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Cilia are sensory microtubule-based organelles that extend from the cell surface to the extracellular environment. Depending on their microtubule organization, cilia can be categorized into two types - “9+0” or “9+2”. Functionally, based on their motility, these can be classed as motile or non-motile cilia 1. Primary cilia is a term commonly used to denote “9+0” non-motile cilia. These have nine parallel doublet microtubules (denoted by ‘9’) and a central pair of microtubules is absent within the central sheath (denoted by ‘0’). However, some “9+0” cilia, such as nodal cilia, which regulate embryo laterality are motile 2. On the other hand, motile cilia are characterized, in addition to the nine parallel microtubule doublets, by an additional central pair of microtubule doublets and associated with dynein motor proteins to facilitate motility. In addition, some “9+2” cilia such as olfactory cilia are non-motile 3. Ependymal cells lining the brain ventricles and the central canal of the spinal cord are characterized by motile cilia that propel the cerebrospinal fluid (CSF) along the brain ventricles 4.
The overall goal of this method is to facilitate studying the motile cilia dynamics and structural abnormalities. The brain’s health and development heavily depend on efficient circulation of CSF within the brain ventricles. For instance, normal CSF flow and fluid balance require normal beating and functional ependymal cilia 5,6, which in turn play critical roles in regulating the directional movement of neuronal cells and stem cell migration 7. As such, abnormal ependymal cilia function or structure can lead to abnormal CSF flow, which is associated with hydrocephalus, a medical condition in which there is an abnormal accumulation of CSF in the ventricles of the brain. This may consequently cause increased intracranial pressure and progressive enlargement of the head, convulsion, tunnel vision, and mental disability 8.
The advantages of this technique over existing methods is that it allowed for the first time to report three distinct ependymal cell types: I, II, and III, based on their unique ciliary beating frequency and beating angle. These ependymal cells are localized within certain regions in the brain ventricles. Furthermore, the effects of age and pharmacological agents such as alcohol and cilostazol on altering the ependymal cell types or their localizations can be demonstrated, which was not possible before this classification of ependymal cells. Cilostazol is an inhibitor of phosphodiesterase-3, an enzyme that metabolizes cAMP to AMP and it also regulates intracellular calcium 9. Using high-speed fluorescence imaging analysis allows imaging and quantifying of the unique intracellular calcium oscillation properties of the ependymal cells. For instance, both alcohol and cilostazol significantly altered the ependymal ciliary beating frequency as well as the intracellular calcium oscillations properties, which in turn, could lead to a change in the cerebrospinal fluid volume replacement by ependymal cilia 10. In summary, this technique was key to provide the first evidence of three distinct types of ependymal cells with different calcium oscillation properties.
In the following section, a detailed step-by-step overview of the procedure is provided, paying close attention to tissue preparation and handling.