Originally published as JHC exPRESS on December 10, 2007. doi:10.1369/jhc.7A7287.2007
Volume 56 (4): 347-358, 2008 Copyright ©The Histochemical Society, Inc. An Immunohistochemical Method for Identifying Fibroblasts in Formalin-fixed, Paraffin-embedded Tissue
Experimental Histopathology, Fred Hutchinson Cancer Research Center, Seattle, Washington (TG,JR-H); Department of Molecular Biology, Princeton University, Princeton, New Jersey (AL-M,HAC); and Department of Pathology, University of Medicine and Dentistry of New Jersey, Newark, New Jersey (MRH,SCA) Correspondence to: Hilary A. Coller, PhD, Department of Molecular Biology, Lewis Thomas Laboratory, Room 140, Princeton University, Princeton, NJ 08544. E-mail: hcoller{at}princeton.edu
Fibroblasts are critical for tissue homeostasis, and their inappropriate proliferation and activation can result in common and debilitating conditions including fibrosis and cancer. We currently have a poor understanding of the mechanisms that control the growth and activation of fibroblasts in vivo, in part because of a lack of suitable fibroblast markers. We have taken advantage of an antibody previously shown to stain stromal cells in frozen tissues (TE-7) and identified conditions in which it can be used to stain fibroblasts and myofibroblasts in the paraffin-embedded tissue samples routinely collected for pathological analysis. We show that this antibody recognizes growing and quiescent fibroblasts and myofibroblasts by immunohistochemistry, immunofluorescence, and ELISA assays. We also present its staining patterns in normal tissue samples and in breast tumors. (J Histochem Cytochem 56:347–358, 2008)
Key Words: fibroblasts immunohistochemistry TE-7
FIBROBLASTS play a critical role in maintaining homeostasis of the microenvironment and in coordinating the complex physiological response to wounds (Martin 1997
To date, fibroblasts have been difficult to positively identify. In some cases, fibroblasts are identified based on their spindle shape combined with positive staining for the mesenchymal marker vimentin and the absence of staining for epithelial or other mesenchymal cell types, such as muscle cells, astrocytes, or hematopoietic cells (Chang et al. 2002
A few antibodies have been previously reported to recognize fibroblasts, some of which take advantage of fibroblasts as the major producer of collagen. One monoclonal antibody (anti-pC) is directed against the cleaved carboxy terminal propeptide of the triple-helical procollagen molecule. This antibody stains some of the fibroblasts from patients with active pulmonary fibrosis, but not fibroblasts that are not actively dividing (McDonald et al. 1986
In an attempt to better understand epithelial–mesenchymal interactions during thymus development, Haynes et al. (1984) Formalin fixation followed by embedding in paraffin is widely used to achieve the best preservation of tissue biopsies before light microscopic analysis. The ability to identify fibroblasts in formalin-fixed, paraffin-embedded tissues would be extremely helpful for a wide variety of pathological analyses. We adopted the TE-7 antibody for identifying fibroblasts in formalin-fixed, paraffin-embedded tissue. We report here its application using immunohistochemistry, ELISA, and immunofluorescence. We also show the results when this antibody is used to stain cultured fibroblasts and other cell types, normal tissue samples, and the fibroblasts surrounding breast tumors.
Cell Culture For ELISA assays and immunofluorescence, human dermal fibroblasts (strain 91FS5) were grown in Fibroblast Growth Medium (FGM)-2 (Cambrex BioScience; Walkersville, MD), which contains 2% FBS, insulin, and fibroblast growth factor (FGF). For cell pellets for immunohistochemistry, human foreskin fibroblasts (HFFs), WI-38 lung fibroblasts, osteoblast-like Saos cells, and glioblastoma U373 cells were grown in DMEM, 0.1 mM non-essential amino acids, 1.0 mM sodium pyruvate, 1% penicillin/streptomycin, and 15% FBS. For THP-1 cells, the same medium was used except the FBS concentration was 10% and 0.05 mM β-mercaptoethanol was added. For cell pellets, cells were rinsed twice with warm PBS and fixed with 10% neutral-buffered formalin at room temperature for 4 hr. Cells were scraped with a rubber policeman, pelleted, and washed with PBS. Pellets were processed and embedded in paraffin as for tissue samples. Alternatively, cells were plated in BD Biocoat poly-D-lysine–coated chamber slides (Thermo Fisher Scientific; Waltham, MA) in appropriate media and incubated overnight at 37C. After transferring the slides to room temperature, the medium was removed and washed twice with PBS. The cells were fixed with 10% neutral-buffered formalin at room temperature for 8 hr and transferred to PBS for immunohistochemistry.
Human Tissue Samples
Immunohistochemistry Isotype control antibodies were used at the same concentration as primary antibodies. Isotype control antibodies were mouse IgG (I-2000; Vector Laboratories), mouse IgG1 (CBL600; Chemicon, Temecula, CA), mouse IgG2a (CBL601; Chemicon), mouse IgG3 (M9019; Sigma-Aldrich, St Louis, MO), mouse IgM (PP50; Chemicon), and rabbit IgG (011-000-003; Jackson Immunoresearch Laboratories). For mouse IgG antibodies, biotinylated goat anti-mouse IgG F(ab')2 was used as a secondary antibody (Code 115-066-003; Jackson Immunoresearch Laboratories). For mouse IgM antibodies, biotinylated goat anti-mouse IgG, IgA, and IgM (Cat. No. 65-6400; Zymed Laboratories) was used as a secondary antibody. To identify epithelial and glandular cells, we used clone AE1/AE3 (mouse monoclonal IgG1 at 1.27 µg/ml; DakoCytomation) with pH 6 citrate buffer target retrieval (DakoCytomation). To identify endothelial cells, megakaryocytes, and platelets, we used an antibody to von Willebrand factor (rabbit polyclonal IgG at 15.5 µg/ml; DakoCytomation) with pH 8 EDTA antigen retrieval (Trilogy; Cell Marque Corporation, Rocklin, CA) followed by the Envision Rabbit Polymer (DakoCytomation) instead of the Vectastain. To identify macrophages, monocytes, neutrophils, basophils, and natural killer (NK) cells, we used an antibody to the cell surface protein CD68 (mouse monoclonal IgG3 1.9 µg/ml; PG-M1, DakoCytomation) with pH 6 citrate buffer target retrieval (DakoCytomation). To identify smooth muscle cells, myofibroblasts, and myoepithelial cells, we used clone 1A4 against smooth muscle actin (mouse monoclonal IgG2a 1.4 µg/ml; DakoCytomation) with pH 6 citrate buffer target retrieval (DakoCytomation). To identify fibroblasts, we used clone TE-7 (mouse monoclonal IgG1 1.3 µg/ml; Chemicon) with pH 8 EDTA antigen retrieval (Trilogy). For samples on chamber slides, Triton X-100 was added for 20 min prior to the addition of the TE-7 antibody. To identify mesenchymal cells, we used an antibody to vimentin (mouse monoclonal IgG1 1.2 µg/ml; Clone V9, DakoCytomation) with pH 8 EDTA antigen retrieval (Trilogy). To identify proliferating cells, we used an antibody against Ki67 clone MIB1 (mouse monoclonal IgG1 0.8 µg/ml; DakoCytomation) with pH 6 citrate buffer target retrieval (DakoCytomation). For the 5B5 antibody (mouse monoclonal IgG1 at 3.1 µg/ml; DakoCytomation), we used pH 6 citrate buffer target retrieval (DakoCytomation). For the 1B10 antibody (mouse monoclonal IgM at 2 µg/ml; Sigma-Aldrich), we used pH 8 EDTA antigen retrieval (Trilogy). For analysis of skin samples, we used a blue chromogen so as not to confuse brown antibody stain with melanin. We performed immunohistochemistry as described above up to the tertiary step. Instead of the Ready-to-use ABC-HRP reagent, the Vectastain ABC-AP kit was used according to the manufacturer's instructions and incubated for 30 min. We washed the slides in Dako Wash Buffer and then PBS for 5 min. We used the Vector Blue Alkaline Phosphatase Substrate Kit III (Vector Laboratories). The reagent was prepared as per the manufacturer's directions immediately before use. One half of the reagent was applied, slides were incubated in the dark for 20 min, the liquid was removed, and the remaining half of the solution was applied for another 20 min. Slides were rinsed in three changes of PBS, followed by three changes of dH2O. Sections were counterstained using Nuclear Fast Red (DakoCytomation) for 3 min, rinsed in dH2O, and mounted.
Indirect Immunofluorescence
Whole Cell ELISA
Immunohistochemical Staining of Cultured Cell Pellets Shows That TE-7 Specifically Recognizes Fibroblasts Our goal was to identify growing and quiescent fibroblasts in formalin-fixed, paraffin-embedded tissue samples. Formalin fixation is the method of choice for preservation of tissue morphology and architecture and is routinely used for collection and storage of patient samples. We tested the TE-7, 1B10, and 5B5 antibodies on formalin-fixed cell pellets from cultured cells to determine which antibody showed the best specificity for fibroblasts (Figure 1 ; Table 1 ). Cells and their surrounding extracellular matrix were fixed on tissue culture plates, scraped off the plate, pelleted, paraffin-embedded, and analyzed by immunohistochemistry. As controls, we included an antibody to smooth muscle actin as a marker for smooth muscle cells and myofibroblasts, an antibody to CD68 as a marker for monocyte/macrophage lineages, and an antibody to vimentin as a marker for mesenchymal cells. Isotype controls for all antibodies were included. All antibodies were tested on two types of fibroblasts: normal lung fibroblasts (WI38) and normal dermal fibroblasts from foreskin. The dermal fibroblasts were tested in both growing and quiescent conditions. For quiescence, the cells were grown to confluence and maintained under low serum conditions for 1 week. The same antibodies were also tested on glioblastoma U373 cells, monocyte-like THP-1 cells, and osteoblast-like Saos cells. Staining for each antibody on each cell type was scored as negative, weakly positive, or positive. In cases of positive staining, the intensity of the staining was graded on a scale of 1–3, and the fraction of positive cells was noted.
The three isotype control antibodies did not positively stain any of the various cell types (Table 1). The antibody to vimentin stained the fibroblasts, the glioblastoma cells, the osteoblast-like cells, and a subset of the monocyte-like cells. The antibody to cell surface marker CD68 recognized the monocyte-like line THP-1. The antibody to smooth muscle actin was negative on the THP-1 monocytes as expected, but stained the glioblastoma U373 and Saos osteoblast-like cells weakly. Stronger staining was observed with smooth muscle actin on a subset of dermal fibroblasts in both the growing and quiescent conditions. Intense smooth muscle actin staining was observed in essentially all of the WI-38 lung fibroblasts, suggesting that these cells have a myofibroblast character. The 5B5 antibody and the 1B10 antibody positively stained dermal and lung fibroblasts (Table 1; Figure 1) as would be expected for fibroblast markers. However, these antibodies also positively stained non-fibroblast cell types: the osteoblasts, monocytes/macrophages, and glioblastoma cells. The TE-7 antibody, in contrast, was negative for staining in the monocyte THP-1, the glioblastoma U373, and the osteoblastoma Saos cells. Approximately 50% of the WI-38 lung fibroblasts and 50% of the growing and quiescent dermal fibroblasts appeared positive for TE-7 staining. TE-7 stained these cell pellets with moderate intensity. We thus conclude that, in formalin-fixed, paraffin-embedded tissues, the TE-7 antibody, but not 5B5 or 1B10, is specific for fibroblasts. Furthermore, the TE-7 antibody recognized dermal and lung fibroblasts, growing and quiescent fibroblasts, and fibroblasts with and without a myofibroblast phenotype.
Immunohistochemistry and Immunofluorescence on Cultured Fibroblasts Shows That TE-7 Stains Growing and Quiescent Fibroblasts
ELISA Assays Show That TE-7 Has High Sensitivity and Specificity for Fibroblasts To further characterize the sensitivity and specificity of the TE-7 antibody and to compare it with the 1B10 and 5B5 antibodies, we performed a whole cell ELISA assay on fibroblasts and the glioblastoma U373 cells. As shown in Figure 3 , TE-7 produced a significantly stronger signal for the same number of cells in fibroblasts compared with glioblastoma cells. This was not the case for 5B5 or 1B10, which gave similar signals for the fibroblasts and glioma cells, consistent with the immunohistochemistry results on cell pellets. When the assay was performed on as few as 5000 fibroblasts per well, increased TE-7 signal was observed compared with the glioblastoma cells.
TE-7 Recognizes the Fibroblasts Within the Adventitia Surrounding Blood Vessels in Skeletal and Heart Muscle We tested TE-7 in formalin-fixed, paraffin-embedded normal human tissue samples. In Figure 4A , we show the staining pattern with a number of antibodies, including TE-7, on a large blood vessel in skeletal muscle. Isotype controls were negative as expected. Staining with the AE1/AE3 antibody that recognizes epithelial cells was negative in skeletal muscle. Endothelial cells lining the large blood vessels and smaller blood vessels were recognized by an antibody against von Willebrand factor. An anti-vimentin antibody recognized all mesenchymal cells, including the smooth muscle cells and fibroblasts in the tunica media and the adventitia surrounding the large blood vessel. The anti-vimentin antibody also recognized the smooth muscle cells lining smaller capillaries scattered throughout the skeletal muscle. A small number of vimentin-positive cells scattered throughout the tissue are most likely cells of monocyte/macrophage origin because they were recognized by an antibody against the monocyte/macrophage surface marker CD68. Smooth muscle cells of the tunica media surrounding the endothelial cells were recognized by an antibody against smooth muscle actin. Smooth muscle actin was also expressed by cells that are likely myofibroblasts in the adventitia of the large vessel. The TE-7 antibody stained essentially all of the spindle-shaped cells in the adventitia of the large blood vessel, as would be expected for a marker that recognizes fibroblasts. TE-7 also stained regions surrounding smaller vessels throughout the skeletal muscle area. In addition, the protein recognized by TE-7 is a constituent of the endomysium that surrounds individual muscle fibers. Staining with the 5B5 antibody previously reported to recognize fibroblasts (Janin et al. 1990
In Figure 4B, we show further staining of an artery within heart muscle. Staining with an isotype control is negative as expected. An antibody to vimentin recognizes the smooth muscle cells surrounding the vessel as well as the fibroblasts in the adventitia and cells within the heart muscle itself. An antibody to smooth muscle actin recognizes the smooth muscle cells surrounding the artery. TE-7 is largely negative for the smooth muscle cells while staining the fibroblasts within the adventitial region and scattered fibroblasts in the heart muscle. Thus, TE-7 does not routinely stain smooth muscle cells surrounding vessels.
TE-7 Recognizes Fibroblasts Below the Epidermal Layer in Normal Skin
TE-7 Recognizes Stromal Regions in Normal Thymus We also used immunohistochemistry with TE-7 to stain paraffin-embedded young human thymus. We discovered that TE-7 did not stain the epithelial cells but did recognize the vimentin-positive fibrous tissue and vessels of the interlobular septae (Figure 6 ). These results are similar to those reported by Haynes et al. (1984)
TE-7 Recognizes Myofibroblast-like Cells Within a Breast Tumor Myofibroblast-like cells surround breast tumors and likely contribute to the tumorigenic process (van den Hooff 1988
Fibroblast proliferation and activation is critical for wound healing (Martin 1997
In formalin-fixed cell pellets, the TE-7 antibody was more specific than the 1B10 or 5B5 antibodies on the cell types tested (Figure 1; Table 1). The TE-7 antibody recognized both dermal and lung fibroblasts and both growing and quiescent fibroblasts, but did not react with osteosarcoma, glioblastoma, or monocyte/macrophage cells. The 1B10 and 5B5 antibodies were less specific; they recognized fibroblasts, but also recognized the non-fibroblast cell types tested. Other anti-fibroblast antibodies have been found to recognize only proliferating fibroblasts. The 5B5 antibody and the (anti-pC) fibroblast-specific antibody, which recognizes the portion of the procollagen molecule that is cleaved before secretion, recognize only fibroblasts that are actively dividing (McDonald et al. 1986 TE-7 also recognized myofibroblasts. In several examples of fibroblasts surrounding blood vessels, including the skeletal muscle blood vessel shown in Figure 4A, TE-7 stained both fibroblasts and myofibroblasts in the adventitia. TE-7 also stained myofibroblasts surrounding breast tumors (Figure 7). We conclude that TE-7 recognizes both fibroblasts and myofibroblasts and fibroblasts in both proliferating and quiescent conditions. We expect the TE-7 antibody will prove a valuable tool for unraveling the role of fibroblasts in development, homeostasis, fibrotic disease, soft tissue tumors, and epithelial carcinomas.
H.A.C. is the Milton E. Cassel Scholar of the Rita Allen Foundation. This work was also supported by grants from the Avon Opportunity Breast Cancer Fund, the Leukemia Lymphoma Society, and the New Jersey Commission on Cancer Research to H.A.C. The authors thank David Madtes, Keith Loeb, Harry Hwang, Robert Hackman, and Sue Knoblaugh [Fred Hutchinson Cancer Research Center (FHCRC)], and Leroy Sharer (New Jersey Medical School) for helpful discussions; Louise Soltow and Eric Vallieres (University of Washington), and Peggy Porter, Lindi Farrell, and Barbara Stein (FHCRC) for assistance with tissue collection; Carrie Francek, Elizabeth Pollina, Joe Goodhouse, and Christina DeCoste (PU), and Lisa McLemore, Sharon McHale, and Liyun Sang (FHCRC), for technical assistance; and Ole William Petersen (The Panum Institute, Copenhagen, Denmark), Tom Norwood and Tony Subaru (University of Washington), and Patricia Robinson, Dai Wang, and Tom Shenk (Princeton University) for reagents.
Received for publication June 6, 2007; accepted November 15, 2007
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