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The pathogenic contribution and effects of resistance artery remodeling are documented in essential hypertension, diabetes and the metabolic syndrome1,2,3,4,5. Deciphering the relationship between the mechanical and microarchitectural properties of the microvascular wall is essential for developing mathematical models of this association. Such models will improve understanding the remodeling process and will support the development of in silico models useful for testing pharmacological strategies targeting disease related remodeling of the arterial wall.
Prior studies focused in understanding how the microarchitecture of the arterial wall relates to arterial wall mechanics by incorporating mechanical measures and the microarchitecture of the extracellular matrix (ECM) are almost exclusively performed on large, elastic conduit arteries from mice or swine6,7,8,9,10,11. Imaging of the microstructures of the wall is typically performed using nonlinear optical techniques, taking advantage of the autofluorescence of elastin and second harmonic generation by collagen. This allows spatiotemporal imaging of the two major components of the extracellular matrix, elastin and collagen, without a need for staining. Imaging of the arterial wall in full thickness is a challenge in large conduit arteries due to scatter of the light in the thick tunica media. However, to determine how the microarchitecture of the structural components of the arterial wall relate to the observed mechanical properties, three-dimensional information must be obtained during the mechanical testing. For large arteries like the human aorta, this requires biaxial mounting, mechanical testing and imaging of regions of interest in 1-2 cm2 pieces of the arterial wall7,9,10,12. Only part of the wall can be imaged and mechanically tested.
For smaller arteries of any species (e.g., human pericardial13, pulmonary14 and subcutaneous15 arteries, rat mesenteric arteries16,17,18,19,20, mouse cremaster, mesenteric, cerebral, femoral and carotid arteries21,22,23,24,25,26,27) imaging of the entire wall thickness is possible and can be combined with mechanical testing. This allows simultaneous recording of the mechanical properties and the structural arrangements within the wall. However, a direct mathematical modeling of the relationship between the observed alterations in the three-dimensional structure of the ECM and changed mechanical properties of the resistance arterial wall, has to the best of our knowledge only been reported upon recently in human resistance arteries13,15.
In this work, an ex vivo method for passive mechanical testing and simultaneous three-dimensional imaging of the microarchitecture of elastin and collagen in the arterial wall of isolated human resistance arteries is described. The imaging protocol can be applied to resistance arteries of any species of interest. Image analyses are described for obtaining measures of internal elastic lamina branching angles and adventitial collagen straightness13 using Fiji28. Collagen and elastin volume densities are determined using Ilastik software29 and finally, the inclusion of the mechanical and imaging data in mathematical models of the arterial wall mechanics is discussed.
The goal of describing the imaging and image analyses techniques in combination with mathematical modeling is to provide investigators a systematical approach to describe and understand observed pressure induced changes in the ECM of resistance arteries. The described method is focused in quantifying the changes in the ECM in a vessel during pressurization, by comparing the structure of the ECM at 20, 40 and 100 mmHg. These pressures were chosen for determining the structure of the arterial wall at its more compliant (20 mmHg), stiff (100 mmHg) and intermediate (40 mmHg) state, respectively. However, any process in the vascular wall of live arteries, including changes induced by vasoactive components, hysteresis and flow, can be quantified, depending on the research hypothesis in question by the investigator.
The use of two-photon excitation fluorescence microscopy (TPEM) in combination with a pressure myograph for studying pressure (or other) induced changes in the ECM of live arteries is emphasized. First, because this allows simultaneous acquisition of the overall three-dimensional structure of the arterial wall (diameter and wall thickness) along with three-dimensional label-free acquisition of high quality, detailed images of the collagen and elastin microarchitectures as described13 by taking advantage of the elastin autofluorescence and the collagen second harmonic generation signal (SHG)30. Second, TPEM allows use of low-energy near-infrared excitation light, minimizing photodamage of the tissue and thus, repeated imaging at exactly the same position within the vascular wall is allowed, permitting repeated-measurements analyses of observed changes.
The use of an alternative approach using confocal imaging of pressure fixed arteries is discussed to allow users without access to TPEM an opportunity to use the described method as well. Information on ECM structure and volume densities can also be retrieved from two-dimensional analyses of tissues sectioned in serial, e.g. as described by31,32. However, due to the lack of possibility to retrieve three-dimensional structural information over the length scales of the artery as well as during changing conditions using this method, it is not recommend using this approach for investigations of pressure and treatment induced three-dimensional changes in the ECM.
The minimum requirement for the investigator to apply the herein described method is the access to a setup for cannulation and pressurization of arteries in combination with a confocal or two-photon excitation fluorescence microscope. The setup described in the following protocol is a custom-built pressure myograph with a longitudinal force transducer, built to fit on a custom built inverted two-photon excitation fluorescence microscope.