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We generated an image set consisting of 25 fields/well, 54 wells/plate (3 cell populations x 6 drug concentrations x 3 replicates), across three plates for a total of 4,050 individual images. The image sets generated over the course of the experiment were analyzed using proprietary software (see table of materials) to extract various quantitative properties of cells (i.e. morphology, fluorescence) which could then be used to classify cell subpopulations. However, because the commercial software used has limited access, comparable downstream pipelines in CellProfiler and CellProfiler Analyst were created.
Heterocellular Classification into Subpopulations
Nuclei were identified and segmented based on the DNA stain (here Hoechst) and cell populations were classified either based upon fluorescence or morphology (Figure 1). For fluorescence-based classification, the fibroblasts (CCD-19Lu) were previously transduced with GFP-lentivirus. The GFP intensity levels were measured for each nucleus, and those that were calculated above the accepted threshold (based on the background signal) were classified as CCD-19Lu while those below were identified as tumor cells (H3255). For morphology-based classification, cells were previously stained with a non-toxic cellular stain (see the table of materials) and this was used to identify and segment the cytoplasm. A machine learning algorithm was trained with ~50-100 cells from each population. Morphological features were identified that were significantly different between the populations, which were then used to design a linear classifier to distinguish between CCD-19Lu and H3255 cells. The fluorescence and morphology classification protocols were 97.4% (n = 1403) concordant at distinguishing between the two cell populations in untreated conditions and 92.5% (n = 916) concordant in drug treated conditions (1 µM erlotinib) (Figure 2).
Phenotypic Analyses of Subpopulations
In addition to discriminating between cell types, we aimed to characterize phenotypic properties of each subpopulation. Multiplexing assays saves time and reagents, adds consistency, and provides additional information regarding the system being studied. There are many potential phenotypic outputs and one should choose them based upon the questions of interest. Here, changes in the cell morphology and viability status in response to erlotinib treatment were investigated. After three days of drug treatment, a decrease in nuclear area and an increase in cellular area of the H3255 cells (Figure 3A) was observed. The mean difference in nuclear area between the "no drug" and "drug" treated populations was found to be statistically significant via a two-sided type-2 (equal variance) t-test (p = 7.92 x 10-16). We hypothesize that this observation is a cellular response to the stress imposed by drug treatment.
It is also of interest to study whether a drug has a cytotoxic (i.e. increase in number of dead cells over time) or cytostatic (i.e. decrease in number of cell births over time) effect on cells, as this has profound clinical impact. For example, a cytostatic drug effect induces growth arrest yet does not eliminate the cells from the tumor, thus there is the potential for cancer cells to reinitiate cell proliferation once the drug is removed. Drug effects can often be context, concentration, and cell type dependent. We previously observed erlotinib eliciting a cytotoxic response in one cell type, while showing a cytostatic response in another13.
Traditional viability assays output relative cell number and therefore, do not discriminate between growth arrests and cell death. Herein, dead cells were identified based upon propidium iodide stain (Figure 3B). Both cytotoxic and cytostatic effects of erlotinib on H3255 cells were observed, with an increase in the number of deaths and a decrease in the number of births following drug treatment (Figure 3C). It is worth noting that the number of dead cells drops following day 1 likely due to cell clearance. CCD-19Lu cells were not affected by the drug. An additional advantage of this platform is the generation of quantitative data. For example, in our co-culture experiment, an initial subpopulation of 1,118 (75.8%) H3255 cells was found to be 2,817 (87.9%) or 396 (57.2%) after three days without or with erlotinib treatment, respectively (Figure 4). Because we can generate actual cell counts instead of relative percentage (as with flow cytometry methods), we conclude that the change in composition during drug treatment is due to a decrease in H3255 cells and not an increase in CCD-19Lu. It is worth nothing that death rates may be underestimated due to cell clearance, which is difficult to assess experimentally and likely differs across cell types.

Figure 1: Overview of the Image Analysis Protocol. Two potential downstream image analysis pipelines to classify heterocellular populations using either morphology-based classification or fluorescence-based classification. Scale bars = 100 µm. Please click here to view a larger version of this figure.

Figure 2: Concordance between Morphology and Fluorescence-based Classification. (A) Concordance plot displaying the overlap of the two classification protocols. The same cells were classified as H3255 using both morphology- and fluorescence-based classification. The two protocols were in agreement, with classification for 97.4% (n = 1403) of untreated cells and 92.5% (n = 916) of cells treated with erlotinib (Note: white area is too small to visualize). (B) 10X images depicting examples of good and poor concordance between fluorescence-based and morphology-based classification. The white arrows point out cells that were inconsistently classified between platforms. Input image: blue – nuclei (Hoechst); green – CCD19Lu (GFP). Classification images: Red – H3255; green – CCD-19Lu. Scale bar = 100 µm. Please click here to view a larger version of this figure.

Figure 3: Multiplexed Phenotypic Measurements from a Single Experimental Setup. (A) Morphological features, such as nuclei and cell area, were calculated on the single cell level in the presence and absence of drug. Note: Cell areas measuring smaller than 100 µm2 were considered debris and excluded from analyses. Box plot depicts median with first and third quartile ranges and 95% confidence interval error bars. (B) H3255 (blue) and CCD-19Lu (green) cells were co-cultured and dead cells were identified based upon the intensity of propidium iodide stain (red) and imaged using a 10X objective. Scale bar = 1 mm (top panel); 100 µm (bottom images). (C) Total number of live and dead cells were calculated over three days with or without drug treatment, with an obvious decrease in number of live cells and increase in dead cells with the addition of erlotinib. Error bars represent standard error of the mean based on of three replicates. Please click here to view a larger version of this figure.

Figure 4: Subpopulation Dynamics over Time. Representative 10X images of wells containing H3255 (blue) and CCD-19Lu (green) on day 0 or day 3 with and without drug. Cells belonging to each subpopulation were counted and proportional pie charts show the actual change in population composition across samples. Scale bars = 1 mm (middle panels, shpwn in ;eftmost panel), 1 mm (top image), 100 µm (bottom images). Please click here to view a larger version of this figure.