Inflammation is the body’s universal response to injury and is a crucial step in both innate and adaptive immune system function. In response to injury and/or inflammatory stimuli, endothelial cells upregulate specific adhesion molecules; this leads to leukocyte extravasation through the microvascular endothelium, primarily in post capillary venules. This process starts with tethering of the free-flowing leukocytes in the bloodstream on the endothelium. Stable rolling and firm adhesion of leukocytes, which in turn leads to transmigration and the secretion of cytotoxic agents, follow this tethering1,2. Selectins are known to mediate the early steps of the cascade3-5; integrins are responsible for the later steps of firm adhesion and transmigration1,6-8.
A growing body of evidence suggests leukocytes and endothelial adhesion molecules have vital roles in animal models of ischemia reperfusion injury, asthma, psoriasis, multiple sclerosis, and age-related macular degeneration9-12. Under these conditions, the inflammatory response is misdirected to attack one’s own body, resulting in the breakdown of healthy tissue. Existing anti-inflammatory agents (such as non-steroidal anti-inflammatory drugs, corticosteroids, or other chemotherapeutic agents) carry the risk of severe side effects with long-term use13. Therefore, it is of great interest to have the appropriate tools with the ability to identify disease-specific molecules, which can ultimately be targeted to have the desired anti-inflammatory effect while remaining non-toxic14.
Existing in vitro methods such as the static leukocyte adhesion assay were used as early as 197615. The parallel flow chamber was first used in vitro in 1987 to study leukocyte-endothelial interactions under flow conditions. In these experiments, stimulated human polymorphonuclear leukocytes (PMNs) from venous blood were perfused over a monolayer of primary human umbilical vein endothelial cells (HUVECs). To control for the hemodynamic flow conditions, the Harvard Apparatus syringe pump was employed16. Alternatively, to avoid artificial leukocytes isolation, whole blood was used in combination with the glass chamber coated with immobilized adhesion molecules17.
To avoid leukocyte stimulation and to mechanistically study their interaction with the adhesion molecules under approximate physiologic conditions, an ex vivo autoperfused, extracorporal, arteriovenous circuit was developed16. In this circuit, the blood flows between the right common carotid artery and left external jugular vein of a live mouse under anesthesia, allowing interaction of native PBLs within a glass microflow chamber coated with single or co-immobilized adhesion molecules. A major advantage to this system is the ability to employ genetically engineered mice, in which inflammatory pathways are directly or indirectly manipulated. Additionally, there is the ability to pinpoint the isolated contribution of leukocyte adhesion molecules to inflammation, free of external activation, under flow conditions. The application of a flow regulator at the input point of the flow chamber provides a wide range of experimental variations of shear forces to mimic either arterial or venous systems18-22. Here we describe in great detail a protocol concerning the preparation and performance of the ex vivo autoperfused microflow chamber assay.