Intravital Widefield Fluorescence Microscopy of Pulmonary Microcirculation in Experimental Acute Lung Injury Using a Vacuum-Stabilized Imaging System

Summary

Intravital fluorescence microscopy can be utilized to study leukocyte-endothelial interactions and capillary perfusion in real-time. This protocol describes methods to image and quantify these parameters in the pulmonary microcirculation using a vacuum-stabilized lung imaging system.

Abstract

Intravital imaging of leukocyte-endothelial interactions offers valuable insights into immune-mediated disease in live animals. The study of acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) and other respiratory pathologies in vivo is difficult due to the limited accessibility and inherent motion artifacts of the lungs. Nonetheless, various approaches have been developed to overcome these challenges. This protocol describes a method for intravital fluorescence microscopy to study real-time leukocyte-endothelial interactions in the pulmonary microcirculation in an experimental model of ALI. An in vivo lung imaging system and 3-D printed intravital microscopy platform are used to secure the anesthetized mouse and stabilize the lung while minimizing confounding lung injury. Following preparation, widefield fluorescence microscopy is used to study leukocyte adhesion, leukocyte rolling, and capillary function. While the protocol presented here focuses on imaging in an acute model of inflammatory lung disease, it may also be adapted to study other pathological and physiological processes in the lung.

Introduction

Intravital microscopy (IVM) is a useful imaging tool for visualizing and studying various biophysical processes in vivo. The lung is highly challenging to image in vivo due to its enclosed location, the fragile nature of its tissue, and motion artifacts induced by respiration and heartbeat^1,2. Various intravital microscopy (IVM) setups have been developed for real-time imaging of leukocyte-endothelial interactions in pulmonary microcirculation to overcome these challenges. Such approaches are based on surgically exposing and stabilizing the lung for imaging.

Animals are typically prepared for lung IVM by surgical procedures. First, animals are intubated and ventilated, which permits surgical excision of a thoracic window and subsequent interventions to stabilize the lung for imaging. One technique involves gluing the parenchyma onto a glass coverslip³, a procedure that risks significant physical trauma to the imaged tissue. More advanced is the utilization of a vacuum system to stabilize the lung under a glass window⁴. This setup facilitates loose adherence of the lung surface to the coverslip via a reversible vacuum spread over a large local area and expands the lung while still limiting the movement in x, y, and z dimensions⁴. The vacuum is applied evenly through a channel surrounding the imaging area of the setup and pulls the tissue into a shallow conical region facing the imaging-grade coverslip⁴. Through this viewing window, the lung microcirculation can be studied using various optical imaging modalities.

Lung IVM enables quantitative imaging of a multitude of microcirculatory parameters. These include measurements such as leukocyte track speed and length⁵, red blood cell flow velocity⁶ and oxygenation⁷, tumor metastases⁸, the distinction of immune cell subpopulations^9,10,11, visualization of microparticles¹², alveolar dynamics^13,14, vascular permeability¹⁵, and capillary function¹⁶. The focus here is on leukocyte recruitment and capillary function. Initiation of leukocyte recruitment in the pulmonary microcirculation involves transient rolling interactions and firm adhesive interactions between leukocytes and endothelial cells, both of which are increased under inflammatory conditions^16,17. Typically, rolling is quantified by the number of leukocytes that pass an operator-defined reference line, while adhesion is quantified by the number of leukocytes that are immobile on the endothelium¹⁶. Capillary function may also be affected in inflammatory states, often resulting in decreased perfusion. This can be attributed to several factors, including a reduction of red blood cell deformability¹⁸ and variegated expression of inducible NO synthase by endothelial cells resulting in pathological shunting¹⁹. Typically, the aggregate length of perfused capillaries per area is measured and reported as functional capillary density (FCD).

Studying leukocyte recruitment in the lungs in real-time requires labeling biological targets with fluorescent dyes or fluorescent-labeled antibodies²⁰. Alternatively, various transgenic mouse strains such as lysozyme M-green fluorescent protein (LysM-GFP) mice can be utilized to image specific immune cell subsets such as neutrophils^21,22. The fluorescent-labeled leukocytes can then be visualized using widefield fluorescence microscopy, confocal microscopy, or multiphoton microscopy. These techniques achieve contrast by utilizing specific excitation wavelengths and detecting emitted fluorescence while simultaneously blocking the detection of the excitation wavelength, thus highlighting the labeled object.

Existing research concerning the quantification of leukocyte rolling, adhesion, and functional capillary density in the murine lung has relied primarily on manual video analysis. This is made possible through open-source software such as Fiji^6,23, proprietary software such as CapImage¹², or custom-made image processing systems²⁴. Conversely, various proprietary software platforms (e.g., NIS Element, Imaris, Volocity, MetaMorph) enable automated measurement of a wide array of other physiological parameters, including many of those previously mentioned here^{5,6,7,8,9,10,11,12,13,15}.

Important observations have been made regarding the pathology of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) using lung IVM. ARDS is characterized by a host of pathophysiological processes in the lung, including pulmonary edema and alveolar damage caused by dysfunction of the endothelium and epithelial barrier²⁵. Using a murine model, it has been found that sepsis-induced ALI is associated with significant detrimental changes in immune cell trafficking in the lung environment²⁶. Neutrophils recruited to the capillaries of mice with sepsis-induced ALI were found to impede microcirculation, thereby increasing hypoxia in ALI²⁶. Additionally, IVM has been used to gain insights into the underlying mechanism of repair following the onset of ARDS²⁷. Lung IVM has also been a valuable tool in understanding pathophysiological changes in various obstructive lung diseases. For example, visualization of mucus transport in diseases such as cystic fibrosis (CF) and chronic obstructive pulmonary disease (COPD) has facilitated the study of novel and existing treatments for mucous clearance²⁸. Leukocyte trafficking under these conditions has been analyzed as well¹⁷.

This protocol expands on the approach initially described by Lamm et al.²⁹ to study leukocyte-endothelial interactions using conventional fluorescence microscopy. The described procedures employ an in vivo lung imaging system, which includes a 16.5 cm x 12.7 cm metal base, micromanipulator, and vacuum imaging window (Figure 1). The system is mounted in a 20 cm x 23.5 cm 3-D printed platform (Supplemental File 1) to provide secure attachment for the ventilator tubing and heating pad. This method offers reproducible and quantifiable imaging of murine pulmonary microcirculation in vivo. Important aspects of the surgical preparation as well as proper utilization of a vacuum-stabilized lung imaging system are explained in detail. Finally, an experimental model of ALI is used to provide representative imaging and analysis of altered leukocyte rolling, leukocyte adhesion, and capillary perfusion associated with inflammation. The use of this protocol should facilitate further important investigations into pathophysiological changes in pulmonary microcirculation during acute disease states.

Protocol

All the procedures described here were performed with prior approval by the Dalhousie University Committee on Laboratory Animals (UCLA). 1. Preparation Lung imaging system: To prepare the window, administer a thin layer of vacuum grease to the top of the outer ring while avoiding contamination of the vacuum channel. Place a clean 8 mm glass coverslip on the window and gently press down to create a seal. Widefield Fluorescence Microscope: Perform imaging w…

Representative Results

To illustrate results achievable through this protocol, acute lung injury (ALI) was induced 6 h prior to imaging using a model of intranasal bacterial lipopolysaccharide (LPS) instillation. Briefly, mice (n = 3) were anesthetized with isoflurane, and small droplets of LPS from Pseudomonas aeruginosa in sterile saline (10 mg/mL) were pipetted into the left naris at a dosage of 5 mg/kg. This was compared to naïve mice (n = 3; no intranasal administration). Upon imaging, a successfu…

Discussion

The protocol presented here requires practice and attention to a few critical steps. First, it is important to prepare the imaging window prior to initiating intubation and surgery. Use a minimal amount of vacuum grease to coat the outer ring of the imaging window, apply the cover glass, and test suction with a drop of distilled water. Preparing this in advance will prevent the exposed lung from drying out during the setup otherwise. While it is possible to flush with warm saline, doing so may risk damaging the fragile p…

Materials

1 mL BD Luer Slip Tip Syringe sterile, single use	Becton, Dickinson and Company	309659	1 mL syringe
ADSON Dressing Forceps, Tip width 0.6 mm, teeth length 11.5 mm, 12 cm	RWD Life Science Co.	F12002-12	Blunt forceps
Albumin-Fluorescein Isothiocyanate	Sigma-Aldrich	A9771-1G	FITC-albumin
Alcohol Swab Isopropyl Alcohol 70% v/v	Canadian Custom Packaging Company	80002455	Alcohol wipe
AVDC110 Advanced Digital Video Converter	Canopus	00631069602029	Digital video converter
B/W – CCD – Camera	Horn Imaging	BC-71	Camera
Bovie Deluxe High Temperature Cautery Kit	Fine Science Tools	18010-00	Cauterizer
C57BL/6 Mice	Charles River Laboratories International	C57BL/6NCrl	C57BL/6 Mice
Cotton Tipped Applicators	Puritan	806-WC	Cotton applicator
CS-8R 8mm Round Glass Coverslip	Warner Instruments	64-0701	Glass coverslip
Digital Pressure Gauge	ITM Instruments Inc.	DG2551L0NAM02L0IM&V	Digital Pressure Gauge
Dr Mom Slimline Stainless LED Otoscope	Dr. Mom Otoscopes	1001	Otoscope
Ethyl Alchohol 95% Vol	Commercial Alcohols	P016EA95	95% ethanol
Fine Scissors – Martensitic Stainless Steel	Fine Science Tools	14094-11	Scissors
Fisherbrand Colored Labeling Tape	Fisher Scientific	1590110	Labeling tape
Gast DOA-P704-AA High-Capacity Vacuum Pump	Cole-Parmer Canada Company	ZA-07061-40	Vacuum pump
Hartman Hemostats	Fine Science Tools	13003-10	Hemostatic forceps
High Vacuum Grease	Dow Corning	DC976VF	Vacuum grease
Isoflurane USP	Fresenius Kabi	CP0406V2	Isoflurane
LIDOcaine HCl Injection 1% 50 mg/5 mL	Teligent Canada	0121AD01	Lidocaine HCl 1%
Lung SurgiBoard	Luxidea, Inc.	IMCH-0001	Designed for intravital microscopy of the lung
Mineral Oil	Teva Canada	00485802	Mineral oil
Mouse Endotracheal Intubation Kit	Kent Scientific Corporation	ETI-MSE	Intubation stand, anesthesia mask, 20 G endotracheal cannula, fibre optic cable
MST49 Fluorescence Microscope	Leica Microsystems	10 450 022	Fluorescence Microscope
N Plan L 20x/0.40 Long Working Distance Microscope Objective	Leica Microsystems	566035	20x objective
Non-Woven Sponges 2" x 2"	AMD-Ritmed	A2101-CH	Gauze
Optixcare Eye Lube Plus	Aventix	5914322	Tear gel
Original Prusa i3 MK3S+ 3D Printer	Prusa Research	PRI-MK3S-KIT-ORG-PEI	3D printer
Oxygen, Compressed	Linde Canada Inc.		Oxygen
PrecisionGlide Needle 30 G x 1/2 (0.3 mm x 13 mm)	Becton, Dickinson and Company	305106	30 G needle
Pyrex 5340-2L 5340 Filtering Flasks, 2000 mL	Cole-Parmer Canada Company	5340-2L	Vacuum flask
Rhodamine 6 G	Sigma-Aldrich	252433	Rhodamine 6G
Secure Soft Cloth Medical Tape – 3"	Primed	PM5-630709	Cloth tape
Silastic Medical Grade Tubing .040 in. ID x .085 in. OD	Dow Corning	602-205	1.0 mm I.D. polyethylene tubing
Somnosuite Low-Flow Anesthesia System	Kent Scientific Corporation	SS-01, SS-04-module	Small rodent ventilator, Low-flow anesthesia system, Heating pad, Rectal temperature probe, Pulse oximeter
Tissue Forceps, 12.5cm long, Curved, 1 x 2 Teeth	World Precision Instruments	501216	Toothed forceps
Transpore Medical Tape, 1527-1, 1 in x 10 yd (2.5 cm x 9.1 m)	3M	7000002795	Medical tape
Tubing,Clear,3/8 in Inside Dia.	Grainger Canada	USSZUSA-HT3314	1.0 cm I.D. polyethylene tubing
Whatman 6720-5002 50 mm In-Line Filters, PTFE, 0.2 µm	Cole-Parmer Canada Company	6720-5002	Inline 0.2µm filter