Here, we present a protocol to image human pancreas sections in three dimensions (3D) using optimized passive clearing methods. This manuscript demonstrates these procedures for passive optical clearing followed by multiple immunofluorescence staining to identify key elements of the autonomic and sensory neural networks innervating human islets.
Using traditional histological methods, researchers are hampered in their ability to image whole tissues or organs in large-scale 3D. Histological sections are generally limited to <20 µm as formalin fixed paraffin section on glass slides or <500 µm for free-floating fixed sections. Therefore, extensive efforts are required for serial sectioning and large-scale image reconstruction methods to recreate 3D for samples >500 µm using traditional methods. In addition, light scatters from macromolecules within tissues, particularly lipids, prevents imaging to a depth >150 µm with most confocal microscopes. To reduce light scatter and to allow for deep tissue imaging using simple confocal microscopy, various optical clearing methods have been developed that are relevant for rodent and human tissue samples fixed by immersion. Several methods are related and use protein crosslinking with acrylamide and tissue clearing with sodium dodecyl sulfate (SDS). Other optical clearing techniques used various solvents though each modification had various advantages and disadvantages. Here, an optimized passive optical clearing method is described for studies of the human pancreas innervation and specifically for interrogation of the innervation of human islets.
Until recently, 3-dimensional (3D) reconstruction of large tissues or whole organs was performed through laborious serial sectioning, staining, and image reconstruction of multiple sections. These methods had several disadvantages including reliance on a large number of serial sections, poor tissue penetration with antibodies, and light scattering preventing deep imaging within tissues. To allow for greater light and antibody penetration, researchers developed chemical methods to preserve protein antigens while removing the majority of light-scattering lipids. Several related methods are Clear Lipid-Exchanged Acrylamide-hybridized Rigid Imaging Tissue hYdrogel (CLARITY), Passive Clarity Technique (PACT), and Perfusion-assisted Agent Release in situ (PARS) (reviewed in 1,2,3,4,5,6). The CLARITY method is based on stabilization of proteins using a formaldehyde, acrylamide, and bis hydrogel followed by lipid removal using electrophoresis in a SDS solution2. This approach was later modified for passive clearing and advanced imaging7. Further optimization led to the elimination of bis and varying percentages of paraformaldehyde in the hydrogel solution (1 – 4%) to obtain optimal antigen stabilization with the shortest clearing time for a technique called PACT 8. Early attempts to develop these optical clearing techniques involved organic or other compounds that were difficult to work with and quenched endogenous fluorescent proteins in transgenic mouse models. These additional methods included ScaleS, Unobstructed Brain/Body Cocktails and Computational analysis (CUBIC), SWITCH and Dimensional Imaging of Solvent-Cleared Organs (DISCO) methods, all with various advantages and disadvantages9,10,11,12. The original CLARITY method was developed in lipid-rich mouse brain tissue and optical clearing methods had limited testing in human tissues7,8,11,13,14.
Optical clearing methods are ideal for tracing nerves over long distances as in the intact mouse central nervous system. The pancreas is well innervated by both autonomic and sensory nervous systems. The pancreatic endocrine compartment, islets of Langerhans, comprise a very small portion of the entire organ (1 – 2%) and islets have known heterogeneity in sizes (50 – 250 µm), endocrine cell proportions, and density particularly in diabetes (reviewed in 15,16). In developing a protocol, several optical clearing methods were tested for human pancreas and a PACT procedure was found to provide the best balance of time to clear (~2 weeks) with excellent morphological preservation of nerves and islets. The final optimized procedure is described here in the delineation of the neuro-insular network for large-scale (millimeter distances) and high-resolution 3D imaging of multiple intact pancreatic islets. The technique is suitable for human pancreas immediately following the fixation or after storage as well as samples fixed in neutral buffered formalin and embedded in paraffin wax. The samples are suitable for imaging by confocal or lightsheet microscopy.
All experiments were conducted in accordance with University of Florida Institutional Review Board and Federal guidelines.
Caution: Paraformaldehyde and acrylamide are toxic irritants. Handle reagents in a fume hood with appropriate personal protective equipment (lab coat, gloves, eye protection).
1. Deparaffinization of Formaldehyde-fixed Tissues (If Working with Fresh Tissues, Skip to Step 2)
2. Prepare 4% Paraformaldehyde (PFA) Fixative
3. Pancreas Fixation
4. Embed Tissue in Hydrogel
5. Degas the Monomer Solution and Polymerize the Hydrogel
6. Tissue Clearing
7. Multiple Immunofluorescence
8. Mounting Samples for Imaging
9. Imaging
These staining procedures were developed to provide a large-scale examination of the human pancreas to examine islets and associated autonomic and sensory networks. Several procedures were tested including CLARITY7, iDISCO17, and PACT8 with the PACT method found best suited for human pancreas and confocal imaging.
Primary antibodies were initially tested on fixed human pancreas samples with suitable positive and negative control samples (mouse brain, other). The primary antibodies and suggested dilutions are listed in Table of Materials, though each laboratory can expect to optimize antibody dilutions depending on lot number and tissue source. Primary antibody lot-to-lot variation can impact the staining intensity and the specificity, and require validation to achieve the same degree of stain intensity as with former reagents.
In the human pancreas, islets were delineated by insulin, glucagon, and secretogranin 3 (Figure 2). Schwann cells were delineated using glial fibrillary acid protein (GFAP, Figure 2 and Figure 3A). Nerves stained with antibodies against the parasympathetic marker vasoactive intestinal peptide (VIP) were imaged on the Lightsheet (Figure 3B). Sympathetic nerves can be seen with staining for tyrosine hydroxylase (not shown).
Figure 1. Human pancreas optical clearing. (A) A razor blade is used to cut and loosen a section of paraffin-embedded tissue (top panels) before removing the tissue section and scraping away excess paraffin from the tissue (bottom panels). Representative tissue samples are shown before (B left, C top) and after (B right, C middle) optical clearing of paraffin-embedded tissue, as described in the protocol section. The cleared, fixed tissue is not completely transparent after clearing (B right, C top) and often tissue swelling can be appreciated (C, middle panel). The cleared tissue becomes fully transparent after equilibration in RIMS (C, lower panel). Scale bars: 500 µm. Please click here to view a larger version of this figure.
Figure 2. Human neuro-insular network. Human pancreas samples were cleared as described from nPOD organ donors or from archival paraffin-embedded tissues. (A-D) Schwann cells (GFAP+, white) and endocrine cells are shown stained by insulin (red) and glucagon (green). (A) Confocal microscopy and maximum intensity projection (MIP) shows tracing of Schwann cells (GFAP+) on nerves coursing next to blood vessels at the islet periphery and extending into the islets. The inset demonstrates high resolution obtained and shows contact between GFAP+ Schwann cells and endocrine cells. (B) A 3D image of panel (scale: x = 50 µm, y = 20 µm, z = 25 µm) A. A paraffin-PACT sample is shown imaged via confocal microscopy and presented as a max intensity projection (C) and in 3D (D), scale: x, y = 50 µm, z = 25 µm). Scale bars A, C: 50 µm. Please click here to view a larger version of this figure.
Figure 3. 3D visualization and stitching. Three stitched image stacks were acquired of Schwann cells stained using GFAP and confocal microscopy and traced using a neurite tracer plugin in the image analysis software. (A) The 3D fill of the trace is shown (Scale bars: x = 150 µm, y = 200 µm (0.2 mm), z = 120 µm) (B) A PACT sample was stained with VIP antibody and imaged using a lightsheet microscope. The stack is >1 mm in depth and nerve fibers are clearly seen in high resolution. Fibers wrapping a duct (D, foreground) and a ganglion (G, background) can be seen (Large grid: x, y, z = 200 µm; tick marks: x, y, z = 40 µm). Please click here to view a larger version of this figure.
Availability of new optical clearing methods has permitted unprecedented large-scale examinations of the central and peripheral nervous systems in animal models. The overall innervation patterns of the human pancreas are largely unexplored due to tissue density and difficulties in acquiring high quality biospecimens. This protocol offers an optimized tissue clearing protocol for human pancreas tissue from either fixed or paraffin-embedded archival samples.
Clearing time depends on the sample size, fixative type, duration, storage duration and may require 1 – 8 weeks, so the following considerations are critical. It is best to clear tissues soon after the 4% PFA fixation if possible because long-term storage increases clearing time. To minimize clearing time, the amount of PFA in the hydrogel monomer was decreased from 4% as used in the fixation step to 1% for the human pancreas. For other tissues, especially mouse tissues, the amount of PFA necessary to provide sufficient hydrogel rigidity to preserve antigens must be determined empirically. Adequate clearing is also essential since antibody penetration is reduced in poorly cleared tissues and surface staining by secondary antibodies is increased. Changing the clearing solution every other day (or, even daily) is best to keep the pH constant and detergent fresh. Conversely, over-clearing negatively impacts cellular morphology and increases tissue friability. Since some pancreas samples clear unevenly due to inherent pathologies such as regions of fibrosis from chronic pancreatitis or other pathologies, it is important to frequently monitor this process. Use of vibratome thick sections can also be used to make uniform thicknesses yet are not required. Monitoring the clearing process, so samples are removed from detergent as soon as light passes easily through the sample, ensures that the sample is sufficiently cleared.
Antibody penetration and surface staining are important issues to consider with PACT samples. To ensure good antibody penetration, it is critical to incubate samples with the primary antibodies for at least 2 days. Various antibodies have different diffusion rates and should be optimized individually, but for most antibodies, 4 days was sufficient duration for full penetration in a 1 mm3 sample. If surface staining is a problem, especially for Lightsheet imaging, the sample may be cut in half, or the surface dissected away after staining. Small format antibodies when available would be expected to assist with tissue penetration8. Preconjugated antibodies do not appear to work as well as the same unconjugated clone and higher background from nonspecific binding and poorer tissue penetration can be observed if they work at all. For improved success with preconjugated antibodies, increase serum and TritonX-100 concentrations in the staining buffer and use longer incubations (>4 days). After staining, incubation of the sample in RIMS for several days is critical. Cleared tissues swell in PBS and RIMS incubation causes them to shrink back to original size. Especially with lightsheet imaging, the sample should be fully equilibrated before imaging.
When imaging samples on the confocal microscope, the correction must be set each time a new position is chosen. Various acquisition depths and variation in staining intensity throughout the tissue necessitates adjustments for each area of the tissue to be imaged optimally. Likewise, the secondary antibodies used must be carefully considered. Spectral unmixing is challenging in PACT samples, so fluorophores must be appropriately chosen for a low excitation or emission overlap to ensure a bright signal when filtering emissions on the confocal microscope. For each application, a balance must be struck between resolution, imaging speed, and noise reduction so that the best quality image can be acquired without photo-bleaching. Resolution greater than 1024 x 1024 is not detectable by the human eye but may be necessary for certain applications if quantification of a stain is needed.
There are many things to consider when choosing an optical clearing technique and when choosing optical clearing over other more traditional methods. Low abundance antigens may not be detectable using the PACT method thus there are limitations on antigen detection. Certain antigens such as immunological antigens (CD3, CD4, CD8, etc.) are destroyed by the PACT method and are undetectable despite high quality antibodies available to detect them. Another limitation of this method is the inherent variability between donor pancreases which are difficult to discern until after clearing staining. Each donor tissue tends to clear and stain similarly between procedures, but different donor tissues have widely varying clearing times and tissue morphology quality after clearing. The ability to use archival tissue may mitigate this limitation if one can have adequate access to a large number of patient pancreas samples though this has not been thoroughly investigated. The PACT protocol reported herein was found to be inexpensive and readily implemented with standard laboratory equipment. Cleared samples were suitable for imaging via traditional confocal microscopy, as well as 2-photon and Lightsheet technologies and provided high resolution 3D images of nerves and islets in large sections of the human pancreas. Future applications of this procedure include studies on the development of the fetal pancreas for both exocrine and endocrine compartments and islet studies in type 1 and type 2 diabetes.
The authors have nothing to disclose.
The authors thank Dr. Ann Fu and Joseph Canzano for technical assistance, Dr. Jennifer Treweek for invaluable advice, and Dr. Kristin Overton and Dr. Karl Deisseroth for training to MCT through the Stanford University CLARITY workshop. JDRF nPOD and the Organ Procurement Organizations provided tissue samples. This work was funded by JDRF (47-2014-1), Helmsley Charitable Trust (HCT 2015-PG-T1D052) and NIDDK 1OT2 TR001773 to MCT.
10x phosphate buffered saline (PBS) | Fisher | BP399-1 | Buffers |
Sodium phosphate dibasic anhydrous | Fisher | S375-500 | PB buffer (RIMS) |
Sodium phosphate monobasic monohydrate | Sigma | 71507-250 | PB buffer (RIMS) |
16% paraformaldehyde (PFA) | Electron Microscopy Sciences | 15714-5 | Immersion fixation, hydrogel, storage solution |
40% acrylamide | Bio-Rad | 161-0140 | Hydrogel |
2% bis-acrylamide | Bio-Rad | 161-0142 | Hydrogel |
VA-044 initiator | Wako Pure Chemical Industries, Ltd. | VA044 | Hydrogel |
Sodium dodecyl sulfate (SDS) | Fisher | BP166-5 | Clearing buffer |
Sodium azide | Sigma | S8032 | Sample storage buffer |
18 gauge needles | Fisher | 14-840-91 | Degassing hydrogel solution |
N2 tank | AirGas | various | Degassing hydrogel solution |
Triton X-100 | Sigma-Aldrich | 100 ml | Buffers |
Goat, normal serum | Vector | S-1000 | Use as 2% in blocking buffer |
Histodenz | Sigma | D2158-100G | RIMS |
8-well chamber slides | Ibidi | 80827 | Imaging |
Laser scanning confocal microscope | Zeiss | 710 | Imaging |
LightSheet microscope | Zeiss | Z1 | Imaging |
Name | Company | Catalog Number | Comments |
Primary Antibody | |||
CD45 | Bioss | bs-4820R-A488 | Host: Rabbit Dilution: 1:100 Comments: Did not work |
CD45 | DAKO | M0754 | Host: Mouse Dilution: 1:200 Comments: Did not work |
GFAP | DAKO | Z0334 | Host: Rabbit Dilution: 1:50 Comments: Worked |
Glucagon | BD Biosciences | 565891 | Host: Mouse Dilution: 1:50 Comments: Worked |
Glucagon | Cell Signaling | 2760S | Host: Rabbit Dilution: 1:200 Comments: Did not work |
Glucagon | Abcam | ab10988 | Host: Mouse Dilution: 1:200 Comments: Worked |
Insulin | DAKO | A0564 | Host: Guinea Pig Dilution: 1:200 Comments: Worked |
NCAM (CD56) | DAKO | M730429-2 | Host: Mouse Dilution: 1:50 Comments: Did not work |
NCAM (CD56)-FITC conjugate | DAKO | M730429-2 | Host: Mouse Dilution: 1:50 Comments: Did not work |
Peripherin | EnCor | RPCA-Peri | Host: Rabbit Dilution: 1:100 Comments: Worked |
PGP9.5 | DAKO | Z5116 | Host: Rabbit Dilution: 1:50 Comments: Did not work |
Secretogranin 3 | Sigma | HPA006880 | Host: Rabbit Dilution: 1:200 Comments: Worked |
Smooth muscle actin | Sigma | A5228; C6198 (Cy5) | Host: Mouse Dilution: 1:200; 1:200 Comments: Worked; Conjugated worked better than unconjugated |
Substance P | BioRad | 8450-0505 | Host: Rat Dilution: 1:200 Comments: Worked |
Tyrosine Hydroxylase | Millipore | AB152 | Host: Rabbit Dilution: 1:200 Comments: Worked |
Tyrosine Hydroxylase | Abcam | Ab76442 | Host: Chicken Dilution: 1:100 Comments: Worked, but weak staining |
Vasoactive Intestinal Peptide (VIP) | Immunostar | 20077 | Host: Rabbit Dilution: 1:100 Comments: Worked |
Vesicular Acetylcholine Transporter (VAChT) | Synaptic Systems | 139103 | Host: Rabbit Dilution: 1:50 Comments: Worked |
Secondary Antibody | |||
Guinea pig IgG | ThermoFisher Scientific | Various | Host: Goat Dilution: 1:200 Comments: AlexaFluor conjugates |
Mouse IgG | ThermoFisher Scientific | Various | Host: Goat Dilution: 1:200 Comments: AlexaFluor conjugates |
Rabbit IgG | ThermoFisher Scientific | Various | Host: Goat Dilution: 1:200 Comments: AlexaFluor conjugates |
Rat IgG | ThermoFisher Scientific | Various | Host: Goat, Donkey Dilution: 1:200 Comments: AlexaFluor conjugates |
Chicken IgG | ThermoFisher Scientific | Various | Host: Goat Dilution: 1:200 Comments: AlexaFluor conjugates |