Fluorescence-Activated Cell Sorting-Radioligand Treated Tissue (FACS-RTT) is a powerful tool to study the role of the 18 kDa translocator protein or Serotonin 5HT2A-receptor expression in Alzheimer's Disease at a cellular scale. This protocol describes the ex-vivo application of FACS-RTT in the TgF344-AD rat model.
Glial cells probably have a considerable implication in the pathophysiology of neurodegenerative disorders, such as Alzheimer’s disease (AD). Their alterations are perhaps associated with a pro-inflammatory state. The TgF344-AD rat strain has been designed to express human APP and human PS1ΔE9 genes, encoding for amyloid proteins Aβ-40 and Aβ-42 and displays amyloid pathology and cognitive deficits with aging. The TgF344-AD rat model is used in this study to evaluate the cellular origin of the 18 kDa translocator protein (TSPO, a marker of glial cell activation) binding, and the 5HT2A-receptor (5HT2AR) serotonin receptor levels that are possibly disrupted in AD. The technique presented here is Fluorescence-Activated Cell Sorting to Radioligand Treated Tissue (FACS-RTT), a quantitative cell-type-specific technique complementary to in vivo PET or SPECT or ex vivo/in vitro autoradiography techniques. It quantifies the same radiolabeled tracer used prior for imaging, using a γ counter after cytometry cell sorting. This allows determining the cellular origin of the radiolabeled protein with high cellular specificity and sensitivity. For example, studies with FACS-RTT showed that (i) the increase in TSPO binding was associated with microglia in a rat model of lipopolysaccharide (LPS)-induced neuroinflammation, (ii) an increase in TSPO binding at 12- and 18-months was associated with astrocytes first, and then microglia in the TgF344-AD rats compared to wild type (WT) rats, and (iii) the striatal density of 5HT2AR decreases in astrocytes at 18 months in the same rat AD model. Interestingly, this technique can be extended to virtually all radiotracers.
Neurodegenerative diseases, such as Alzheimer's Disease (AD), are characterized by a neuronal loss associated with increased symptoms. AD, the most common cause of dementia, accounting 60%-70% of cases, affects around 50 million people worldwide1. At a neuropathological level, the two major characteristics of AD are the accumulation of extracellular amyloid-β (Aβ) plaques and intracellular Tau neurofibrillary tangles. Glial cell alterations have also been associated with AD2 and possible disruption of several neurotransmitter systems3,4.
The TgF344-AD rat line has been modified to model AD by expressing human APP and PS1ΔE9 transgenes, leading to soluble and insoluble Aβ-40 and Aβ-42 expression and amyloid plaque formation5. It also presents the accumulation of hyperphosphorylated forms of the Tau protein leading to tauopathy. From the age of 9-24 months, the rats progressively develop the pathological hallmarks of AD and a cognitive impairment5,6,7,8,9.
Positron Emission Tomography (PET), Single-Photon Emission computed Tomography (SPECT), and autoradiography are techniques based on the emission and quantification of γ rays. Radiotracers are quantified either in vivo (PET and SPECT) or ex vivo/in vitro (autoradiography). Those sensitive techniques have contributed to the understanding of mechanisms of several brain diseases, such as AD. Indeed, in terms of neuroinflammation, there are a lot of studies assessing 18 kDa Translocator Protein (TSPO), an in vivo neuroinflammation marker, with radiolabeled tracers such as [11C]-(R)-PK11195 or [11C]PBR28 (for review see10). In addition, alterations of neurotransmitter systems have been studied using radiotracers11,12,13.
However, those techniques do not determine the cellular origin of the radioactive signal. This could hamper the interpretation of the biological underpinnings of the alteration in the binding of a radioligand in PET/SPECT. For instance, in the case of TSPO studies of neuroinflammation, understanding whether the increase or decrease of TSPO is due to astrocytic or microglial changes is of paramount importance. The Fluorescence-Activated Cell Sorting to Radioligand Treated Tissue (FACS-RTT) technique was developed to get around these problems, allowing the assessment of radioligand binding in every cell type separately and the quantification of the target-protein density per cell. This innovative technique is consequently complementary and highly compatible with PET and SPECT imaging.
Here, this technique was applied along two axes: the study of neuroinflammation using TSPO-specific radioligands and assessing the serotonergic system. On the first axis, the aim was to understand the cellular origin of the TSPO signal in response to an acute inflammatory reaction. Therefore, FACS-RTT was used on the brain tissues of rats after the induction of neuroinflammation via a lipopolysaccharide (LPS) injection and following an in vivo [125I]CLINDE SPECT imaging study. Further, the same imaging and FACS-RTT protocol were applied on 12- and 24-month-old TgF344-AD rats and matching wild-type (WT) rats. The second axis aimed to determine the origin of serotoninergic system alterations in this rat model via ex vivo 5-HT2AR density assessment by cell type.
All experimental procedures were conducted in agreement with the Ethics Committee for Human and Animal Experimentation of the Canton of Geneva, the Cantonal Commission for Research Ethics (CCER), and the General Direction Of The Health Of The Canton Of Geneva (Switzerland), respectively. Data are reported following Animal Research: Reporting In-vivo Experiments (ARRIVE) guidelines.
1. SPECT camera preparation and calibration
2. Workspace setup for SPECT imaging
3. [125I]CLINDE radiotracer synthesis
CAUTION: Radioactivity can have sufficient ionizing energy to affect the atoms of the living cells and damage their genetic material (DNA).
4. [125I]R91150 radiotracer synthesis
NOTE: Ensure to follow the same security rules as mentioned in the CLINDE synthesis section.
5. Animal preparation
6. SPECT acquisition
7. Scan reconstruction
8. Rat brain extraction
9. Cell isolation
10. Cell sorting
11. Gamma counting
WT rats experienced in vivo SPECT scan with [125I]CLINDE radiotracer after a unilateral LPS injection (Figure 2). This scan (using summed data from images of 45-60 min post radiotracer injection) showed higher binding of [125I]CLINDE in the site of the LPS injection (Figure 2A) than in the contralateral region of the brain (Figure 2B). The ex vivo samples that underwent FACS-RTT confirmed those results and revealed the presence of a higher number of [125I]CLINDE binding sites only in microglia, showing that the cellular origin of the [125I]CLINDE signal in the ipsilateral side of the brain was microglial (Figure 3A)15.
Using the same [125I]CLINDE radiotracer, the protocol was then performed on the hippocampus of old TgF344-AD Rats (12- and 24-month-old) and compared with 24-month-old WT. The results demonstrated that the increase in TSPO binding at 12 months in TgF344-AD rats was restricted to astrocytes. In 24-month-old rats, the increase in TSPO binding was due to both astrocytic and microglial alterations (Figure 3B). The results showed that the TSPO overexpression in astrocytes is probably observed before the microglial one. Independently, using the radiotracer [125I]R91150, this technique was used at a cellular scale to show that in older TgF344-AD rats, striatal astrocytes displayed a decreased 5HT2AR density when compared with WT (Figure 3C)16.
Finally, FACS-RTT was performed on human AD post-mortem samples. After dissociation, the cells were incubated with [125I]CLINDE before staining and the FACS procedure. This allowed discovering a cortical overexpression of TSPO in both astrocytes and microglia of AD subjects compared with age-matched controls (Figure 3D).
Figure 1: SPECT Camera Set-up. (A) SPECT camera overall presentation. (B) Bed presentation with heater and respiratory rate monitoring. (C) Anesthesia tube plugs. (D) Heating bed and respiratory probe socket. (E) Phantom positioning monitoring view from the software. Please click here to view a larger version of this figure.
Figure 2: TSPO brain imaging using SPECT with [125I]CLINDE radiotracer. Representative images (45-60 min post-injection of [125I]CLINDE) of the hippocampus after (A) LPS or (B) saline injection in the ipsilateral (white) and contralateral (red) side of the brain. In vivo time-activity curves measured in the volume-of-interest are represented in the right panel. SPECT: single-photon emission computed tomography; TSPO: translocator protein; LPS: lipopolysaccharide. n = 7 animals per condition. This figure has been modified from Tournier et al.15. Please click here to view a larger version of this figure.
Figure 3: Quantification of TSPO and 5HT2AR. (A) Cellular origin of TSPO overexpression after a unilateral brain injection of LPS. The radioactivity was measured (% injected dose/g of tissue) in each cell population in the contralateral (gray, n = 7) and the ipsilateral (green, n = 7) side of the injection. Statistical test used: paired t-test. (B) TSPO in old TgF344-AD rat. The [125I]CLINDE concentrations (% injected dose/g of tissue) were determined in 24-month-old wild-type animals (gray, n = 9) and in 12- (green, n = 8) and 24-month-old (purple, n = 7) TgF344- AD rats. Statistical test used: two-way ANOVA. (C) 5HT2AR is decreased in astrocytes of the striatum in old TgF344-AD rats. The [125I]R91150 concentration was determined in astrocytes and microglia at the cellular level (% injected dose/cell) in WT (gray, n = 7) and old TgF344-AD (green, n = 11) rats. Statistical test used: one-way ANOVA. (D) Cell provenance of TSPO overexpression in the frontal cortex in Alzheimer's disease (AD). In each cell population, the radioactivity is measured (% injected dose/g of tissue) in AD subjects (green, n = 9) and control (gray, n = 9). Statistical test used: unpaired t-test. All data are represented as mean ± 95% CI with the following annotation: * p < 0.05, ** p < 0.01, *** p < 0.001. Please click here to view a larger version of this figure.
To our knowledge, this technique was the first to describe an approach that allows a better understanding of in vivo binding alterations of a radiotracer at the cellular level. The protocol describes a multiscale method to quantify radiotracer binding at the cellular level using [125I]CLINDE (TSPO) or [125I]R91150 (5HT2AR) as examples.
This technique is robust and sensitive enough to precisely detect the cellular origin of a wide spectrum of glial cell alterations ranging from an intense inflammatory reaction induced by LPS to more subtle glial cell alterations observed in a rat model of AD, bringing important complementary information to in vivo nuclear neuroimaging, as the microglial origin of the signal obtained with SPECT that was determined. The study further showed that FACS-RTT was even able to discern neuroreceptor density alterations at the cellular scale with the example of 5HT2AR (Figure 3C). Finally, evidence for using the technique in human post-mortem tissues was provided, showing an increased TSPO concentration in astrocytes and microglia of AD subjects.
The main advantage of this technique is its complementarity with PET and SPECT imaging. Indeed, nuclear imaging is a powerful technique that can extract information from a brain region or voxel level. However, its limit resides at the cellular scale; it is impossible to distinguish each cell type's contribution to the signal. FACS-RTT allows going further by revealing a radiotracer concentration in each cell type. Interestingly, in theory, an unlimited set of targets can be assessed with this technique, the limitation being the availability of a radiotracer for the target of interest.
The critical steps of the protocol include the use of radioactivity that must be performed in a secure environment with qualified personnel. Furthermore, it is crucial to consider radioactive decay. For FACS preparation, one must ensure antibody specificity, wavelength, light intensity that differ depending on the cell type and need optimization for efficient cell sorting.
One of the limitations of this technique underlined in the studies presented here lies in using aged animals and human post-mortem brain samples because of autofluorescent cells. Lipofuscin, i.e., a residue of lysosomal digestion, is fluorescent and accumulates in aging neurons, microglia, and astrocytes. FACS can, with prior optimization, distinguish autofluorescent cells from positively labeled ones, which is an essential step if older animals are studied. Another limitation of the technique is the impossibility to directly compare the radiotracer concentration between the different sorted cell types across different animals. This could be performed if the concentration of the non-metabolized, non-protein bound radiotracers in blood was considered for normalization across animals.
One final limitation is the need for all the equipment used, e.g., cyclotron, PET/SPECT camera, FACS, and γ counter, to be in close physical proximity to each other, especially if short half-life isotopes are used for in vivo imaging and FACS-RTT.
FACS-RTT could also be used as a standalone approach, i.e., not necessarily following an in vivo nuclear imaging study15. The complexity of brain disease requires studying mechanisms at a cellular level or single-cell scale. FACS-RTT could be a translational tool bridging in vivo imaging approaches with a vast spectrum of ex vivo or in vitro cellular and molecular biology approaches.
The authors have nothing to disclose.
This work was supported by the Swiss National Science Foundation (grant no. 320030-184713). Authors BBT and KC are supported by the Velux Foundation (project n. 1123). Author ST received support from the Swiss National Science Foundation (Early Post-Doc Mobility Scholarship, no. P2GEP3_191446), the Prof Dr. Max Cloetta Foundation (Clinical Medicine Plus scholarship), and the Jean and Madeleine Vachoux Foundation.
Acetic acid | Sigma-Aldrich | ||
Acetonitrile | Sigma-Aldrich | ||
BioVet | BioVet | Software for vitals check | |
Bondclone C18 reverse-phase column | Phenomenex, Schlieren, Switzerland | ||
Des-Sur | University Hospital of Geneva | Virucide | |
Fc Block / anti-CD32 | BD Biosciences | BDB550270 | Reactivity for rat |
FITC-conjugated anti-rat CD90 | Biolegend | 202504 | Reactivity for rat |
Heparin | B. Braun | B01AB01 | |
HPLC | Knauer | ||
Insyte-W 24 GA 0.75 IN 0.7 x 19 mm | BD Biosciences | 321312 | 24 G catheter |
Isoflurane | Baxter | ZDG9623 | |
Lacryvisc | Alcon | 2160699 | |
LS Columns | Miltenyi Biotec | 130-042-401 | |
MACS MultiStand | Miltenyi Biotec | 130-042-303 | |
Micropore soft tape | 3M | F51DA01 | |
MILabs-Uspect II | MILabs | Software for SPECT Camera | |
MoFlo Astrios | Beckman Coulter | Cell sorter | |
Myelin Removal Beads II | Miltenyi Biotec | 130-096-733 | Contains beads and myelin removal buffer. |
NaCl 0.9% Sterile solution | B. Braun | 395202 | |
Neural Dissociation Kit (P) | Miltenyi Biotec | 130-092-628 | Contains the enzyme mixes, pipets 1, 2 and 3. |
Nylon Mesh Sheet | Amazon | CMN-0074-10YD | 40 inch width, 80 micron size mesh |
Peracetic acid | Sigma-Aldrich | ||
QuadroMACS Separator | Miltenyi Biotec | 130-090-976 | |
R91150 précursor | CERMN | ||
Sep-Pak C18 Column | Waters | Concentration column | |
Sodium iodide Na125 | PerkinElmer | ||
Tributylin precursor | CERMN | ||
U-SPECT Rec2.38c | MILabs | Version Rec2.38c | Software for SPECT images reconstruction |
USPECT II | MILabs | Spect Camera | |
Wizard 3" | PerkinElmer | Gamma counter |