Protocol for propagation of dissociated high grade glioma surgical specimens in serum-free neurosphere medium to select for cells with cancer stem cell phenotype. For specimens that fail to grow as neurospheres, an alternative protocol is suggested. A paraffin embedding technique for maintaining the 3D neurosphere architecture for immunocytochemistry is described.
Glioblastomas, the most common and aggressive form of astrocytoma, are refractory to therapy, and molecularly heterogeneous. The ability to establish cell cultures that preserve the genomic profile of the parental tumors, for use in patient specific in vitro and in vivo models, has the potential to revolutionize the preclinical development of new treatments for glioblastoma tailored to the molecular characteristics of each tumor.
Starting with fresh high grade astrocytoma tumors dissociated into single cells, we use the neurosphere assay as an enrichment method for cells presenting cancer stem cell phenotype, including expression of neural stem cell markers, long term self-renewal in vitro, and the ability to form orthotopic xenograft tumors. This method has been previously proposed, and is now in use by several investigators. Based on our experience of dissociating and culturing 125 glioblastoma specimens, we arrived at the detailed protocol we present here, suitable for routine neurosphere culturing of high grade astrocytomas and large scale expansion of tumorigenic cells for preclinical studies. We report on the efficiency of successful long term cultures using this protocol and suggest affordable alternatives for culturing dissociated glioblastoma cells that fail to grow as neurospheres. We also describe in detail a protocol for preserving the neurospheres 3D architecture for immunohistochemistry. Cell cultures enriched in CSCs, capable of generating orthotopic xenograft models that preserve the molecular signatures and heterogeneity of GBMs, are becoming increasingly popular for the study of the biology of GBMs and for the improved design of preclinical testing of potential therapies.
Glioblastoma (GBM), a WHO grade IV astrocytoma, is the most prevalent and aggressive primary brain tumor. Diverse developmental phenotypes are adopted by GBM tumor cells, including cells exhibiting "cancer stem cell" (CSC) characteristics, such as the expression of neural stem cell (NSC) markers, long term self-renewal, and the potential to give rise to more differentiated cells expressing astrocytic markers and forming the bulk of the tumor1-3. While clarification is still needed regarding CSC molecular identity and clinical implications, the focus of the present work is on the operational definition of CSC: long term self-renewal in vitro and the ability to differentiate and reproduce the original tumor upon orthotopic implantation in immunocompromised rodents.
Glioblastoma cells have been cultured for decades in traditional medium containing 10% fetal bovine serum (FBS) and several high passage commercially available serum cultured GBM cell lines are tumorigenic in immunocompromised rodents, but there is considerable genomic and molecular divergence from the original tumor4, limiting their use as clinically relevant models. More recently, cells with stem/progenitor phenotype responsive to EGF and bFGF were identified in GBMs2. Subsequently, dissociated GBM tumor samples were cultured in a serum-free medium3, originally formulated for the selection and expansion of neural stem cells from the adult mammalian brain5. These culture conditions hinder the growth of most nonneoplastic and more differentiated tumor cell populations, while favoring the growth of stem and progenitor cells as floating multicellular spheroids, or neurospheres3, mimicking the behavior of adult mammalian neural stem cells5. Comprehensive side by side comparison of primary GBM cells cultured in either neurosphere medium supplemented with growth factors (NMGF) or in the traditional growth medium supplemented with 10% FBS, revealed that the GBM neurospheres were tumorigenic, presented multilineage differentiation potential, and preserved the genotype of the original tumor, in contrast to the 10% FBS cultures which were not tumorigenic at low passages and considerably diverged from the original tumors at late passages4.
Isolation of CSC from dissociated GBM tumors by cell sorting based on the expression of putative CSC marker CD133 has also been proposed6,7, but further work indicated that the CSC phenotype is not definitively associated with the expression of such markers8-10, decreasing the initial enthusiasm for this strategy, whereas new markers are still being tested10. The unavailability to date of a validated set of markers defining CSC, along with the goal of large scale amplification of these cells for preclinical studies, renders the use of cell sorting impractical for routine CSC-enriched cultures. GBM cells selected by the ability to grow as neurospheres in NMGF invariably express neural stem cell markers. We have observed that Sox2 and nestin are ubiquitously expressed in neurosphere cultures, while CD133 protein is present in a subset of the GBM neurospheres (unpublished data and reference11).
Several laboratories are pursuing neurosphere cultures from glioblastoma tumors using the same general approach of enzymatic dissociation and culturing in serum-free medium supplemented with growth factors3,4,11-14, while other colleagues have reported attempts to grow long term neurosphere cultures from GBM samples without success . The general method for enzymatic dissociation and neurosphere culture of high grade gliomas presented here is similar to what has been outlined in the above publications. We have optimized the protocol based on our experience of dissociating and culturing over 100 GBM samples. The efficiency of obtaining long-term neurosphere cultures from fresh GBM samples applying the protocol presented here is over 40%, similar to the few reports showing efficiency data3,15, leading to the exploration of alternative protocols such as culturing cells continually or intermittently in serum-free medium in the presence of EGF and bFGF as monolayers on surfaces coated with ECM protein16,17. Neurosphere cultures are still the most validated and increasingly popular approach to preserve GBM tumors molecular characteristics and tumorigenic potential3,4,11-14, thus our approach is to attempt neurospheres cultures first, while concomitantly testing alternative methods for culturing GBM cells that fail to form long term self-renewing neurospheres (Figure 1), to increase the representation of GBM tumors that can be used in animal models. Here we present a protocol for culturing neurospheres from GBMs. For cells that fail to form neurospheres, we show a simple modification in the growth medium, as the first attempt to culture tumorigenic cells from nonneurosphere forming GBMs, with promising results and still undergoing extensive validation.
1. Single Cell Suspension from Fresh Surgical Glioblastoma Specimen for Neurosphere Culture
For 500 ml of DMEM/F12 | ||
Stock solution | Volume | final concentration |
N2 supplement (10x) | 5 ml | 1x |
250 mg/ml BSA stock solution | 1 ml | 0.5 mg/ml |
10 mg/ml Gentamicin reagent | 1.25 ml | 25 μg/ml |
100x antibiotic/antimycotic | 2.5 ml | 0.5x |
100 mg/ml bFGF | 0.1 ml | 20 ng/ml |
100 mg/ml EGF | 0.1 ml | 20 ng/ml |
2. Glioblastoma Neurosphere Culture Maintenance and Downstream Applications
3. Alternative Protocol for Culturing Tumorigenic Glioblastoma Cells (for the cases where neurosphere culture fails)
4. Morphological and Molecular Analysis of Neurospheres by Immunohistochemistry
We have applied the protocol described above to dissociate and culture 125 fresh surgical glioblastoma specimens (Figure 1), 88 newly diagnosed, and 37 recurrent tumors (Table 2), with approved patient consent and under institutional guidelines. The efficiency of the protocol for establishing long term neurosphere cultures was 41.6%, and similar for newly diagnosed tumors and recurrent tumors (Table 2). For some GBM samples, neurospheres form in the first few days (Figures 1B and 1C), while for others longer culturing time is required (Figures 1D and 1E).
Efficiency of neurosphere formation was not exclusively dependent on the level of necrosis in the tissue, as exemplified by the results from a newly diagnosed tumor with high cell density (GBM1) and a recurrent and necrotic tumor (GBM2) processed according to Protocols 1 and 2, both yielding neurosphere cultures (Figure 2).
Testing the tumorigenic potential of each neurosphere culture in immunocompromised mice is the crucial validation of this approach for enrichment of CSCs. Using a protocol similar to previously described18, GBM1 and GBM2 neurospheres were implanted into the brains of immunocompromised mice, under institutional and IACUC animal care guidelines. The xenograft tumors present morphological characteristics of GBMs, such as invasion into the brain parenchyma and necrosis (Figure 2).
GBM3 was dissociated (Figure 1A) and cultured in neurosphere medium (Figures 1D and 1E), and in 2% FBS/NMGF (Figures 1D, 1G, and 1H). Monolayer cells cultured in 2% FBS/NMGF and neurosphere cells cultured in NMGF were dissociated and the same number of cells were implanted in nude mouse, using the same procedure as in Figure 2. No differences in survival, tumor growth dynamics, or morphology were observed between the two preimplant culture methods (Figures 3A-C). Tumor growth characteristics do not change up to the latest passage tested, P20 for neurospheres, and P10 for 2% FBS/NMGF. While neural stem cell markers, including Sox2, are downregulated in most primary GBM cells cultured in 10% FBS 3,4,11, NMGF supplemented with 2% FBS allows for the retention of Sox2 expression (Figure 3D).
Neurospheres were processed according to Protocol 4, and labeled with H&E (Figure 4A), anti-Sox2 antibody, showing nuclear localization (Figure 4B), and EGFR antibody, cell membrane localization (Figure 4C). This protocol has been applied to access stimuli-dependent alterations in the expression of nestin, GFAP, and the proliferation marker Ki6711.
Table 2. Efficiency of deriving long term self-renewing neurosphere cultures from GBMs.
Pathology | n | Percentage of samples yielding long term self-renewing neurospheres (n) |
Glioblastoma – untreated, first surgery | 88 | 42.0% (37) |
Glioblastoma – recurrent | 37 | 40.5% (15) |
TOTAL | 125 | 41.6% (52) |
Figure 1. Cell culture from fresh glioblastoma surgical specimens. Fresh tumors are enzymatically dissociated into single cells. Nucleated cell interface from density separation medium is then plated in NMGF. Dissociated neurospheres are plated in NMGF, and typically 1 day after plating there are dead cells, debris, attached single cells, and occasional dividing cells in suspension (A). Neurosphere formation is faster for some cases (B,C), and slower for others (D,E). All neurospheres are dissociated and replated for at least 10 passages, 41.6% GBMs yield long term self-renewing neurospheres. Viable GBM dissociated cells that fail to grow as neurospheres (F) can be transferred to alternative culture conditions, for example 2% FBS/NMGF (G,H). Bar (A), 100 μm, applies to all images. Click here to view larger image.
Figure 2. Neurosphere generation and orthotopic mouse xenografts from GBM tumors. A tumor sample presenting high cell density (GBM1) and a tumor with high necrotic content (GBM2) were dissociated and neurospheres cultured for 10 passages according to Protocols 1 and 2. Immunocompromised mice were implanted with 3 x 105 dissociated neurosphere cells and sacrificed when moribund. Mouse brains were formalin fixed and paraffin embedded for H&E staining and immunohistochemistry detection of human markers, human mitochondria (hMit) or major histocompatibility class I subunit HLA-A (MHC-I). Click here to view larger image.
Figure 3. Similar tumor growth in mice implanted intracranially with GBM3 cells cultured as neurospheres in NMGF or as monolayers in 2% FBS/NMGF. (A) Kaplan-Meier survival curves for GBM3 cultured as either neurospheres in NMGF or monolayers in 2%FBS/NMGF (both passage <10) show no difference in survival (n=10, p=0.7174, log-rank test). (B) Tumor growth monitored by live bioluminescence imaging (BLI) show no significant difference in tumor growth dynamics between the two groups. (C) Tumor morphology is indistinguishable for 4 GBM3 xenografts, 2 cultured in NMGF and 2 cultured in 2% FBS/NMGF. MHC-I stain as described for Figure 2. Scale, 600 μm. (D) Western blot showing the stem cell maker Sox2 expression retained in 2% FBS/NMGF cultures used to initiate the xenograft tumors (A-C). Click here to view larger image.
Figure 4. Analysis of protein expression in neurosphere sections by immunohistochemistry. Neurosphere cultures were formalin-fixed and paraffin embedded as described in Procedure 4, and stained with H&E (A), anti-Sox2 antibody (B), and anti-EGFR antibody (C). DAB substrate was used to visualize (B,C). Bar, 20 μm. Click here to view larger image.
Proper enzymatic tumor cell dissociation is a critical step in this protocol. The tissue must be minced well prior to incubation in cell dissociation solution at 37 °C under rotation, for a minimum of 30 min, when the tissue must be mechanically triturated and the extension of the dissociation verified. Depending on the degree of tissue cohesion, incubation can be extended for additional 15-30 min, as needed to complete dissociation into single cells. Incubation in dissociation solution for longer than 1 hr is not recommended due to decreased cell viability. Although the optimal amount of starting tissue is 200-500 mg, this protocol has led to successful neurosphere cultures from as little as 50 mg of tumor tissue.
Serum-free NMGF is a selective medium, and a percentage of neoplastic cells comprising the bulk of the tumor, as well as host cells, will not survive, while others will attach to the tissue culture treated flask after plating. It is critical that the neurospheres that will form over 1-3 weeks (Figures 1B-E) are transferred to fresh flasks, to separate from differentiated tumor cells and debris.
GBM cells enzymatically dissociated and never cultured (step 1.10) can be cryopreserved as a backup source of cells to culture in alternative media, in case the neurosphere culture fails. We have successfully obtained neurosphere cultures from such frozen stocks, as well as monolayer cells growing in 2% FBS/NMGF.
Conceptually, "cancer stem cell" is a work in progress and this emerging field will benefit from additional clarification, since the clinical implications are considerable, particularly in the generation of tumor heterogeneity, plasticity, and resistance to therapy19,20. In addition to being vital for generating patient-specific GBM animal models, the neurosphere cultures are also valuable for in vitro studies such as alteration in cell signaling and gene expression in response to growth factors, hypoxia, and pharmacological agents11,21. We have opted for using cross-sections of formalin fixed and paraffin embedded neurospheres, preserving the 3D architecture, to study protein expression and post-translational modifications by immunohistochemistry11, due to the superior subcellular localization in relation to the more common method of labeling and imaging the whole sphere.
It has been shown that not all cells within neurospheres derived from adult mammalian brain are stem cells22. Similarly, the neurospheres cultured from GBM tumors are likely not clonal, due to the presence of more differentiated cancer progenitor cells and self-aggregation, known to occur at high cell densities23, which is considered a limitation of this method by some. To favor enrichment for long term self-renewing stem cells, as opposed to just progenitors which can transiently grow as neurospheres22, the primary neurospheres are dissociated for secondary neurosphere formation, and further passaged for a minimum of 10 passages, roughly equivalent to 2 months in continuous culture, which is an indication of a population enriched in stem cells22. In our experience, GBM neurosphere cultures that achieve that mark can continue to be expanded as neurospheres indefinitely. Tumor grade matters, since we have obtained successful cultures from GBMs and anaplastic astrocytomas, WHO grade IV and III, respectively, but not from lower grade gliomas.
The most prevalent method of culturing glioblastoma cells, in traditional growth medium supplemented with 10% FBS, leads to considerable genomic and phenotypic divergence from the original tumors 4. On the other hand, neurosphere cultures are a stable and long term source of cells presenting cancer stem cell phenotype4. The neurosphere method has become increasingly popular for the enrichment of CSC in long term cultures for orthotopic mouse xenograft models, despite not being successful for all high grade astrocytoma samples, which represents the main weakness of this method. Studies to understand how molecular characteristics of the parental tumors can affect neurosphere formation are underway. Exploration of practical alternative methods to culture high grade gliomas, followed by extensive validation are granted, given the momentous advantages of having patient specific GBM models, as we advance into an era of personalized medicine, fuelled by the accessibility of "omics" information and increased numbers of potential targeted therapies.
The authors have nothing to disclose.
This work has been funded by the Hermelin Brain Tumor Center, Henry Ford Hospital.
DMEM/F12 | Life Technologies | 11330-032 | |
Trypsin – EDTA 0.05% | Life Technologies | 25300-054 | |
Hank’s Balanced Salt Solution, calcium- and magnesium-free | Life Technologies | 14170-120 | |
Hank’s Balanced Salt Solution, with calcium and magnesium | Life Technologies | 24020-117 | |
Collagenase Type 4 | Worthington | 5004188 | |
Trypsin Inhibitor | Sigma | T7659 | |
DNase I | Sigma | D4527 | |
N2 Supplement (100x) | Life Technologies | 17502-048 | |
Albumin from Bovine Serum, cell culture grade | Sigma | A4919 | |
Gentamicin Reagent Solution | Life Technologies | 15710-064 | |
Antibiotic/Antimycotic | Life Technologies | 15240-062 | |
Recombinant Human FGF-basic | PeproTech | 100-18B | |
Recombinant Human EGF | PeproTech | AF-100-15 | |
Lympholyte-Mouse | Cedarlane Laboratories Ltd. | CL5031 | |
Recovery Cell Culture Freezing Medium | Life Technologies | 12648-010 | |
Sterile Cell Strainer, 40 μm | Fisher | 22363547 | |
Dulbecco's Phosphate-Buffered Saline (DPBS), no calcium and no magnesium | Life Technologies | 14190-144 | |
Fetal bovine serum | Life Technologies | 26140-079 | |
Trypan Blue Stain, 0.4% | Life Technologies | 15250-061 | |
Neutral Buffered Formalin | Protocol | 245-684 | |
Histoplex Tissue Cassettes | Thermo Scientific | 22-146-426 | |
Rotator | Miltenyi BioTec | 130-090-753 | |
GlutaMAX Supplement | Life Technologies | 35050-061 | |
KnockOut D-MEM/F12 | Life Technologies | 12660-012 | |
Stem Pro Neural Supplement | Life Technologies | A1058-01 |