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The first density gradient centrifugation using Ficoll yields a white interphase containing the PBMCs (Figure 1A) i.e. lymphocytes and monocytes. This can be confirmed through a May-Gruenwald staining (Figures 1B and C) of the collected cells which shows both a high nucleus/cytoplasm ratio (typical of lymphocytes) and bean- or ring-shaped nuclei (typical of monocytes). When these cells are then loaded onto a second density gradient using Percoll, the monocytes can be further separated from the lymphocytes and again appear as a white interphase (Figures 1D-F). For each buffy coat the described double density gradient centrifugation routinely yields 150 ± 40 x 106 monocytes which can be differentiated to 70 ± 30 x 106 macrophages (Figure 2) per buffy coat. The mean macrophage yield from 20 independent preparations was 47 ± 14% of total isolated monocytes.
After the Percoll gradient centrifugation there might still be some residual non-monocytic cells present in the preparation which is dependent on the blood donor as well as on the accuracy of the isolation process. However, after the differentiation phase of 6-7 days, the preparation mainly consists of mature macrophages (Figure 3) which can be further enriched due to their adherence to plastic surfaces, a feature that is not shared by the random contaminating cells (Figures 4A and B). Once plated, the majority of the macrophages show a classical “fried egg” morphology while there are also cells with a stretched spindle-like phenotype (Figures 4C and D). This is mirrored by their F-actin distribution within the cytoplasm and adhesion clusters. The differentiated cells are characterized by the expression of CD45, CD14, CD16, CD206 (mannose receptor), CD11b and CD11c which are typical markers for mature macrophages (Figure 5). The presence of CD11b argues against a predominantly dendritic differentiation which is supported by the fact that the cells are negative for the dendritic cell marker CD209 (DC-SIGN).
After the differentiation process the cells remain functionally and metabolically active for approximately 5-7 days (Figure 6) as it can be visualized by calcein AM staining and their ability to take up extracellular vesicles shed from tumor cells. Additionally, the cells can still be activated as shown e.g., for the stimulation with lipopolysaccharide (LPS) which results in the expression of several pro-inflammatory genes (Figure 7).

Figure 1. Appearance and composition of the PBMC- and monocyte-layer after double density gradient centrifugation. Photograph illustrating (A) the PBMC-band after the Ficoll gradient and (D) the monocyte-phase after the iso-osmotic Percoll centrifugation. May-Gruenwald stainings of cytospin preparations of the (B, C) PBMC fraction and the remaining (E, F) monocytes. Scale bar = 200 µm in B and E, = 50 µm in C and F.

Figure 2. Yield of monocytes and macrophages. Representative cell countings of isolated monocytes and macrophages of 20 buffy coat preparations.

Figure 3. Micrographs and cell size measurements of monocytes and macrophages. Phase contrast microscopy of monocytic cell suspension before (A) and after (B) macrophage differentiation. Corresponding cell size histograms of monocytes (C) and macrophages (D). Scale bar = 100 µm.

Figure 4. Morphology and cytoskeletal organization of adherent macrophages. Phase contrast microscopy of adherent macrophages before (A) and after (B) removal of non-adherent cells. (C, D) Phalloidin-TRITC staining of filamentous actin in adherent, non-stimulated macrophages. Scale bar = 100 µm in A-C, 20 µm in D. Please click here to view a larger version of this figure.

Figure 5. Immunophenotype of differentiated macrophages. Flow cytometry analysis of macrophages after 6 days of differentiation in FEP Teflon-coated cell culture bags (indicated in red). The corresponding isotype controls are shown in grey. Please click here to view a larger version of this figure.

Figure 6. Uptake of tumor cell microvesicles by macrophages. Micrographs of adherent macrophages after exposition to PKH26-labeled (red fluorescent) tumor cell-derived microvesicles. Images are overlayed to the corresponding (A) brightfield or (B) cytosolic staining with the viability dye calcein AM. Scale bars = 100 µm. Please click here to view a larger version of this figure.

Figure 7. Upregulation of IL-1β, Wnt5a, TNFα, IL-6, MMP-2, MMP-7, and MT1-MMP after stimulation of macrophages with LPS (100 ng/ml) for 24 hr. Gene expression was measured by quantitative RT-PCR from total RNA samples (A) and normalized on HPRT1 and GNB2L1 expression. The values shown are fold changes in comparison to the untreated control (means ± SD, n=5, *p<0.05, **p<0.01, ***p<0.001). TNFα and IL-6 induction under LPS stimulation were further confirmed by ELISA (B) (means ± SD, *p<0.05).