$$\rightleftharpoonup{xx}$$
$$\longleftharp{xx}$$,
$$\longrightharp{xx}$$,
Immune cells which enter the PNS from the circulation, as defined by the expression of CD45 and CD11b, help to maintain the integrity of the nerve and play a role both in regeneration and degeneration1. Macrophages (defined by their expression of CD68 in mouse) can be skewed towards an inflammatory phenotype, expressing more MHC class II and CD86 on their surface (M1), or towards an anti-inflammatory phenotype, expressing more intracellular CD206 (M2)2. Skewing of the macrophage phenotype is a dynamic process regulated through Akt signaling3, reflecting the different tasks of macrophages in the defense against pathogens (M1) and the role in tissue regeneration (M2). Regeneration of an injured nerve first requires phagocytosis of myelin debris by macrophages in the nerve4,5, and anti-inflammatory (CD68+CD206+) M2 macrophages have been shown to promote axon outgrowth in the PNS6. Reduced recruitment or macrophages to the PNS, or impaired capacity for phagocytosis may result in impaired regeneration and maintenance of nerve integrity. Inflammatory M1 macrophages, expressing MHC class II, are less capable of phagocytosis than M2 macrophages, and neuronal inflammation is implicated in the pathogenesis of several neurodegenerative diseases7.
The changes that occur to the nerve resident immune system as a consequence of damage may be quantitative, manifesting in loss of CD45+ leukocytes (or increased infiltration of CD45+ leukocytes in the case inflammation), or qualitative, such as change of macrophage phenotype from M2 to M1 phenotype. The immune cells of the PNS have traditionally been analyzed by means of IF, using frozen sections or paraffin-embedded material8. IF is required for determining localization of the cells of interest. However, quantification using IF often relies on counting a relatively small number of cells in a narrow section of the tissue, making quantification unreliable and vulnerable to selection bias. For identification of specific subsets of immune cells, the simultaneous detection of extracellular and/or intracellular markers is required, whilst determination of the macrophage phenotype requires at least at least two markers, specifically CD206 and MHC class II. As most commonly available microscopes are limited to at least two-color channels, such as fluorescein isothiocyanate (FITC) and phycoerythrin (PE), the characterization of the specific subsets of immune cells by IF can be restrictive and incomplete, requiring the need to have multiple slides, derived from the same area of interest, which are stained and analyzed in parallel. This time-consuming aspect therefore does not necessary lend itself to the analysis of large sample sets. Furthermore, as most of the markers of interest are extracellular, the detection in tissue, which has either been embedded in paraffin or cryoconserved, can be problematic due to the disruption of membrane integrity and the masking of epitopes, as well as the loss of the antigens of interest from the use of solvents, such as acetone and methanol9.
In contrast, flow cytometry, which measures optical and fluorescence characteristics of single cells in suspension as they pass through a beam of light, provides a more practical and comprehensive means for analysis of the cell populations. Flow cytometry, rather than producing a digital image of the tissue, provides an automated quantification of set parameters, which include a cell's relative size and reflective index, referred to as the forward scatter (FSC), granularity/internal complexity or side-scatter (SSC), and relative fluorescence intensity, providing that the cell has been labeled with an appropriate fluorophore, such as a conjugated antibody. A typical flow cytometer consists of two, air-cooled lasers; an argon laser produces blue light at 488 nm and a helium-neon laser produces light at 633 nm. This combination allows for the detection and measurement, simultaneously, of at least five targets either on the surface or within the intracellular compartment. More advanced flow cytometers can consist of multiple lasers, which allow for the detection of up to eight different fluorochromes at once, providing that the peak emission wavelengths of the selected fluorochromes do not overlap significantly.
For analyzing by flow cytometry, the tissue of interest must first be enzymatically digested, generally with collagenase, to generate a single-cell suspension. The analysis of murine sciatic nerves has previously been difficult due to the small amount of tissue obtained from each mouse. In addition, the high fat content of the myelin around the axons hampers cell recovery and produces large amounts of debris. The method described herein for sciatic nerve preparation and digestion was adapted from the Schwann cell isolation protocol of Barrette et al.7, and aims to isolate enough cells from nerves of individual mice for flow cytometry analysis, in order to reduce variation between mice. Using DAPI for the identification of single cells in the raw tissue digest circumvents the need to remove axon debris, which commonly leads to cell loss. Washing several times with a detergent-rich buffer aids in the release of cells trapped within the fatty debris, thereby increasing the yield. Digestion of both full-length sciatic nerves from a single mouse according to this protocol generates ≥30,000 single nucleated events and at least 3 times that number was retrieved from the DRG. The proportion of CD45+ leukocytes was approximately 5% of total cell content in the sciatic nerve digest and approximately 5-10% in the DRG digest. The majority of the CD45+ cells in the sciatic nerve expressed the macrophage markers, CD68 and CD206.