluorescent α-bungarotoxin labeling and intensity profile analysis. We evaluated these NMJ parameters and found an increase in the junctional fold distance (d) and width (w) of AChR stripes in the gastrocnemius muscle of mutants (358.3 nm ± 11.97 nm and 320.8 nm ± 10.90 nm for the distance, and 216.9 nm ± 10.51 nm and 186.3 nm ± 7.015 nm for the width, in ColQDex2/Dex2 as compared to wild-type mice, respectively, p < 0.05) (Figure 4C,D).
Figure 1: Flowchart of the video protocol for 3D multiscale NMJ characterization by confocal and STED microscopy. Tibialis anterior (TA) and gastrocnemius (GA) muscles were collected from mice, and muscle fibers were teased before labeling with α-bungarotoxin-F488 or α-bungarotoxin-F633, DAPI, primary antibodies directed against neurofilament M (NF-M) and synaptic vesicle glycoprotein 2 (SV2), and fluorophore (F488 or F594)-conjugated secondary antibodies. Image stacks were acquired by confocal microscopy and processed to measure postsynaptic NMJ volume, presynaptic NF-M accumulation, NMJ axon terminal occupancy, postsynaptic maximum intensity projection (MIP) endplate area, and tortuosity (dObj(AB) is the distance between A and B along the perimeter of the object (red line), whereas dEuc(AB) is the Euclidian distance between A and B (green line)). For STED microscopy analysis, the width of acetylcholine receptor (AChR) stripes and the distance between junctional folds were quantified from intensity profiles of α-BTX-F633 staining. Please click here to view a larger version of this figure.
Figure 2: Multi-parameter postsynaptic NMJ characterization in mouse models of spinal muscular atrophy (SMA) and ColQ-related congenital myasthenic syndrome (CMS). (A) Representative images of postsynaptic motor endplates from TA and GA muscles labeled with α-bungarotoxin-F488 (α-BTX). (B) Quantification of NMJ postsynaptic endplate volume, (C) maximal intensity projection (MIP) area and (D) relative tortuosity in TA of 3 week-old wild-type (WT) and Smn2B/- mice (left graphs, N = 3 animals per genotype, n = 37 and n = 56 NMJs, respectively) and 6 week-old WT and ColQDex2/Dex2 mice (right graphs, N = 5 mice per genotype, n = 89 and n = 97 NMJs, respectively). Data are expressed as the mean per mouse (dot) ± SEM. Differences between groups were analyzed by Mann-Whitney test (* p < 0.05). Scale bar is 10 µm. Please click here to view a larger version of this figure.
Figure 3: Morphometric analysis of presynaptic axon terminal distribution in muscles of WT and mutant mice. NMJ innervation pattern in tibialis anterior (TA) and gastrocnemius (GA) muscles of wild-type, SMA and ColQ-related CMS mice. (A, B) Representative neuromuscular junctions from TA of WT and Smn2B/- mice at 21 days of age labeled with antibodies against neurofilament M (NF-M, red) and α-bungarotoxin-F488 (α-BTX, green) (A), and results from quantitative analysis of neurofilament accumulation (B); (C, D) Representative neuromuscular junctions from GA of 6 week-old WT and ColQDex2/Dex2 mice labeled with antibodies against neurofilament M (NF-M, red) and α-bungarotoxin-F488 (α-BTX, green), showing fragmented and immature postsynaptic endplates (C), and results of neurofilament accumulation in the two groups of animals (D). N= 4 (n = 34 NMJs) (B) and N = 3 (n = 54 NMJs) (D) WT animals, and N=3 (n = 36 NMJs) Smn2B/- and N = 3 (n = 55 NMJs) ColQDex2/Dex2 mice were analyzed in the experiments (B, D). (E, F) Representative images of axon terminal occupancy in NMJs from TA of 3 week-old WT and Smn2B/- mice labeled with antibodies against synaptic vesicle glycoprotein 2 (SV2, red) and α-bungarotoxin-F488 (α-BTX, green) (E), and results of NMJ occupancy (SV2/AChR volume ratio) (F). Muscles from N = 3 (n = 50 NMJs) wild-type and N = 4 (n = 62 NMJs) Smn2B/- mice were analyzed. Data are expressed as the mean value per mouse (dot) ± SEM. Differences between groups were analyzed by Mann-Whitney test (* p < 0.05). Scale bars are 20 µm. Please click here to view a larger version of this figure.
Figure 4: STED imaging of NMJ postsynaptic endplates. (A) Representative STED image of a NMJ labeled with α-bungarotoxin-F633 (α-BTX) from gastrocnemius of a 6 week-old wild-type mouse showing postjunctional AChR stripes (scale bar is 5 µm). (B) Higher magnification of a region with AChR stripes (bottom panel) that was used to generate the intensity profile. The width (w) of AChR stripes and the distance between two adjacent stripes (d) of this region were quantified and presented in the bar graph. Schematic representation of the postsynaptic endplate to illustrate AChR stripe width (w) and distance (d). These parameters, (C) AChR stripe distance and (D) width, were measured in ColQDex2/Dex2 mice and control littermates at 6 weeks of age. NMJs from 5 WT (total n = 29 NMJs) and 6 ColQDex2/Dex2 (total n = 43 NMJs) animals were analyzed blindly. Data are expressed as the mean per mouse (dot) ± SEM. Statistical differences between groups were analyzed by using the Mann-Whitney test (* p < 0.05). Please click here to view a larger version of this figure.
Supplemental Figure 1: Launch of LAS X software and parameters for confocal acquisitions. The various steps to acquire confocal images are described in sections 3.1.2 to 3.1.7 of the protocol. For each NMJ stack acquisition, a project is opened (step 3.1.4) and the parameters of image size, acquisition speed, X, Y and Z axes are selected (step 3.1.7), with each sequential scan indicated (Seq.1, laser 405 for DAPI; Seq.2, laser 488 for α-BTX-F488; and Seq.3, laser 552 for F594 conjugated secondary antibodies). Please click here to download this File.
Supplemental Figure 2: Launch of LAS X software and parameters for STED acquisitions. The steps to acquire STED images are described in sections 3.2.2 to 3.2.8 of the protocol. The microscope is launched in configuration mode STED ON (step 3.2.2), and a project is opened (step 3.2.3). The parameters for image acquisition (step 3.2.7) (image size, acquisition speed, Zoom factor, X axis), with each sequential scan are indicated (Seq.1 for α-BTX-F633; Seq.2 for F488 conjugated secondary antibodies). Please click here to download this File.
Supplemental Figure 3: Images of α-BTX-stained junctional folds obtained by STED microscopy. Image examples of a postsynaptic endplate labeled with α-BTX-F633 from a 6 week-old wild-type mouse that were acquired with either a correct (left) or incorrect focus (right). Please click here to download this File.
Supplemental Figure 4: Windows pop-ups to describe the input and output data obtained by the custom ImageJ macros. Input data examples (.tif and .lif files) of NMJ images are shown on the left column. The output data from the macros (right column) are saved in folders (Save_Volume, Save_Accu) that contain images of the junction (.tif) and datasheets containing the results (.csv files). Please click here to download this File.
Supplemental Figure 5: AChR stripe distance and width analysis from a STED acquisition using the LAS X software. The steps to analyze NMJ STED images are described in section 5 of the protocol. A) Image of a labeled postsynaptic endplate region containing AChR stripes. The region of interest for stripe analysis is selected by drawing a perpendicular line (green line, for stripe distance), or a perpendicular rectangle (purple rectangle, for stripe width). (B, C) Intensity profiles of the selected regions and measurements to calculate the distance between AChR stripes (B) and the AChR stripe width (C) are shown. Please click here to download this File.
Supplementary Coding File 1: Macro_NMJ_VOL_Marinelloetal. ImageJ custom macro to extract NMJ parameter measurements (NMJ volume, MIP endplate area, and NMJ tortuosity). Please click here to download this File.
Supplementary Coding File 2: Macro_NMJ_ACCU_Marinelloetal. ImageJ custom macro to extract NF-M accumulation and SV2 staining. Please click here to download this File.
The described video protocol provides a detailed method to quantify the 3D structure of neuromuscular junctions by combining confocal and STED microscopy that can be used to characterize pathological changes at the pre- and postsynaptic levels. The high resolution of STED microscopy allows visualization and morphometric analysis of nanostructures that are not identifiable by conventional confocal imaging. This procedure enabled us to measure structural alterations of NMJs in two appendicular muscles, tibialis anterior and gastrocnemius, of SMA and ColQ-related CMS mice.
To obtain reliable results with this technique, it is critical to dissect and tease muscles properly, paying particular attention to the fascia surrounding the muscle and the applied strength to separate muscle bundles; otherwise, the innervation pattern could be disrupted impeding proper presynaptic NMJ assessment. Although detailed information is provided to analyze NMJs from TA and GA, in principle, this protocol could be adapted to other muscles, including flat muscles, such as the diaphragm or transverse abdominis37, which do not require the teasing step. Tissue fixation is also crucial to ensure good quality staining; therefore, it is recommended to use high-quality PFA at an appropriate volume (15-20 times that of the muscle). In addition, the exposure time to the fixative is an important step because artifacts, such as shrinkage and clumping, may appear due to over-fixation and influence NMJ features. Given the size of the samples and the penetration rate of the paraformaldehyde solution in tissues38, a fixation time of 18-24 h is recommended for this type of muscle. In case the staining step is planned more than a week after tissue harvesting, it is suggested to keep PFA-fixed muscles in PBS supplemented with sodium azide at 4 °C to prevent bacterial proliferation.
This protocol presents an approach using α-BTX-F488 for confocal and α-BTX-F633 for STED imaging. These fluorophores were chosen to fit with the described experimental design but can be modified according to the available equipment and materials. For instance, α-BTX F488 labeling can be selected when using a STED CW 592 nm laser for image acquisitions and quantification. However, it appears that the configuration that was applied in the present study (pulsed excitation gated STED, 775 nm depletion) exhibits higher performance and better resolution than other approaches, such as continuous wave STED39, making it more suitable for the current application. It is also important to select carefully the laser power settings, especially for STED (both excitation and depletion), since the characteristics of an intensity profile cannot be measured in case of saturation, and therefore any saturated signal in a NMJ image could jeopardize the whole analysis.
This detailed workflow, including image acquisitions and analysis using microscope software and ImageJ macros, was developed to facilitate autonomous NMJ morphometric analysis by confocal and STED microscopy from a single muscle. Previously described workflows for NMJ confocal analysis, such as NMJ-morph2 or NMJ-Analyser14, paved the way for the design of semi-automatic methods that facilitate morphological analysis of NMJs and comparative studies. NMJ-morph (and its updated version aNMJ-morph15) is a free ImageJ-based platform that uses the maximal intensity projection to measure 21 morphological features, and NMJ-Analyser uses a script developed in Python that generates 29 relevant parameters from the entire 3D NMJ structure. Manual thresholding is the only step during image processing in these two methods that require user analysis. This integrated protocol details steps for tissue preparation, 3D confocal image acquisitions, and ImageJ-based processing of NMJs from entire skeletal muscles and provides a simplified overview of five important parameters of the postsynaptic (volume, maximal projection area, and tortuosity) and presynaptic (axon terminal occupancy and neurofilament accumulation) endplates. An additional parameter of biological relevance, the AChR organization pattern of the postsynaptic junctional folds, was incorporated for morphometric analysis at the nanoscale level by super-resolution STED microscopy (resolution 20-30 nm)40. Interestingly, tissue preparation for STED imaging is simpler than other methods used for NMJ ultrastructural studies, such as conventional transmission electron microscopy (TEM)9, which is a rather complex and time-consuming procedure that requires a skilled manipulator in order to obtain ultrathin sections of the appropriate muscle region. In addition, quantitative data from multiple junctional folds can be obtained automatically by using the STED-associated software.
This protocol was applied to illustrate previously known NMJs defects in SMN and ColQ deficient muscles20,36,41,42. Common changes were found in the two mouse models by confocal microscopy, such as decreased postsynaptic endplate volume, MIP area, and relative tortuosity, and increased neurofilament accumulation, whereas some more specific findings (decreased NMJ occupancy), were observed only in SMA mice, as an indicator of impaired vesicles trafficking36. Finally, an increase in AChR stripe distance and width were detected in ColQ-KO by STED analysis, which are signs of ultrastructural defects in the postsynaptic junctional folds, as previously observed by TEM20. Importantly, this protocol may help in a more in-depth morphological characterization of neuromuscular junctions during development, maintenance, and under various pathological conditions.
The authors have nothing to disclose.
We thank Genethon's "Imaging and Cytometry Core Facility", as well as the histology service, which are supported in part by equipment funds from the Region Ile-de-France, the Conseil General de l'Essonne, the Genopole Recherche of Evry, the University of Evry Val d'Essonne and the INSERM, France. We are also grateful to Dr. Rashmi Kothary for providing the Smn2B/2B mouse line (University of Ottawa, Canada) and Dr. Eric Krejci for the ColQDex2/+ mouse line (unpublished, University of Paris, France). We thank Guillaume Corre for his support in statistical analysis. The 2H3 (developed by Jessel, T.M. and Dodd, J.) and SV2 (developed by Buckley, K.M.) monoclonal antibodies were obtained from the Developmental Studies Hybridoma Bank (DSHB), created by the NICHD of the NIH and maintained at The University of Iowa, Department of Biology, Iowa City, IA 52242. This work was supported by the Association Française contre les Myopathies (AFM-Telethon), the INSERM and the University of Evry Val d'Essonne.
Buffers and Reagents | |||
Alexa Fluor 488 goat anti-mouse IgG (F488) | Life Technologies, Thermofisher | A-11001 | |
Alexa Fluor 488 α-bungarotoxin (F488-a-BTX) | Life Technologies, Thermofisher | B13422 | |
Alexa Fluor 594 goat anti-mouse IgG (F594) | Life Technologies, Thermofisher | A-11032 | |
ATTO-633 α-bungarotoxin (F633-a-BTX) | Alomone Labs | B-100-FR | |
Bovine serum albumin (BSA) | Sigma | A2153 | |
DAPI Fluoromount-G | Southern Biotech | 00-4959-52 | |
DPBS | Gibco, Invitrogen | 14190-169 | |
Ethanol Absolute | VWR | 20821.296 | |
Immersion Oil, n = 1.518 | THORLABS | MOIL-10LF | Low autofluorescence |
Neurofilament (NF-M) antibody | DSHB | AB_531793 | |
Paraformaldehyde (PFA) | MERCK | 1.04005 | |
Synaptic vesicle glycoprotein 2 (SV2) antibody | DSHB | AB_2315387 | |
Triton X-100 | Sigma | T8787 | |
Materials | |||
Alnico Button cylindrical magnets | Farnell France | E822 | diameter of 19.1 mm with maximal pull of 1.9 Kg |
63x 1.4 NA magnitude oil immersion HCX Plan Apo CS objective | Leica Microsystems | ||
100x 1.4 NA HC PL APPO CS2 Objective | Zeiss | ||
Curved thin forceps-Moria iris forceps | Fine Science Tools | 11370-31 | |
Extra thin scissors – Vannas-Tübingen Spring Scissors | Fine Science Tools | 15-003-08 | |
Fine serrated forceps | Euronexia | P-95-AA | |
Gel loading tip round 1-200 µL | COSTAR | 4853 | |
Leica laser-scanning confocal microscope TCS SP8 | Leica Microsystems | ||
Leica Laser-scanning confocal microscope TCS SP8 Gated STED 775 nm | Leica Microsystems | ||
Lens Cleaning Tissue | Whatman (GE Healthcare) | 2105-841 | |
Medium serrated forceps | Euronexia | P-95-AB | |
Microscope cover glasses 24×50 nm No 1.5H 170±5 µm | Marienfield | 107222 | High precision |
Nunclon delta surface (12-well plates) | Thermo Scientific | 150628 | |
Nunclon delta surface (24-well plates) | Thermo Scientific | 142475 | |
Safeshield scalpel | Feather | 02.001.40.023 | |
Sharp-blunt scissors – fine Scissors – Martensitic Stainless Steel | Fine Science Tools | 14094-11 | |
Superfrost plus slides | Thermo Scientific | J1800AMNZ | |
Software | |||
GraphPad | Prism, San Diego (US) | Release N°6.07 | Statistical software |
ImageJ software | National Institutes of Health | Release N° 1.53f | |
Leica Application Suite X software | Leica Microsystems | Release N°3.7.2.2283 | Free microscope software available at https://www.leica-microsystems.com/products/microscope-software/p/leica-las-x-ls/downloads/ |