IST combined with IHC provides an essential tool for detecting, characterizing, and quantifying antigen-specific CD8 T cells in native environments with the context of other cells and tissue structures. Here, we described detailed procedures for IST combined with IHC, followed by quantitative image analysis, to determine the location, abundance, and phenotype of antigen-specific CD8 T cells in lymph nodes from rhesus macaques. Similar staining can be applied to human, mouse, or other species tissues for which MHC-I tetramers are available. In addition, peptide MHC Class II tetramer or dextramer staining can be performed using relatively similar methodologies to label antigen-specific CD4 T cells in tissues4,5,6,7,8,9,10,11,12,13. IST can also be combined with ISH to determine, for example, in vivo effector-to-target cell levels18,19. In the future, it will be interesting to carry IST/IHC further by combining IST/IHC with advanced in situ RNA and DNA detection methodologies. Recent advancements in in situ hybridization assays include the development of RNAscope and DNAscope24. These techniques allow for the detection of target RNA and DNA in tissues. It will be exciting to combine these methodologies with IST and IHC to simultaneously detect virus-specific-CD8 T cells, viral RNA, viral DNA, and antibody-labeled antigens of interest.
While we originally described IST methods with fresh tissues, tissues that were fixed for a short duration, and frozen tissues4, in recent years, we have exclusively used fresh tissue sections, as they consistently produce the highest-quality stains and allow for the examination of cells in thick tissue sections. As an alternative to the procedures presented here, one can apply tetramers to tissues, incubate overnight, fix, embed, and cryopreserve in freezing medium (e.g., OCT), produce frozen thin sections, and perform IHC later22. Similarly, we routinely stain a subset of tissue sections with tetramers alone and then freeze the sections in OCT to allow for additional counterstaining combinations in the future. In addition, Qdot 655-conjugated peptide-MHC multimers can be used to directly visualize antigen-specific T cells in cryopreserved tissue sections13.
We have described here indirect tetramer staining. Direct staining using APC- or PE-conjugated tetramers has also been shown to work4,22. In this case, the concentration of MHC tetramer required is higher than that used in indirect tetramer staining. In our hands, a concentration of 20 µg/mL of APC-labeled tetramer was effective at detecting antigen-specific cells. However, the staining intensity was much lower than that obtained with indirect labeling, which includes amplification with anti-FITC antibodies.
We found that the use of a compression-based microtome (see the Table of Materials) for fresh tissue cutting eased the process of cutting fresh tissue sections as compared to using a vibrating microtome23. However, in instances where a compression-based microtome is not available, a vibrating microtome or scalpel can be used for fresh tissue sectioning.
A major limitation of this technique is the use of fresh tissues. Using fresh tissues is much more difficult than fixed or frozen tissues because they require immediate attention and processing. We have successfully shipped fresh tissues overnight on ice in tissue culture medium or PBS-H. However, there have been occasional issues with shipping; for example, snow storms have delayed the shipment of tissues for 48 h or more. In these instances, we found that fresh tissues sectioned and those stained 48 h post-extraction generally show specific staining, with signs of some tissue degradation; tissues stained 72 h post-extraction are too degraded for staining. We also found that the shipment of fresh tissues with ice blocks that are too cold or too close to the tissues can freeze the tissues during shipping; this freezing generally destroys the tissue for staining. Thus, it is extremely important to ship fresh tissues chilled, but not frozen, and to initiate IST staining within 24 h. Fresh tissue processing also requires a great deal of student and staff time, as tissues from multiple animals or study participants cannot be collected and stained together on a later date. Despite these difficulties, we find that fresh tissue sections are the best choice for beautiful, specific IST/IHC staining.
Another limitation of the IST/IHC method described here is the indirect staining approach. Due to limitations on the number of distinct species of animals available to generate secondary antibody combinations, we are limited by indirect antibody staining methods to only three or four fluorescent antibody staining combinations at a time. This limits the amount of information that can be collected on one tissue slab. Direct IHC staining overcomes this limitation and can expand the capabilities, detecting eight or more antibody-tagged antigens simultaneously, albeit with each antibody producing a much weaker fluorescent signal compared to indirect methods. Thus, indirect IHC might be used as an alternative to indirect IHC for counterstaining IST-stained tissues, allowing for the detection of increased numbers of cellular antigens when combined with the IST detection of antigen-specific CD8 T cells.
In some instances, substantial autofluorescence and/or non-specific tetramer or antibody binding may occur with IST/ISH. Because of this, good positive and negative controls are necessary to discern specific stains from background and autofluorescent staining. Good negative controls for MHC I tetramers include negative control tissues (e.g., non-infected tissues; tissues stained with MHC I tetramers loaded with irrelevant peptides or irrelevant MHC tetramers; or, in a pinch, tissues stained with no tetramers but with amplifying antibodies).
In summary, MHC I IST combined with IHC is a valuable tool to determine the location, abundance, and phenotype of antigen-specific CD8 T cells in tissues. This methodology allows for the detection of antigen-specific CD8 T cells in native environments, with the relative localization to other cell types and tissue structures maintained. This method is broadly applicable because it can be used to localize, phenotype, and quantify essentially any antigen-specific CD8 T cell for which MHC tetramers are available, in any tissue.