This article provides a detailed methodology for the measurement of isolevuglandins in tissues by immunofluorescence using alkaline phosphatase-conjugated ScFv D11 antibody. Hypertension models in both mice and humans are used to explain the step-by-step procedures and fundamental principles associated with isolevuglandin measurement in tissue samples.
Isolevuglandins (IsoLGs) are highly reactive gamma ketoaldehydes formed from H2-isoprostanes through lipid peroxidation and crosslink proteins leading to inflammation and various diseases including hypertension. Detection of IsoLG accumulation in tissues is crucial in shedding light on their involvement in the disease processes. However, measurement of IsoLGs in tissues is extremely difficult, and currently available tools, including mass spectrometry analysis, are laborious and extremely expensive. Here we describe a novel method for in situ detection of IsoLGs in tissues using alkaline phosphatase-conjugated D11 ScFv and a recombinant phage-display antibody produced in E. coli by immunofluorescent microscopy. Four controls were used for validating the staining: (1) staining with and without D11, (2) staining with bacterial periplasmic extract with the alkaline phosphatase linker, (3) irrelevant scFV antibody staining, and (4) competitive control with IsoLG prior to the staining. We demonstrate the effectiveness of the alkaline phosphatase-conjugated D11 in both human and mouse tissues with or without hypertension. This method will likely serve as an important tool to study the role of IsoLGs in a wide variety of disease processes.
Isolevuglandins (IsoLGs), also known as isoketals, are isomers of the 4-ketoaldehyde family, which are products of lipid peroxidation, and react with and adduct to primary amines on proteins1,2. IsoLGs have been implicated in several diseases, including cardiovascular, Alzheimer's, lung and liver diseases, and many types of cancer3. IsoLGs have been most extensively studied in their contribution to cardiovascular disease (CVD), which is a significant health and economic burden globally, including the United States. It is estimated that 92.1 million US adults have at least one type of CVD, with 2030 estimated projections reaching to 43.9% of the US adult population4. Lowering blood pressure, cholesterol, and smoking cessation reduces the overall risk and occurrence of CVD events5.
High blood pressure or hypertension is a major risk factor for cardiovascular disease and affects approximately half of the US population6. Previous studies have found that inflammation is an underlying cause of hypertension and that IsoLGs play a role7. Hypertensive stimuli, including angiotensin II, catecholamines, aldosterone, and excess dietary salt, induce IsoLG accumulation in antigen presenting cells including dendritic cells (DCs), which in turn activate T cells to proliferate and produce inflammatory cytokines that contribute to hypertension8,9.
Previously, IsoLGs have been measured by immunohistochemistry, mass spectrometry, enzyme-linked immunosorbent assay, and flow cytometry10,11. To facilitate the measurement of IsoLGs, a single-chain fragment variable (scfv) recombinant antibody (D11) was developed against IsoLGs12. Initially, this D11 antibody contained an 11 amino acid E-tag and required a secondary antibody for immunohistochemistry detection11. However, it was difficult to find a reliable secondary antibody against the E-tag after the discontinuation of its production by the manufacturer. Therefore, we have developed a reliable protocol for immunofluorescent staining of IsoLGs using D11 conjugated with alkaline phosphatase (D11-AP), which we have demonstrated in mouse and human tissues with and without hypertension.
Vanderbilt University's Institutional Animal Care and Use Committee approved all procedures described in this manuscript. Mice are housed and cared for in accordance with the Guide for the Care and Use of Laboratory Animals. All subjects gave written informed consent before enrolling in the study as approved by the Institutional Review Board of Vanderbilt University. All procedures were performed according to the Declaration of Helsinki.
1. Preparation of plasmids encoding D11-alkaline phosphatase fusion protein and negative control vectors
2. Protein expression and generation of periplasmic extract
NOTE: Generation of the periplasmic extract is a commonly used method for protein expression in phage display, mainly because the formation of disulfide bonds is important in scFv and antibody generation. The method avoids the need to generate lysates (commonly containing inclusion bodies) and ensures that proteins are properly folded. pCANTAB has a gIII signal sequence upstream of the scFv portion of the D11-BAP fusion protein. The signal sequence ensures that the protein is shuttled to the periplasmic space of the bacterium, and then the signal sequence is cleaved. The periplasmic space provides an oxidizing environment, which is crucial to the proper formation of disulfide bridges. Osmotic shock is used to derive periplasmic extracts because it disrupts the outer membrane enough to release the periplasmic proteins into the surrounding medium, while keeping the bacterium intact.
4. Characterization of D11-AP titer in ELISA
5. Immunofluorescence
6. Negative controls
NOTE: Four negative control experiments can be performed to confirm the specificity of D11-AP staining for IsoLG. Negative control experiments should be performed in the same staining set under the same conditions.
In representative experiments, D11 scfv with an alkaline phosphatase conjugation (D11-AP) was used in immunofluorescence to detect IsoLGs present in angiotensin II-treated mice compared to normal sham mice and humans with hypertension compared to normotensive humans. Mice were treated with angiotensin II at a dose of 490 ng/kg/min for two weeks, and hypertension was confirmed with increased systolic blood pressure compared to sham mice10. To ensure specificity of D11-AP, tissues were stained with or without the presence of D11-AP. As demonstrated by D11-AP staining, the aorta of mice with angiotensin II-induced hypertension showed elevated concentration of IsoLGs when compared to control mice (Figure 1). Background staining or autofluorescence was limited, as shown by negative controls that were not stained with D11-AP.
D11-AP was used to detect IsoLGs present in intestinal tissues of human patients with hypertension (HTN) or normotensive humans (NTN). Hypertension status was established from the hospital records as systolic blood pressure above 140 and diastolic blood pressure above 80 mmHg. Researchers developing immunofluorescence protocol for D11-AP were blinded to the hypertension status of human tissues. Sections were stained in the presence and absence of D11-AP to ensure antibody specificity and show background staining or autofluorescence. As shown in Figure 2, we found that tissues from patients with HTN had elevated concentrations of IsoLGs compared to patients with NTN. Staining without D11-AP also showed minimal background staining and autofluorescence. Endogenous alkaline phosphatase is expressed by intestinal epithelium, so the limited fluorescence of tissues stained without D11-AP shows the antigen retrieval used in this protocol was sufficient in inactivating endogenous alkaline phosphatase present in tissues. In combination with the results in mice, these results also show that the immunofluorescence protocol effectively shows elevated IsoLGs in hypertension when compared to normotensive status.
D11-AP was isolated and stored in the bacterial periplasmic extract. Mouse and human tissues were stained with D11-AP and periplasmic extract containing the AP linker without D11 to ensure that other factors that may be present in the periplasmic extract, such as excess or non-conjugated alkaline phosphatase, do not contribute to the staining observed in tissues treated with D11-AP (Figure 3). Tissues stained with D11-AP resulted in brighter staining compared to tissues stained with periplasmic extract. These results confirm that D11-AP is staining the tissues, and the staining is not due to non-conjugated bacterial alkaline phosphatase that can potentially be present in the periplasmic extract and result in false staining of IsoLGs or contribute to background staining.
A competitive control was performed by pre-incubating D11-AP with IsoLG adducted to MSA or non-adducted MSA before staining tissues to show the specificity of D11-AP to IsoLG. If D11-AP is specific for IsoLG, the antibody would bind to IsoLG-MSA, resulting in a depleted availability of D11-AP to stain tissues, and D11-AP incubated with non-adducted MSA would have similar staining to normal D11-AP. In tissues stained with D11-AP pre-incubated with the IsoLG competitor, we found diminished staining compared to tissues that were stained with D11-AP without any preincubation (Figure 4). In tissues stained with D11-AP preincubated with non-adducted MSA, we found staining to be similar to staining observed in tissues with D11-AP. These results show the specificity of D11-AP to IsoLGs due to reduced staining of tissues when D11-AP was pre-incubated with IsoLG/MSA, but not non-adducted MSA. In the final negative control, mouse tissue was stained with D11-AP or irrelevant scFv antibody, D20. Staining mouse aorta with D11-AP resulted in strong staining compared to D20 indicating the specificity of D11-AP to IsoLGs in hypertensive aortae (Figure 5).
Figure 1: Immunofluorescence of the aorta in hypertensive and normotensive mice. Arteries from angiotensin II and sham infused mice were stained with and without D11-AP (D11) to show presence of IsoLGs. (A) Artery from an angiotensin II treated mouse probed with D11-AP (green) and nuclear counterstain (magenta), (B) Artery from a control sham treated mouse probed with D11-AP, (C) Artery from an angiotensin II treated mouse without D11-AP, (D) Artery from a control sham treated mouse without D11-AP (scale bar =100 µm). Please click here to view a larger version of this figure.
Figure 2: Immunofluorescence of human intestinal tissues from hypertensive and normotensive patients. Tissues from patients with hypertension (HTN) and normotensive humans (NTN) were stained with and without D11-AP (D11) to show presence of IsoLGs in patients with HTN. (A) HTN tissues stained with D11-AP (green) and nuclear counterstain (magenta), (B) NTN tissues stained with D11-AP, (C) HTN tissues stained without D11-AP, (D) NTN tissues stained without D11-AP (scale bar =100 µm). Please click here to view a larger version of this figure.
Figure 3: Mouse and human tissues stained with periplasmic extract with and without D11-AP. Mouse and human tissues were stained with periplasmic extracts with and without D11-AP. Images show limited staining of tissues with periplasmic extract without D11-AP, which show staining is mostly due to D11-AP binding rather than another component that may be present in periplasmic extract. (A) Ang mouse aorta stained with D11-AP (green) and nuclear counterstain (magenta), (B) Ang mouse aorta stained with periplasmic extract, (C) Sham mouse aorta stained with D11-AP, (D) Sham mouse aorta stained with periplasmic extract, (E) hypertensive human intestinal tissue stained with D11-AP, (F) hypertensive human intestinal tissue stained with periplasmic extract, (G) normotensive human intestinal tissue stained with D11-AP, (H) normotensive human intestinal tissue stained with periplasmic extract (scale bar =100 µm). Please click here to view a larger version of this figure.
Figure 4: Competitive control in vessels of Ang and Sham mice. In this competitive control, D11-AP was pre-incubated with IsoLG-adducted MSA or non-adducted MSA. D11-AP without any pre-incubation was used as a control. These results show the specificity of D11-AP to IsoLGs because there is reduced staining of tissues with the IsoLG-MSA competitor compared to D11-AP. This reduction is due to IsoLG and not MSA because the non-adducted MSA pre-incubation resulted in staining similar to D11-AP control. Angiotensin II (A) and Sham (B) mouse aortae stained with D11-AP (green) and nuclear counterstain (magenta), Angiotensin II (C) and Sham (D) mouse aortae stained with D11-AP after incubating with IsoLG-MSA, Angiotensin II (E) and Sham (F) mouse aortae stained with D11-AP after incubating with non-adducted MSA (scale bar =100 µm). Please click here to view a larger version of this figure.
Figure 5: Mouse aortae stained with D11 and irrelevant scFv, D20. Mouse tissue were stained with D11-AP and compared to an irrelevant control antibody, D20, which is specific for glycoprotein A2. Staining of tissue with D11-AP (green) and nuclear counterstain (magenta) (A) resulted in intense immunofluorescence compared to D20 (green) and nuclear counterstain (magenta) (B) which indicates specificity of D11-AP to IsoLGs (scale bar =100 µm). Please click here to view a larger version of this figure.
D11 has been used extensively to detect IsoLG-adducted proteins in cells or tissues as a marker for inflammation or oxidative stress in disease8,9,20. Previously, D11 contained an E tag and IHC development required the use of a secondary anti-E tag antibody conjugated with HRP10,20,21. Here, we have developed and optimized protocol for detection of IsoLG-adducted proteins using the D11 antibody conjugated with alkaline phosphatase in place of the E-tag, which eliminates the need for a secondary antibody incubation.
To determine the specificity of D11-AP, four negative control experiments were performed. We performed the protocol without the presence of D11 and had minimal development. These results have a two-fold indication: endogenous alkaline phosphatase is not contributing to development, and the staining observed is due to D11 and not another contributing factor. Next, we stained slides with the AP linker without D11. This experiment resulted in little staining, which indicates free AP or other factors in the periplasmic extract is not causing the stain we observe in the presence of D11. To ensure the specificity of D11 to IsoLG, we preincubated D11-AP with purified IsoLG before staining slides. We saw a decrease in development which indicates that the D11-AP was bound to IsoLG protein, thus exhausting the amount of free D11-AP to bind to IsoLG present in the tissue. Finally, to ensure D11-AP was binding to IsoLG and not the MSA protein IsoLG was bound to, we preincubated D11-AP with MSA only. There were no changes in development, indicating D11-AP was not binding to MSA but the IsoLG protein. Lastly, researchers developing the staining protocol were blind to hypertensive status of human intestinal tissue. The differences in staining observed between patients with hypertension and patients with normotension were not due to bias and have been previously described22,23.
Although our protocol for detection of IsoLG-adducted proteins using the D11 antibody conjugated with alkaline phosphatase in place of the E-tag is rigorous and robust and eliminates the need for a secondary antibody incubation, it has some limitations. One limitation is that we used D11 conjugated with alkaline phosphatase in the periplasmic extract, and there could be false staining of endogenous alkaline phosphatase in the periplasmic extract or certain tissues, such as intestine24. However, the first step to develop this protocol included disabling endogenous alkaline phosphatase that may be present in tissues25. Initially, cold acetic acid, BME, and Levamisole26 were tested for efficiency. None of these completely diminished the presence of active endogenous alkaline phosphatase. Heat has been used to deactivate alkaline phosphatase27, so we tested heat deactivation of alkaline phosphatase in different buffers. We found heating mounted and hydrated slides in citrate buffer eliminated most endogenous alkaline phosphatase. Slides were developed initially using a Chemiluminescent/Fluorescent Substrate, but when imaged without this substrate, there was a high amount of autofluorescence. VectorRed is a substrate which develops in the presence of alkaline phosphatase to produce a chromogen which can be visualized in the Texas Red/TRITC channel range. Using this substrate, we were able to more easily observe signal above background autofluorescence. Care should be taken during the staining process to minimize artifactual staining. Drying of tissues on slides after hydration until imaging has resulted in heightened development. D11-AP should be aliquoted and stored at -20 °C. Multiple freeze-thaw cycles should be avoided when working with D11-AP. Phosphate-buffered saline (PBS) can also affect the enzymatic activity of alkaline phosphatase and should not be used as a wash buffer28. As with any antibody-based approach, thorough testing and optimization must be carried out to ensure that staining is specific, and that signal is not over or under amplified.
In conclusion, we have developed a powerful, rigorous, and robust optimized protocol to detect IsoLG-adducted proteins using the D11 antibody conjugated with alkaline phosphatase in place of the E-tag. This protocol presents several advantages: First, using D11 as an alkaline phosphatase fusion protein is cheaper. D11 was originally derived from a phage antibody library that could not be commercialized and was expensive to purify. Although D11 in E. coli periplasmic extract could provide an inexpensive alternative, it was ineffective in most assays. Second, the alkaline phosphatase fusion approach allows D11 scfv to have a useful reporter15 (alkaline phosphatase) fused to it and would not need to be purified for use in immunoassays as substrates are commercially available. Third, the E. coli alkaline phosphatase forms dimers29. So D11, when fused to the alkaline phosphatase would also form dimers and this increase the antibody's avidity and binding activity30. Finally, D11 conjugated with alkaline phosphatase in periplasmic extract can easily be cleaned using Cibacron Blue Sepharose. D11 has a high isoelectric point (~9.2 pH). As such, it is positively charged and can bind to Cibacron Blue through pi-cation interactions. Most of the impurities in the E. coli periplasmic extract can be eluted off the resin. The D11 conjugated with alkaline phosphatase can then be eluted using high salt (~1.5M NaCl) in water. The eluted D11 conjugated with alkaline phosphatase is quite stable at 4-8 °C in the high salt solution. Thus, we have developed a protocol which not only makes the D11 antibody available at a low cost, but also eliminates the extra steps and need for the secondary antibody incubation. This protocol facilitates reproducible measurement of IsoLGs, which accumulate in tissues in multiple diseases where increased oxidative stress plays a role.
The authors have nothing to disclose.
This work was supported by National Institutes of Health grants K01HL130497, R01HL147818, R01HL144941, and R03HL155041 to A.K. We thank the Digital Histology Shared Resource – Vanderbilt Health Nashville, TN https://www.vumc.org/dhsr/46298 for visualization and slide scanning.
1 ml TALON HiTrap column (Cobalt-CMA) | Cytiva | 28953766 | |
200 Proof Ethanol | Pharmco | 111000200 | |
2xYT powder | MP Biomedicals | 3012-032 | |
384-well, clear, flat-bottom polystyrene microplates | ThermoFisher (NUNC) | 242757 | |
4-Nitrophenyl phosphate disodium salt hexahydrate (pNPP) | Carbosynth | EN08508 | |
5-Bromo-4-chloro-3indoxyl phosphate, p-toluidine salt (BCIP) | Carbosynth | EB09335 | |
Ampicillin, sodium salt | Research Products International (RPI) | A40040 | |
Bovine Serum Albumin | RPI | A30075 | |
Chemically competent TG1 E. coli | Amid Biosciences | TG1-201 | |
Diethanolamine, >98% | Sigma-Aldrich | D8885 | |
EDTA | Sigma-Aldrich | ED | |
Fluoromount-G | SouthernBiotech | 0100-01 | Mouting medium |
Glucose | Research Products International (RPI) | G32045 | |
Glycerol | Sigma-Aldrich | G7893 | |
Histoclear | National Diagnostics | HS-200 | Xylene alternative |
Hoechst 33342 | ThermoFisher | H3570 | stock solution = 10 mg/mL |
Hydrochloric acid (HCl), 30%, Macron Fine Chemicals | ThermoFisher | MK-2624-212 | |
Imidazole | Research Products International (RPI) | I52000 | |
MgCl2 (anhydrous) | Sigma-Aldrich | M8266 | |
Mouse Serum Albumin (MSA) | Sigma-Aldrich/Calbiochem | 126674 | |
Nitroblue tetrazolium chloride (NBT) | Carbosynth | EN13587 | |
Potassium chloride (KCl) | Sigma-Aldrich | P4504 | |
Potassium phosphate, monobasic (KH2PO4) | Sigma-Aldrich | P0662 | |
Pressure Cooker | Cuisinart | CPC-600 | |
Slide-a-Lyzer Dialysis cassettes, 10K MWCO, 3 ml | ThermoFisher | 66380 | |
Sodium chloride (NaCl) | Research Products International (RPI) | S23020 | |
Sodium Citrate | Sigma-Aldrich | 1064461000 | |
Sodium phosphate, dibasic (Na2HPO4) | Research Products International (RPI) | S23100 | |
Sucrose | Research Products International (RPI) | S24065 | |
Tris base | Research Products International (RPI) | T60040 | |
Tris-buffered Saline | Boston Bio-Products | 25mM Tris, 2.7mM KCl, 137 mM NaCl, pH 7.4 | |
Tris-HCl | Research Products International (RPI) | T60050 | |
Tween20 | Sigma-Aldrich | P9416 | |
Vector Red | Vector Labs | SK-5105 |