Inflammatory bowel disease (IBD), i.e., Ulcerative Colitis (UC) and Crohn's disease (CD) are idiopathic inflammatory disorders of the gastrointestinal tract1. Research into the underlying pathophysiology of IBD and the evaluation of potential new drugs or novel diagnostic approaches is particularly of importance. In both basic research and the clinical management of IBD patients, the intestinal mucosa has become a focus of attention2,3. The mucosa represents an anatomical boundary, at which the interaction between commensal bacteria, epithelial cells and various cellular components of the intestinal immune system orchestrate gut homeostasis4,5. However, in IBD patients, uncontrolled and persistent intestinal inflammation leads to mucosal damage, detectable as ulcerations or stenosis, which can finally culminate in breakdown of epithelial barrier function, which itself aggravates local inflammation6.
Epithelial wound healing is therefore crucial for epithelial regeneration following inflammation but is also a core requirement for the healing of gastrointestinal ulcers or anastomotic leakage after gastrointestinal surgery7. Epithelial wound healing can be simulated in in vitro wound healing assays and in murine models of intestinal inflammation8,9. Both in vitro and in vivo approaches have drawbacks, which limit the accuracy of experimental assessment. In vitro assays, like classical scratch assays, require protracted staining procedures or transfection with fluorescent chromophores. They are often limited by their discontinuous monitoring of cell proliferation and migration that cannot be automated10. In vivo models, such as dextran sodium sulphate (DSS)-induced colitis, frequently lack robust read-outs, in part due to the significant variation seen in laboratory markers, making such markers inappropriate to evaluate colitis severity11,12. Histological analysis of the inflamed mucosa is currently still the most valid approach to determine colitis severity but this, like in vitro epithelial wound healing assays, requires staining and is dependent on investigator's expertise13.
Recently digital holographic microscopy (DHM), a variant of quantitative phase microscopy14, was identified as useful tool for the evaluation of epithelial wound healing in vitro and in vivo15. DHM allows assessment of tissue density by measuring optical path length delay (OPD), which prospects novel cancer diagnosis16-18 and quantification of inflammation related tissue alterations19. Additionally, DHM allows monitoring of cell morphology dynamics by determining cell thickness, cell covered surface area and intracellular (protein) content quantity15,20. In in vitro assays, DHM also enables the analysis of physiological processes, e.g., cellular water permeability by evaluating changes in cell volume and thickness21,22. Moreover, DHM measurements can be automated which prevents investigator-associated sample bias.
Here, we demonstrate the use of DHM in a murine model of intestinal inflammation, and also apply DHM to analysis of human tissues samples for quantitative monitoring of wound healing as a label-free in vitro assay. First, we evaluate inflammatory alterations of different colonic wall-layers in colitic mice and tissue sections from humans with IBD. After describing the DHM quantitative phase imaging procedure, we provide detailed instructions for using the microscope components, the preparation of tissue sections and also describe the evaluation of the acquired quantitative phase images.
Next, we show that DHM can be utilized for continuous multimodal monitoring of epithelial wound healing in vitro, and describe the analysis of cellular characteristics like cell layer thickness, dry mass and cellular volume give insight into drug induced and physiologic cell alterations.