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Rheumatoid Arthritis Methods and Protocols Methods in Molecular Biology 2766 2nd Edition Shuang Liu
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Synthetic Biology Methods and Protocols Methods in Molecular Biology 2760 2nd Edition Braman Jeffrey Carl Edt
University of Hertfordshire Hatfield, Hertfordshire, UK
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RheumatoidArthritis
Methods and Protocols
Second Edition
Edited by Shuang Liu
Department of Pharmacology, Ehime University School of Medicine, Toon, Ehime, Japan
Editor
Shuang Liu Department of Pharmacology
Ehime University School of
Medicine
Toon, Ehime, Japan
ISSN 1064-3745ISSN 1940-6029 (electronic)
Methods in Molecular Biology
ISBN 978-1-0716-3681-7ISBN 978-1-0716-3682-4 (eBook) https://doi.org/10.1007/978-1-0716-3682-4
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Preface
Welcome to the second edition of Rheumatoid Arthritis: Methods and Protocols. This comprehensive volume represents a testament to the ever-evolving field of rheumatoid arthritis (RA) research, where groundbreaking advances continue to emerge on multiple fronts. As we embark on this journey through the labyrinthine world of RA investigation, we find ourselves at the forefront of a scientific endeavor that holds the promise of transforming the lives of millions afflicted by this debilitating autoimmune disease.
Rheumatoid arthritis is a complex, systemic autoimmune disorder characterized by chronic inflammation, joint destruction, and a wide spectrum of associated comorbidities. Despite the significant progress made in understanding the pathogenesis and treatment of RA in recent years, there is an unceasing need for innovative approaches, methodologies, and therapies to further enhance our understanding and management of this disease.
This second edition builds upon the foundations laid by its predecessor, expanding and refining the content to encompass the most cutting-edge laboratory and clinical protocols employed in RA research today. The book’s contents have been meticulously curated to provide a comprehensive roadmap for researchers, clinicians, and students who aspire to delve deep into the intricate world of rheumatoid arthritis.
In this edition, we examine the multifaceted aspects of RA research, covering a wide range of methodologies and techniques. We explore the utilization of cell culture systems to decipher the intricate molecular pathways underlying RA pathogenesis. We navigate through the intricate realm of animal models that mirror the disease’s complexity and provide invaluable insights for translational research. Genetic modification techniques unveil the genetic underpinnings of RA susceptibility and offer potential avenues for therapeutic intervention.
Furthermore, we delve into the development of novel therapeutics, including the promising realms of aptamers and antibodies. In silico docking and bioinformatics methods offer a computational approach to drug discovery, saving time and resources in the quest for effective treatments. We dive deep into the world of RNA sequencing, exploring bioinformatics techniques to unlock the secrets hidden within the vast transcriptomic landscape of RA.
Finally, we navigate the challenging waters of clinical research, where the knowledge gleaned from laboratories meets the real-world complexities of patient care. We explore the latest clinical study designs, patient-centered approaches, and emerging trends in RA management.
This second edition of Rheumatoid Arthritis: Methods and Protocols stands as a testament to the dedication and collaborative efforts of researchers worldwide. It is our hope that this book will serve as an indispensable resource, guiding you through the ever-evolving landscape of RA research and facilitating breakthroughs that will ultimately improve the lives of individuals living with this chronic condition.
We extend our heartfelt gratitude to the authors, contributors, and the scientific community for their unwavering commitment to advancing our understanding of rheumatoid arthritis. May this book inspire and empower the next generation of researchers to continue pushing the boundaries of knowledge and innovation in the quest to conquer this challenging autoimmune disease.
Toon, Ehime, JapanShuang Liu
Yasuyuki Suzuki
Noritaka Saeki and Akihiro Nakata
Yasuyuki Suzuki and Shuang Liu
33 Assessment of Disease Activity, Structural Damage, and Function in Rheumatoid Arthritis
Jun Ishizaki and Hitoshi Hasegawa
34 Assessment of Musculoskeletal Ultrasound of Rheumatoid Arthritis. .
Jun Ishizaki
35 16S rRNA Gene Amplicon Analysis of Human Gut Microbiota. .
Noriyuki Miyaue
Index
Contributors
HITOSHI HASEGAWA • Department of Hematology, Clinical Immunology, and Infectious Diseases, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
MAKOTO INUI • Department of Pharmacology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
JUN ISHIZAKI • Department of Hematology, Clinical Immunology and Infectious Diseases, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
TAKESHI KIYOI • Division of Analytical Bio-medicine, Department of Pharmacology, Kanazawa Medical University, Kahoku, Japan
SHUANG LIU • Department of Pharmacology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
MOCHITSUKI MARII • Department of Pharmacology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
SAHO MARUYAMA • Department of Basic Medical Research and Education, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
NORIYUKI MIYAUE • Department of Clinical Pharmacology and Therapeutics, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
MAYA MIYOSHI • Department of Pharmacology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
MASAKI MOGI • Department of Pharmacology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
AKIHIRO NAKATA • Department of Pathophysiology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
NORITAKA SAEKI • Division of Medical Research Support, Advanced Research Support Center, Ehime University, Toon, Ehime, Japan; Division of Integrative Pathophysiology, ProteoScience Center, Ehime University, Toon, Ehime, Japan
YASUYUKI SUZUKI • Department of Anaesthesiology, Saiseikai Matsuyama Hospital Matsuyama, Ehime, Japan; Department of Pharmacology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan; Research Division, Saiseikai Research Institute of Health Care and Welfare, Tokyo, Japan
HIROYUKI TAKEDA • Proteo-Science Center, Ehime University Matsuyama, Ehime, Japan
ERIKA TAKEMASA • Department of Pharmacology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
WEI ZHOU • Proteo-Science Center, Ehime University Matsuyama, Ehime, Japan
Part I
Animal Models
Chapter 1
Collagen-Induced Arthritis Models
Maya Miyoshi and Shuang Liu
Abstract
Due to the limitations of using patient-derived samples for systemic kinetic studies in rheumatoid arthritis (RA) research, animal models are helpful for further understanding the pathophysiology of RA and seeking potential therapeutic targets or strategies. The collagen-induced arthritis (CIA) model is one of the standard RA models used in preclinical research. The CIA model shares several pathological features with RA, such as breach of tolerance and generation of autoantibodies targeting collagen, synovial inflammatory cell infiltration, synovial hyperplasia, cartilage destruction, and bone erosion. In this chapter, a protocol for the successful induction of CIA in mice is described. In this protocol, CIA is induced by active immunization by inoculation with type II heterologous collagen in Freund’s adjuvant in susceptible DBA/1 mice.
Key words Collagen-induced arthritis, Freund’s adjuvant, Type II collagen, Emulsion, Immunization
1 Introduction
Rheumatoid arthritis (RA) is a chronic inflammatory disease that initially affects the joints, manifesting as pain, stiffness, and synovitis, leading to cartilage and bone erosion by invading fibrovascular tissue [1]. The central pathogenesis of RA is characterized by the activation of macrophages by autoreactive T cells, resulting in the release of a series of proinflammatory cytokines. However, how the systemic chronic inflammatory state triggers the onset of articular disorder is still poorly understood [2]. To further define the pathogenesis of RA, it is helpful to study human-derived cells and explanted tissues from patients who have undergone arthroscopic surgery or prosthetic replacement arthroplasty. However, this has significant limitations for systemic kinetic studies. Therefore, animal models are not only essential to facilitate understanding of the pathophysiology of RA and seek potential therapeutic targets or strategies but are also the starting point for in vivo application of new therapeutic agents.
Based on the methods of induction, systemically induced models include those elicited by active immunization, such as
collagen-induced arthritis model and proteoglycan-induced arthritis model, those elicited by passive immunization, such as collagen antibody-induced arthritis model and K/BxN antibodyinduced arthritis model, and those elicited by administration of irritant chemicals resulting in chronic inflammation [1, 3]. Each animal model is only an experimental tool that mimics a part of the disease and cannot reproduce the entire condition of human RA. The choice of model depends on the phase of the disease to be studied and the question to be addressed.
The collagen-induced arthritis (CIA) model is a long-lasting and well-explored mouse model for RA. CIA and RA initial similarity in breach of tolerance and generation of autoantibodies targeting collagen, one of the important self-antigens that are also observed in human RA [2, 4]. CIA is induced by active immunization by inoculation with type II heterologous collagen (CII) in Freund’s adjuvant in susceptible strains of mice. DBA/1 mice are commonly used for the CIA model. The model requires at least 6–8 weeks for the accomplishment of clinical signs of disease, such as polyarthritis characterized by synovial inflammatory cell infiltration, synovial hyperplasia, cartilage destruction, and bone erosion [5, 6]. The autoreactive antibody observed in CIA mice is predominately IgG2 subclass, and high levels of both IgG2a and IgG2b are observed at the peak of CIA. Typical cytokine axes involving in human RA pathogenies, such as proinflammatory type 1 T help (Th1) cell-axis, anti-inflammatory cytokine interleukin (IL)-10 axis, and Th17 cell-axis, can be investigated using the CIA model [6, 7]. These characteristics of the CIA model make it the gold standard in vivo model for RA studies.
In this chapter, a protocol for the successful induction of CIA in mice is described. Like any other antigen-induced model, certain technical skills and stable environmental factors are required. The highest arthritis incidence is obtained if the emulsion is correctly performed using bioactivity-qualified CII and appropriate intradermal immunization is performed.
2 Materials
2.1 Emulsion Preparation
1. Type 2 collagen (2 mg/mL, immunization grade) (see Note 1).
2. Incomplete Freund’s adjuvant (IFA).
3. Complete Freund’s adjuvant (CFA).
4. Glass syringes without needles (1 mL) (Hamilton).
5. Electronic homogenizer with a small blade (diameter of 5 mm or less).
6. T-shape stopcock.
7. 5-mL and 10-mL disposable plastic syringes.
2.2 Animal Immunization
1. DBA/1 mice (male, 8–10 weeks old) (see Note 2).
2. 70% ethanol.
3. CII emulsion (CFA)/CII emulsion (IFA).
4. 25 and 27 gauge × 5/8″ needles.
3 Methods
3.1 Emulsion
Preparation (See Notes 3 and 4)
3.2 Animal
Immunization (See Note 7) (Fig. 1)
1. Fill glass syringes with 500 μL of CFA (IFA for booster injection) and 500 μL of immunization grade CII, respectively.
2. Seal the tips of both syringes with a T-shape stopcock.
3. Connect the rest of the connector of the T-shape stopcock with a 5-mL or 10-mL plastic syringe without a plunger and cut halfway from the plunger opening.
4. Push the plunger of the glass syringes and let CFA (IFA for booster injection) and CII solution mix in the plastic syringe. Air bubbles should be avoided during solution mixing.
5. After sealing the plastic syringe with the T-shape stopcock, take off the glass syringes.
6. Clamp the syringe to a ring stand and place it in an ice water bath to keep the emulsion cool during mixing.
7. Homogenize the mixture to emulsify CFA (IFA for booster injection) with the collagen solution until the emulsion is stable (see Note 5).
8. Transfer the emulsion to a 1-mL glass syringe for animal injection (see Note 6). The prepared emulsion should be injected into animals as soon as possible (within 1 h). Keep the emulsion cool at 4 °C until use.
1. DBA/1 mice are used for induction of CIA. Primary intradermal injection of CII and CFA emulsion is performed at a site 2 cm distal to the base of the tail on day 0.
2. Use a squirt bottle to apply 70% ethanol to the injection site and wipe with tissue.
3. Place a 25-or 27-gauge needle on the glass syringe. Wipe the needle to prevent leakage of emulsion.
4. Inject 100 μL (100 μg CII/ mouse) of CII and CFA emulsion intradermally at the base of the tail, with noticeable tissue resistance to the injection (see Note 8).
5. Put the mouse in a clean cage, and house the mice in specific pathogen-free (SPF) conditions.
Fig. 1 Typical appearances of hindpaws of (a) non-arthritis control mouse and (b) collagen-induced arthritis (CIA) mouse. Erythema and edema are observed in CIA mouse
6. Administer a booster injection of emulsion of CII and IFA on day 21. The injection site is about 3 cm from the base of the tail. Choose a different location from the initial injection site.
7. Use a squirt bottle to apply 70% ethanol to the injection site and wipe with tissue.
8. Place a 25-or 27-gauge needle on the glass syringe. Wipe the needle to prevent leakage of emulsion.
9. Insert the needle 3 cm from the base of the tail until the tip reaches 1.5 cm from the base. Inject 100 μL (100 μg CII/ mouse) of CII and IFA emulsion intradermally at the base of the tail, with noticeable tissue resistance to the injection.
10. Put the mouse in a clean cage and house the mice in SPF conditions. The incidence of CIA should be 90–100% at 42–56 days. The CIA mice are ready for evaluation of arthritis severity.
4 Notes
1. Immunization-grade CII should be solubilized and stored in a diluted solution of acetic acid.
2. DBA/a (H-2q) and B10.RIII(H-2r) are highly susceptible to CIA. DBA/I mice respond to chick, bovine, and porcine type II collagen, while B10.RIII mice respond to bovine and porcine collagen, but poorly respond to chick and human collagen.
3. The procedures for emulsion preparation should be performed under sterile conditions.
4. A method using an electric homogenizer is highly recommended for preparing emulsion. Do not use syringe–syringe or sonication methods in the establishment of CIA.
5. The highest arthritis incidence is obtained if the emulsion is correctly performed so that it has a consistency of dense whipped cream and it should not disperse quickly when a droplet of emulsion is placed on the surface of water.
6. It is sometimes difficult to move the plunger when a plastic disposable syringe is used.
7. The animal experiment protocols should be performed in accordance with the guidelines of the Animal Care Committee of the institute.
8. If the injection is rapid and easy without tissue resistance, it can result in a low incidence of CIA.
References
1. Liu S, Kiyoi T, Takemasa E, Maeyama K (2015) Systemic lentivirus-mediated delivery of short hairpin RNA targeting calcium release-activated calcium channel 3 as gene therapy for collageninduced arthritis. J Immunol 194:76–83
2. McInnes IB, Schett G (2011) The pathogenesis of rheumatoid arthritis. N Engl J Med 365: 2205–2219
3. Bessis N, Decker P, Assier E, Semerano L, Boissier MC (2017) Arthritis models: usefulness and interpretation. Semin Immunopathol 39:469–486
Trentham DE (1982) Collagen arthritis as a relevant model for rheumatoid arthritis. Arthritis Rheum 25:911–916
5. Caplazi P, Baca M, Barck K, Carano RA, DeVoss J, Lee WP et al (2015) Mouse models of rheumatoid arthritis. Vet Pathol 52:819–826
6. Miyoshi M, Liu S, Morizane A, Takemasa E, Suzuki Y, Kiyoi T et al (2018) Efficacy of constant long-term delivery of YM-58483 for the treatment of rheumatoid arthritis. Eur J Pharmacol 824:89–98
7. Mauri C, Williams RO, Walmsley M, Feldmann M (1996) Relationship between Th1/Th2 cytokine patterns and the arthritogenic response in collagen-induced arthritis. Eur J Immunol 26: 1511–1518
Chapter 2
Human Xenograft Model
Shuang Liu
Abstract
Human-SCID grafting is a commonly used technique for the long-term investigation of rheumatoid arthritis (RA) explants. To establish a chimeric immunological system in NOD/SCID mice, RA patientderived pannus tissue from the synovial membrane, articular cartilage, and bone can be transplanted subcutaneously. Same patient-derived peripheral mononuclear cell chimerism can be successfully achieved by intraperitoneal engraftment. This xenograft model is able to be used for the initial screening of human target-specified biologics.
Key words Xenograft rheumatoid arthritis model, NOD/SCID mouse, Peripheral mononuclear cell, Ar ticular tissue, Synovial invasion
1 Introduction
Several animal models, including antigen-induced models, such as collagen-induced arthritis, and spontaneous models, such as TNF-α transgenic mice and SKG mice, have been developed for the study of rheumatoid arthritis (RA). However, these models are not able to be used for in vivo screening of human target-specified biologics, especially for chimeric, humanized, and human-type monoclonal antibody or gene therapeutic products, which have been widely studied for clinical treatment of RA patients. Therefore, a xenograft model, in which human-derived explants are transplanted to a severe combined immunodeficiency (SCID) mouse, has been established for human target-specified biologics screening.
It was first reported that RA synovial tissue could be transplanted into SCID mice, and this animal model was useful for studying the pathogenesis of RA and the development of antirheumatic drugs in the early 1990s [1]. The initial studies were conducted on small pieces of synovium transplanted beneath the renal capsule in the mice. The maintenance of human-derived lymphocytes was poor, and usage of the model was limited. Next,
Shuang Liu (ed.), Rheumatoid Arthritis: Methods and Protocols, Methods in Molecular Biology, vol. 2766, https://doi.org/10.1007/978-1-0716-3682-4_2,
a challenge approach in which transplantation was changed to subcutaneous tissue on the back of SCID was conducted. In this model, tissue with a relatively large size, such as pannus tissue from the synovial membrane, articular cartilage, and bone, collected together from RA patients at the time of prosthetic replacement arthroplasty, was used for transplantation [2, 3]. The histologic features of human RA, such as pannus formation, proliferative synovial fibroblasts, osteoclasts and hyaluronic acid-positive articular cartilage, were observed. Based on the technique of the subcutaneous xenograft model, a chimeric human–mouse model was established using NOD/SCID mice, which are characterized by the absence of functional T cells and B cells, deficient NK function, lymphopenia, hypogammaglobulinemia, and a normal hematopoietic microenvironment. Patient-derived synovial tissue, bone, and articular cartilage were xenografted into NOD/SCID mice. To mimic the supporting inflammatory microenvironment of RA, peripheral blood mononuclear cells (PBMCs) derived from joint engrafts of the same patients were suspended in serum and engrafted into NOD/SCID mice [4]. Human multilineage hematocytes, including T lymphocytes, B lymphocytes, monocytes, myeloid maturation stages, and primitive progenitor cells, were sustained in xenografted mice for at least 8 weeks. Human rheumatoid factor was detected in the serum of xenografted mice, and invasion of synovium into the implanted cartilage was able to be scored. In this model, the maintenance of an inflammatory microenvironment is successfully achieved as a critical supportive factor for synovial invasion into cartilage.
2 Materials
To obtain explants from RA patients, research protocols should be approved by the Institutional Ethics Committee. All animal experiment protocols should be performed in accordance with the guidelines of the Institutional Animal Care and Use Committee and approved by the committee.
1. Animals: Male NOD/ShiJic-scid (NOD/SCID) mice, 6–10 weeks of age, are used for xenograft experiments (see Note 1).
2. Explants from RA patients: Peripheral blood (20 mL), synovium, bone, and articular cartilage explants can be obtained from RA patients who have undergone prosthetic replacement arthroplasty for therapeutic purposes. All explants should be transferred between institutions or units in a biohazard and cooling container. Explants should be handled for the xenograft procedure as soon as possible after explantation.
10ShuangLiu
3 Methods
3.1 Isolation of PBMC from Peripheral Blood from RA Patients
3. Inhalation anesthesia unit (see Note 2).
4. Centrifuges and centrifuge tubes.
5. Operating table.
6. Warming plate or heating pad.
7. Forceps (fine blunt) and scissors (fine dissection).
8. Syringes, 1 mL.
9. Wound clips and applier.
10. Pipettes and chips.
11. 70% ethanol.
12. Isoflurane or other anesthetics.
13. Histopaque 1077.
14. Cell suspension buffer: Phosphate-buffered saline (PBS), pH 7.2, and 2 mM EDTA. Sterilize the buffer by membrane filtration and keep it cold (2–8°C).
1. For serum collection, collect 2 mL of whole blood into a regular 1.5-mL Eppendorf tube and centrifuge the sample for 15 min at 1500× g at 4 °C. Harvested serum is ready for PBMC suspension.
2. Dilute the remaining whole blood with the same volume of cell suspension buffer.
3. Carefully layer 35 mL of diluted whole blood over 15 mL of Histopaque 1077 in a 50-mL conical tube.
4. Centrifuge at 400× g for 30 min at 20 °C in a swinging bucket rotor without a brake.
5. Harvest the mononuclear cell layer undisturbed at the interphase and carefully transfer the mononuclear cell layer to a new 50-mL conical tube.
6. Fill the conical tube with cell suspension buffer and mix gently. Centrifuge the tube at 300× g for 10 min at 20 °C and carefully remove the supernatant completely.
7. Wash the cells with cell suspension buffer and centrifuge the tube at 300× g for 10 min at 20 °C. Carefully remove the supernatant completely.
8. Resuspend PBMC (1 × 107) using 200 μL of the same patientderived serum for further transplantation.
3.2 Trimming
Explanted Joint Tissue
3.3 Implantation
(See Notes 4 and 5)
1. Keep the explants in saline-wet gauze at 4 °C and use as soon as possible.
2. Trim the explanted synovium and cartilage with bone to a block about 4–6 mm in diameter prior to implantation (see Note 3).
1. Put NOD/SCID mice in an anesthetic induction chamber. Initial induction can be performed using 2.5% isoflurane vaporized in 100% medical oxygen. Following induction, anesthesia should be maintained by placing the mice in front of a small face mask connected to the anesthetic machine using 1% isoflurane vaporized in 100% medical oxygen.
2. Weigh and put mice on the operating table. Place the mouse on its abdomen to expose the back. Shave the back. Use a squirt bottle to apply 70% ethanol to the back and wipe with tissue.
3. Cut the skin with fine dissection scissors, making a 1-cm vertical incision at a point level of the fourth to sixth lumbar vertebrae.
4. After exposing the subcutaneous tissue, the oblique external abdominal muscle is scraped with a scalpel until it bleeds.
5. Put the trimmed RA patient-derived synovium on the oblique external abdominal muscle, and let the connective tissue site of synovium attach to the bleeding muscle.
6. Put the articular cartilage and bone on the synovium (see Note 6) and let the smooth surface of the cartilage touch the articular luminal side of the synovium.
7. Clip the skin together with wound clips or sew up with two or three stiches. Clean the wound with 70% ethanol.
8. Inject serum-suspended PBMC (200 μL), prepared as described in Subheading 3.1, intraperitoneally (see Note 7).
9. At the end of the procedure, put the mouse in a clean cage and place the cage on a warming plate until the mouse recovers from the anesthetic.
3.4
1. Anesthetize the xenografted mice at 6–8 weeks after transplantation (see Note 8).
2. Remove the implanted tissues from xenografted mice, and immerse in 4% paraformaldehyde for tissue fixation. Decalcify and embed the tissues (the protocol can be found in Chap. 5). The sections should be stained with the methods as desired (e.g., hematoxylin and eosin) (Fig. 1).
3. For semi-quantification of synovial invasion into cartilage and bone tissues, sections can be scored from 0 to 4 based on the
Evaluation of Invasion of Synovium
Fig. 1 Histological analysis of implants in xenografted mice. The engrafted tissues were explanted at 8 weeks after transplantation. Following fixation and decalcification, tissue sections were stained using hematoxylin and eosin (original magnification, ×400). Arrows indicate invasion of synovium into implanted cartilage. S synovium, C cartilage
number of invading cell layers and number of invasive sites [4, 5], as follows (see Note 9):
• 0: no or minimal invasion
• 0.5: invasion of 1–2 cells at three independent cartilage sites
• 1: invasion of 3–5 cell layers
• 1.5: invasion of 3–5 layers at three independent cartilage sites
• 2: invasion of 6–10 cell layers
• 2.5: invasion of 6–10 layers at three independent cartilage sites
• 3: invasion of >10 cell layers
• 3.5: invasion of >10 layers at two independent cartilage sites
• 4.5: invasion of >10 layers at three or more independent cartilage sites
4
Notes
1. NOD/SCID mice are characterized by the absence of functional T cells and B cells, deficient natural killer cells, lymphopenia, hypergammaglobulinemia, and a normal hemotopoietic microenvironment. To avoid any unexpected complications, the age of NOD/SCID mice used in the xenograft model should be under 10 weeks. Due to their severely immunocompromised state, NOD/SCID mice should be housed in maximum-barrier facilities. Below are the conditions that we recommend for housing NOD/SCID mice:
• Use microisolator (filter bonneted) or pressurized, individually ventilated cages (PIV/IVC).
• Sterilize or disinfect food, water, bedding, cages, and anything that will come in contact with the mice.
• Only personnel involved in the care of the mice should have access to the mouse room, and caretakers should wear personal protective equipment.
• Before accessing the housing room, operators or caretakers should pass the air shower unit.
• Cages should be changed under a laminar flow hood. Change cages weekly to prevent the introduction of minimum-inoculating doses of opportunistic or commensal organisms into the cage environment.
2. All equipment should be used under sterile conditions.
3. For the evaluation of invasion of synovium, cartilage and bone with normal appearance rather than the lesion site should be chosen.
4. Implantation should be carried out under sterile conditions.
5. NOD/SCID mice could be pretreated by a single intraperitoneal cavity injection of 50 μL anti-asialo-GM1 serum to deplete natural killer cells 1 day before performing xenografting. In our experience, NOD/SCID mice can tolerate the engrafting procedure without any pretreatment.
6. Articular cartilage is always explanted with the bone beneath the cartilage.
7. PBMC can be engrafted by a single injection into the intraperitoneal cavity, intravenous, or intrasplenic injection [6]. The highest amount of human PBMC chimerism can be achieved by intrasplenic injection in NOD/SCID mice. Chimerism of human PBMC is poor using intravenous injection. Considering adverse effects, we chose intraperitoneal injection for engrafting human PBMC.
8. The optimal timing of explantation is strain-and treatmentdependent. A pilot study is required for optimizing the end point of engrafting.
9. Quantification should be carried out on five high-power fields in each section and three sections for each specimen.
Acknowledgment
This work was supported by a Japan Society for the Promotion of Science KAKEMHI Grant (15K19575).
References
1. Rendt KE, Barry TS, Jones DM, Richter CB, McCachren SS, Haynes BF (1993) Engraftment of human synovium into severe combined immune deficient mice. Migration of human peripheral blood T cells to engrafted human synovium and to mouse lymph nodes. J Immunol 151:7324–7336
2. Matsuno H, Yudoh K, Uzuki M, Kimura T (2001) The SCID-HuRAg mouse as a model for rheumatoid arthritis. Mod Rheumatol 11: 6–9
3. Sakuraba K, Fujimura K, Nakashima Y, Okazaki K, Fukushi J, Ohishi M et al (2015) Brief report: successful in vitro culture of rheumatoid arthritis synovial tissue explants at the air-liquid interface. Arthritis Rheum 67:887–892
4. Liu S, Hasegawa H, Takemasa E, Suzuki Y, Oka K, Kiyoi T et al (2017) Efficiency and safety of CRAC inhibitors in human rheumatoid arthritis xenograft models. J Immunol 199: 1584–1595
5. Maeshima K, Yamaoka K, Kubo S, Nakano K, Iwata S, Saito K et al (2012) The JAK inhibitor tofacitinib regulates synovitis through inhibition of interferon-gamma and interleukin-17 production by human CD4+ T cells. Arthritis Rheum 64:1790–1798
6. Zhou W, Ohdan H, Tanaka Y, Hara H, Tokita D, Onoe T et al (2003) NOD/SCID mice engrafted with human peripheral blood lymphocytes can be a model for investigating B cells responding to blood group A carbohydrate determinant. Transpl Immunol 12:9–18
Chapter 3
Scaffolded Chondrogenic Spheroid-Engrafted Model
Shuang Liu
Abstract
Therapeutic approaches using mesenchymal stem cells (MSCs) for a cartilage regeneration strategy are based on their multipotent differentiation for skeletal regeneration. With the utilization of allergenic neutralized type I atelocollagen during the pre-formation of chondrogenic MSC spheroids, cellular condensation and chondrogenic differentiation can be easily achieved. It also benefits the recruitment of host MSCs, which differentiate into chondrocyte-like cells after implantation into the experiment model. Using pre-formed chondrogenic MSC spheroids, the efficacy of anti-rheumatoid agents for cartilage repair can be screened on a large scale ex vivo. Furthermore, atelocollagen-scaffolded chondrogenic spheroids can be utilized for in vivo transplantation into a humanized xenografted arthritis model. Thus, the ability of cartilage self-repair can be qualitatively and quantitatively evaluated.
Because cartilage destruction directly causes joint pain and functional disability, the basic strategy of rheumatoid arthritis (RA) management is to alter the systemic immune status to prevent or delay cartilage destruction. After a prolonged period of time, cartilage and bone damage is almost irreversible, and very limited options remain other than considering prosthetic replacement arthroplasty. Since the regenerative capacity of cartilage is limited due to the slow metabolic rate of chondrocytes, lack of vascularity, and limitation of the number of progenitor cells, how to repair existing damage of cartilage has been challenging [1]. Autologous cellular implantation, including the employment of chondrocytes or multipotency mesenchymal stem cells (MSC), has emerged for joint regeneration [2, 3].
Therapeutic approaches using MSC for a regeneration strategy are based on their immunomodulatory capabilities to achieve systemic immunosuppression and multipotent differentiation for
skeletal regeneration [4]. Human MSC utilized for cartilage regeneration can be obtained from many types of tissues, including bone marrow, synovial tissue, peripheral blood, periosteum, and adipose tissue [5]. Several MSC-based tissue engineering techniques for cartilage regeneration using a pellet culture system or threedimensional (3D) scaffold have been reported [6–8]. Encapsulating cells in a natural biomaterial-based scaffold with a loose framework and high water content, such as collagen, fibrin, hyaluronic acid, or agarose, has been widely studied for 3D spheroid formation [5]. Since collagen molecules are a major component of the car tilage extracellular matrix and are degraded by endogenous collagenases, after removing telopeptide, antigenic-neutralized collagen-based scaffolds provide a suitable background for the application for an articular cartilage repair strategy. Among diverse shapes of scaffolds such as sponge, hydrogel, fibers, and microparticles, collagen-sponge has been utilized for 3D-MSC-derived chondrogenic spheroid formation because of its biocompatibility and capability for maintaining the chondrogenic microenvironment for functional cartilage regeneration [9].
When MSCs are cultured on type I atelocollagen scaffolds, cellular condensation and chondrogenic differentiation are induced. The expression of cartilage-specific markers such as Sox9, type II collagen, and aggrecan was confirmed in atelocollagen-encapsulated MSCs along with a chondrocyte-like appearance [9]. Moreover, type I atelocollagen scaffolds are able to recruit host MSCs in vivo, which can differentiate into chondrocyte-like cells [10, 11]. In this chapter, a laboratory protocol for the establishment of an atelocollagen-scaffolded chondrogenic-MSC-spheroid-based anti-rheumatoid agent screening system is introduced. Using pre-formed chondrogenic MSC spheroids, the efficacy of anti-rheumatoid agents for cartilage repair can be screened on a large scale ex vivo. Furthermore, atelocollagenscaffolded chondrogenic spheroids can be easily utilized for in vivo transplantation into a humanized xenografted arthritis model [12]. Thus, the ability of cartilage self-repair can be qualitatively and quantitatively evaluated.
1. MSC suspension, 2.5 × 105 cells for each spheroid (see Note 1).
3. Human Mesenchymal Stem Cell Functional Identification Kit (#SC006, R&D Systems, Minneapolis, MN), including Chondrogenic Supplement 100× (PART# 390417) and ITS Supplement 100× (PART#390418) (see Note 2).
2.2 Implantation In Vivo
ScaffoldedChondrogenicSpheroid-EngraftedModel19
4. Complete chondrogenic conditioned medium: Poweredby10 Medium containing chondrogenic Supplement 1× and ITS Supplement 1× .
5. AteloCell® Atelocollagen, Honeycomb Disc 96 (Koken, Tokyo, Japan).
6. 2% Atelocollagen Implant (Koken).
7. Round-bottom 96-well cell culture plates (see Note 3).
8. Forceps (fine blunt), sterile conditions.
9. Pipettor and tips, sterile conditions.
10. 37 °C and 5% CO2-incubator suitable for cell culture.
All animal experiment protocols should be reviewed and approved by the Institutional Animal Care and Use Committee.
1. Animals: Male NOD/ShiJic-scid (NOD/SCID) mice, 6–10 weeks of age.
2. MSC-atelocollagen-scaffoldedchondrogenicspheroids (in round-bottom 96-well cell culture plate).
3. Explants from patients used for human xenograft model establishment, including synovium, articular cartilage, and bone explants obtained from patients who underwent prosthetic replacement arthroplasty for therapeutic purposes (see Chap. 2, Subheading 2). Explants should be handled for the xenograft procedure as soon as possible after explantation.
4. Saline-wet gauze at 4 °C.
5. 70% ethanol.
6. Inhalation anesthesia unit.
7. Chondrogenic spheroids.
8. Operating table.
9. Forceps (fine blunt) and scissors (fine dissection).
10. Wound clips and applier.
11. Isoflurane.
12. Phosphate-buffered saline (PBS), pH 7.2.
3 Methods (See Note 4)
3.1 3D Culture of Chondrogenic Spheroids
1. Using fine pointed curved forceps, carefully set Atelocollagen Honeycomb Discs onto a round-bottom 96-well cell culture plate.
2. Immerse the Honeycomb sponge in 50 μL of 2% Atelocollagen Implant (see Note 5).
3. Incubate the matrix at 37 °C for 1 h.
3.2 Implantation In Vivo (See Note 7)
Fig. 1 Evaluation of chondrogenic micromass in vitro. Atelocollagen-scaffolded MSC spheroids were pre-formed by 21 days of culture in a chondrogenic conditioned medium containing methotrexate (MTX) at doses of 0, 0.01, 0.1, and 1 μM. Scanning of micromass was performed using an MR imaging and analytic system for small animals. T2-weighted scout images were acquired and reconstructed as a three-dimensional image. The volume of the region of interest could be easily achieved
4. Add 200 μL of prewarmed Poweredby10 Medium into the well.
5. Calibrate the formed matrix at 37 °C in a humidified atmosphere with 5% CO2 overnight.
7. Remove the Poweredby10 Medium in the well and carefully seed MSC on the pre-formed matrix.
8. Culture the atelocollagen-scaffolded spheroids for 21 days. Change the culture medium with freshly prepared complete chondrogenic differentiation medium every 3 days (see Note 6).
9. By directly applying drugs into the chondrogenic conditioned medium and quantifying the volume of 3D-formed micromass, atelocollagen-scaffolded chondrogenic spheroids could be directly utilized for evaluation of efficacy ex vivo (Fig. 1).
1. Trim the synovium and cartilage with bone to a block about 4–6 mm in diameter prior to implantation. Keep the explants in saline-wet gauze at 4 °C.
2. Put NOD/SCID mice in an anesthetic induction chamber. Initial induction can be performed using 2.5% isoflurane vaporized in 100% medical oxygen. Following induction, anesthesia should be maintained by placing the mice in front of a small face mask connected to an anesthetic machine using 1% isoflurane vaporized in 100% medical oxygen.
3. Put mice on the operating table. Place the mouse on its abdomen to expose the back. Shave the back. Use a squirt bottle to apply 70% ethanol to the back and wipe with tissue.
4. Cut the skin with fine dissection scissors, making a 1.5 cm longitudinal incision at the level of the fourth to sixth lumbar vertebrae.
5. After exposing the subcutaneous tissue, the oblique external abdominal muscle is scraped with a scalpel until it bleeds.
6. Put the trimmed synovium on the oblique external abdominal muscle, and let the connective tissue site of synovium attach to the bleeding muscle.
7. Briefly rinse a chondrogenic spheroid in PBS and carefully set the spheroid on the synovium (Fig. 2a).
Fig. 2 Implantation and evaluation of chondrogenic spheroid in a xenograft model. (a) Implants for xenograft model. Two pieces of in vitro pre-formed atelocollagen-scaffolded chondrogenic MSC spheroid are set on patient-derived synovium. The explanted articular cartilage and bone should be set on the spheroid, with the smooth surface of the cartilage touching the spheroid on the articular luminal side. A representative image of hematoxylin and eosin staining of xenografted-implants (b) without chondrogenic MSC spheroid and (c) with chondrogenic MSC spheroid 8 weeks after implantation is shown. Invasion of synovium into cartilage was observed in the xenograft model without chondrogenic spheroid implantation, while the cartilage damage was repaired and cartilage with a smooth surface was maintained in the chondrogenic MSCspheroid-implanted xenograft model. C patient-derived cartilage, CS chondrogenic MSC spheroid, S patient-derived synovium. Scale bar: 100 μm
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