Imaging the cleared embryonic heart
Vertebrate heart formation is a spatiotemporally regulated morphogenic process and depends on the organization and differentiation of progenitor cells from four different sources1. Cells from the first heart field of the cardiac crescent will fold toward the ventral midline to form a linear heart tube. The cells from the second heart field, initially residing dorsomedially to the first heart field, subsequently translocate to the pharyngeal and splanchnic mesoderm, from where they migrate to the pre-existing scaffold of the linear heart tube. The cells of second heart field will contribute to the right ventricle, outflow tract (OFT) myocardium and to some endocardium25-28. Cardiac neural crest cells (CNCC), originating from postotic rhombomeres 6, 7 and 8, will migrate to the caudal pharynx and contribute significantly to the smooth muscle layer and endocardial cushions in the OFT. They also contribute to the formation of the aorticopulmonary septum29,30. The fourth population consists of epicardial cells derived from the pro-epicardial organ (PEO), and contributes to fibroblasts, smooth muscle cells and potentially other cardiac cell types31. The epicardium regulates coronary vascular development, cardiac growth and morphogenesis21.
The most important concept about cardiac morphogenesis is that during heart development, abnormal cell migration/differentiation of the four progenitor cell populations will result in malformations or congenital heart defects4,22,32, which is the number one cause of birth defects in the world. Determining the mechanisms of cardiac morphogenesis at the cellular and molecular level is an essential step toward improving diagnosis and potential treatments for CHDs. Therefore, it is critical to image the process of heart morphogenesis at the whole heart level with single cell resolution. To achieve that, we labeled the cardiomyocytes by crossing the Cre line under the control of cardiac specific troponin T (cTnT), which is specifically expressed in cardiomyocytes18, with mTmG reporter line. The embryos at E8.5 were harvested and stained for PECAM to distinguish endocardial and endothelial cells from cardiomyocytes. The embryos were then cleared by Scale and the heart was imaged. The myocardium was labeled by GFP due to cTnT-driven Cre-mediated recombination of the mTmG reporter, and the endocardium was labeled with PECAM (Figure 1A and Supplementary Movie 1). The cardiomyocytes can be observed at a single cell resolution (Figure 1A). The heart structures of the imaged portion, such as the primitive ventricle and OFT can be clearly identified after 3D reconstruction using 3D reconstruction software (Figure 1B and Supplementary Movie 2).
Imaging single clones of the cleared embryonic heart
Cardiac morphogenesis depends on cardiac lineage differentiation and individual cell organization at the whole heart level22, and thus, it is essential to image single cardiac progenitor cell differentiation to different cardiac cell types and to also image cell morphology at single cell resolution. To achieve that, Rosa26CreERT2 15 was crossed to R26R-Confetti16, and the pregnant female was gavaged with Tamoxifen at a low concentration. After 48 hr, the embryo was harvested at E9.5, and whole mount stained for PECAM, and then the whole heart was imaged. We found that there was only one cluster of cells, localized to the OFT, and this clone had 8 cells based on the reconstructed image and consecutive sections (Figures 2A, 2B and Supplementary Movie 3), indicating that these cells are derived from a single progenitor cell. The cellular morphology and cellular behavior such as cellular proliferation and migration can be inferred from the ultimate positioning of the cells (Figure 2A). We also applied the CUBIC method to clear the embryonic heart at E9.5 and E10.5, and found that even after only 24 hr of incubation with reagent 1, the embryos were subtly dissolved and the tissue structure was adversely affected (Data not shown).
Imaging of cleared postnatal and late embryonic hearts
We applied both Scale and CUBIC to clear postnatal hearts. P2 hearts with the genotype of αMHC-Cre; mTmG (αMHC-Cre is specifically expressed in cardiomyocytes17) were cleared with Scale for 48 hr, but did not display any more transparency than the hearts treated with PBS only (Data not shown), indicating that Scale clearing is not effective for postnatal hearts. When P2 hearts were cleared with CUBIC reagent 1 for 48 hr, and reagent 2 for 96 hr, they were much more transparent than the hearts cleared with reagent 1 for 48 hr and reagent 2 for 48 hr. The imaging depth was significantly increased with 96 hr of reagent 2 incubation (Supplementary Movies 4 and 5), indicating that longer incubation with the CUBIC reagents promotes transparency and provides for an increase in imaging depth. The shape and size of each cardiomyocyte can be identified by the membrane localized GFP (Figure 3A), which can be used to identify hypertrophy.
We also cleared Nfatc1-Cre;Confetti (Confetti female plugged with Nfatc1Cre male) E17.5 hearts (Nfatc1-Cre is expressed in cardiac endocardial cells19) with CUBIC reagent 1 for 48 hr and reagent 2 for 48 hr. The hearts are transparent, and fluorescent proteins including GFP, YFP, CFP and RFP were expected to label the endocardial cells and their derived cells; however, only GFP and YFP could be imaged through the whole heart (Figures 3B, 3C and Supplementary Movies 6 and 7), and the CFP and RFP could not be detected (Data not shown). The staining for PECAM (Alexia Fluor 647) also could not be detected (Data not shown), suggesting that the CUBIC reagent quenches the CFP, RFP and the antibody conjugated fluorophore in this protocol.

Figure 1: Imaging the Sac/e cleared embryonic heart. (A) One optical slice of an E8.75 heart (cTnT-Cre;mTmG) is shown. V: ventricle; OFT: outflow tract. (B) Shows the reconstructed heart structure of 93 consecutive optical slices with a total depth of 110.4 µm. Scale bar = 20 µm in A. Please click here to view a larger version of this figure.

Figure 2: Imaging single clone of Sca/e cleared embryonic heart. (A) One optical section of a clone from an E9.5 heart with the genotype of ROSA26-CreERT2; ROSA26-Confetti. The arrow points to a cellular protrusion of a cardiomyocyte. (B) Shows the reconstructed clone in the OFT region of the E9.5 heart with 10 optical slices and 36 µm total depth. Scale bar = 20 µm in A. Please click here to view a larger version of this figure.

Figure 3: Imaging the CUBIC cleared postnatal and late embryonic hearts. (A) Shows one optical section of a P2 heart with the genotype of αMHC-Cre;mTmG; all of the optical sections are shown in Supplementary Movie 5. (B) Shows one section of an E17.5 heart with the genotype of Nfatc1-Cre;ROSA26-Confetti. (C) Shows the reconstructed heart structure from 106 optical slices with a total depth of 630 µm. The Scale bar = 20 µm in A and is 100 µm in B. Please click here to view a larger version of this figure.

Supplementary Movie 1: Imaging the Scale cleared embryonic heart (Right click to download). Movie 1 shows optical sections of a Scale treated E8.75 heart (cTnT-Cre;mTmG) from heart surface to heart lumen. The depth is 110.4 µm and there are 93 slices in total.

Supplementary Movie 2: Imaging the Scale cleared embryonic heart (Right click to download). Movie 2 shows the 3D surface picture of the reconstructed heart in Movie 1, reconstructed via the 3D reconstruction software. Yellow marks the PECAM expression and green labels all the cardiomyocytes.

Supplementary Movie 3: Imaging a single clone of the Scale cleared embryonic heart (Right click to download). Movie 3 shows sections of a clone from an E9.5 heart with the genotype of ROSA26-CreERT2.

Supplementary Movie 4: Imaging the CUBIC cleared postnatal hearts (Right click to download). Movie 4 shows sections of a CUBIC treated P2 heart (αMHC-Cre;mTmG) from heart surface to heart lumen. This P2 heart was cleared with CUBIC reagent 1 for 48 hr, and CUBIC reagent 2 for 96 hr.

Supplementary Movie 5: Imaging the CUBIC cleared postnatal hearts (Right click to download). Movie 5 shows a heart that was cleared with reagent CUBIC 1 for 48 hr and reagent CUBIC 2 for 48 hr. The depth is 136 µm with 6 µm per section in movie 4 and the thickness is 76 µm with 6 µm per section in movie 5.

Supplementary Movie 6: Imaging the CUBIC cleared late embryonic heart (Right click to download). Movie 6 shows sections of a CUBIC treated E17.5 heart (Nfatc1-Cre;ROSA26-Confetti) from heart surface to heart lumen. The depth is 630 µm with 6 µm per section.

Supplementary Movie 7: Imaging the CUBIC cleared late embryonic heart (Right click to download). Movie 7 shows the 3D surface picture of the heart in Movie 6, reconstructed via the 3D reconstruction software.