Summary

A Comprehensive Approach to Analyze the Cell Components of Cerebral Blood Clots

Published: July 21, 2023
doi:

Summary

This study describes a fast and effective method for the cell component analysis of cerebral blood clots through clot dissolving, cell staining, and routine blood examination.

Abstract

Cerebral thrombosis, a blood clot in a cerebral artery or vein, is the most common type of cerebral infarction. The study of the cell components of cerebral blood clots is important for diagnosis, treatment, and prognosis. However, the current approaches to studying the cell components of the clots are mainly based on in situ staining, which is unsuitable for the comprehensive study of the cell components because cells are tightly wrapped in the clots. Previous studies have successfully isolated a fibrinolytic enzyme (sFE) from Sipunculus nudus, which can degrade the cross-linked fibrin directly, releasing the cell components. This study established a comprehensive method based on the sFE to study the cell components of cerebral thrombus. This protocol includes clot dissolving, cell releasing, cell staining, and routine blood examination. According to this method, the cell components could be studied quantitatively and qualitatively. The representative results of experiments using this method are shown.

Introduction

Cerebrovascular disease is one of three major diseases that can threaten human health, among which ischemic cerebrovascular disease accounts for more than 80%. Cerebral thrombosis and cerebral vein thrombosis are the most concerned ischemic cerebrovascular diseases today, mainly caused by cerebral blood clots1,2. If the treatment is not done properly, it will have high disability and mortality rates and a high recurrence rate after discharge3.

Recently, a growing number of studies have shown that the cell components of cerebral blood clots are tightly correlated with the diagnosis, treatment, and prognosis of cerebral thrombosis4,5,6. Therefore, the availability of data on thrombus composition, especially the cell components, is important for clinical diagnosis and treatment. Unfortunately, the currently available methods cannot comprehensively analyze the blood clot component quantitatively and qualitatively. For example, Martius Scarlett Blue based in-situ staining can only study the red/white blood cells of certain slices of the clot7. Immunohistochemistry (IHC) based in-situ staining can only study limited blood components of certain slices of the clot using their antibodies8. The microscopic image-based methods are only concerned with the specific structure of the clot9. Moreover, all those methods are laborious and time-consuming10. To date, the procedures for quantitatively and qualitatively studying cerebral thrombi cell components have not been reported. It is widely acknowledged that the cross-linked fibrin tightly wraps the blood cells in the clots11. Consequently, the specific degradation of the cross-linked fibrin and release of the intact cells is critical for the accurate analysis of cell components.

Previous works isolated a fibrinolytic enzyme from Sipunculus nudus (sFE), which can degrade the fibrin specifically and quickly12. Herein, a method for analyzing the cell components of the cerebral thrombi based on the unique activity of sFE was proposed. This protocol utilized sFE to degrade the fibrin of clots first and then analyzed the cell components by Wright's Staining and routine blood examination13,14. According to this method, the cell components of cerebral thrombi can be quantitatively and qualitatively studied. This simple and effective protocol might be applied for the cell component analysis of other blood clots.

Protocol

The research was performed in compliance with the institutional guidelines of the Medical Ethics Committee of Huaqiao University. The cerebral blood clots were surgically removed and collected at Quanzhou First Hospital, affiliated to Fujian Medical University, with informed consent from the patients. 1. Blood clot pretreatment Place the clots on a clean dish, add 5 mL of physiological saline with a tweezer, shake the dish gently, and remove the saline with a pipet…

Representative Results

In the initial stage of the degradation process, it was found that the blood clots had a red compact structure, and the working solution was colorless. After incubation for 30 min, the working solution turned light red, which indicated the crossed blood cells were released into the working solution. Most clots were dissolved when lengthening the incubation time to 5 h, and the working solution became light red. On the contrary, there was no significant change in the physiological saline group (NC) even after 10 h incubat…

Discussion

sFE is a fibrinolytic agent that can degrade the fibrin directly and effectively12,16. Here, sFE was employed to degrade the cross-linked fibrin of the cerebral blood clots, release the enclosed cells within the clots, and analyze the cell components of the clots qualitatively and quantitatively. The microscopy data and routine blood examination indicated that the enclosed cells were released from the blood clots. Furthermore, the cell types and structures of the…

Disclosures

The authors have nothing to disclose.

Acknowledgements

This research was funded by the Science and Technology Bureau of Xiamen City (3502Z20227197), and the Science and Technology Bureau of Fujian Province (No. 2019J01070, No.2021Y0027).

Materials

Agglutination Reaction Plate ROTEST RTB-4003
Auto Hematology Analyzer SYSMEX XNB2
Automatic Vertical Pressure Steam Sterilizer  SANYO MLS-3750
Centrifuge Tube (1.5 mL) Biosharp BS-15-M
Clean bench AIRTECH BLB-1600
Constant Temperature Incubator JINGHONG JHS-400
Culture Dish (100 mm) NEST 704001
DHG Series Heating and Drying Oven  SENXIN DGG-9140AD
Electronic Analytical Balance DENVER TP-213
Filter Membrane (0.22 µm) Millex GP SLGP033NK
Micro Refrigerated Centrifuge  Cence H1650-W
Microscope Slides CITOGLAS 01-30253-50
Milli-Q Reference Millipore Z00QSV0CN
Normal Saline CISEN H37022337
Optical Microscope Nikon ECLIPSE E100
Parafilm Bemis PM-996
Phosphate-Buffered Saline Beyotime C0221A
Pipette Tip (1 mL ) Axygene T-1000XT-C
Pipette Tip (200 µL) Axygene T-200XT-C
Pipettor (1 mL) Thermo Fisher Scientific ZY18723
Pipettor (200 µL) Thermo Fisher Scientific ZY20280
Scalpel MARTOR 23111
Small-sized Vortex Oscillator Kylin-Bell VORTEX KB3
Tweezer Hystic HKQS-180
Wright Staining Solution Beyotime C0135-500ml

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Cite This Article
Lin, W., Lin, H., Xin, P., Yan, H., Kang, B., Tang, M. A Comprehensive Approach to Analyze the Cell Components of Cerebral Blood Clots. J. Vis. Exp. (197), e65791, doi:10.3791/65791 (2023).

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