$$\rightleftharpoonup{xx}$$
$$\longleftharp{xx}$$,
$$\longrightharp{xx}$$,
This procedure requires a unique surgical preparation of the kidney for 2-photon imaging and access, which is illustrated in Figure 1. This preparation shown here allows a vertical imaging column with the objective above the kidney with few density changes for best-possible optics for 2-photon microscopy simultaneously with lateral access for the pipette, driven exclusively in the horizontal (x) dimension. Partial extrusion of the kidney prevents excess tension on the renal pedicle and preserves vascular flow, and construction of a custom kidney support enables the two objectives of imaging and access. The second challenge in this procedure is precise positioning of the pipette within the kidney in 3 dimensions, which requires registration of the pipette and stage coordinate systems. The critical step for this process is illustrated in Figure 2, which shows the pipette being spotted in the water column of the 2-photon microscope under DAPI-excitation. Entering the water column and registering the coordinates of the pipette to those of the stage prior to entering the kidney is critical to enable precise stereotactic positioning of the pipette within the target Bowman's space. The pipette enters the imaging water column from the right. With DAPI excitation turned on, the red quantum dot-coated pipette fluoresces brightly in the red-orange, and it can be carefully positioned under the middle of the objective. As the excitation beam passes through the center of the objective, the pipette may be freely moved to the point of maximum fluorescence, ensuring that it will be visible in the eyepiece.
Proper pipette pulling and glomerulus selection are critical to the success of this protocol, as illustrated in Figure 3, Figure 4, Figure 5. In Figure 3A, a properly-pulled, red-fluorescent quantum dot-coated glass micropipette imaged in the fluid column during the pipette registration portion of the procedure can be seen. The tip is 6 microns in width. In Figure 3B, a poorly-pulled pipette with 12 µm tip is shown. This pipette cannot penetrate the renal capsule without causing vascular trauma due to the 12 µm diameter and irregular tip surface (note the bur at the top of the bevel). In Figure 3C and 3D, the importance of optimal positioning rather than imaging of the target glomerulus is shown. The beautiful, near-surface glomerulus illustrated in Figure 3C demonstrates favorable imaging (due to its surface position at 20 µm below the renal capsule) but would not be suitable for access by this procedure because it is too close to the surface, and the pipette would hit the coverslip. In Figure 3D, optimally-positioned glomeruli are shown. Note the different scale used to illustrate both glomeruli (scale bars are all 50 µm). These glomeruli appear less sharp because of refraction caused by depth; this image was taken at 70 µm below the renal capsule. The lateral kidney edge is 250 µm to the right, making both of these glomeruli accessible. During an access procedure, imaging is tightly focused on the target glomerulus as in Figure 4, and every-second image acquisition is used, allowing the investigator to precisely observe positioning of the pipette in Bowman's space.
Figure 4 illustrates a typical renal entry and the result, a pipette tip within Bowman's space. In Figure 4A, a mean intensity projection from a z-stack with orthogonal views demonstrates the pipette tip in Bowman's space. Note that there is red pipette tip spectral artifact (round ball of fluorescence) due to extremely bright fluorescence of the quantum dots arranged on the conical section of the tip. In Figure 4B, a volume projection of z-stack data demonstrates another pipette in Bowman's space. Note that the pipette dragged Bowman's capsule in the direction of travel on entry, creating apparent tenting behind the tip as described in the protocol.
In Figure 5, the results of a failed procedure are shown in which a pipette with a too-large opening broke at the renal capsule, causing bleeding. The pipette was too blunt; on attempting to pass the renal capsule, the capsule was pushed ahead of the pipette tip until breakage occurred. In this image, the renal capsule is visible, enhanced by subcaspular bleeding, in FITC-fluorescent green. FITC signal is visible within the pipette itself, indicating that blood under pressure entered the pipette lumen. The arrow points to many red blood cells visible within the pipette lumen as filling defects in the FITC-dextran.
Figure 6 depicts a representative mass spectrum obtained from Bowman's space aspirate, mouse urinary protein 17 (MUP17). Lastly, Table 1 demonstrates example results of successful aspiration procedures, listing proteins identified using nanoscale mass spectrometry on aspirate collected over 6 minutes from each of 3 mice. In each case, the pipette was imaged as it was withdrawn from Bowman's space, and no FITC fluorescence was observed within Bowman's space or the pipette lumen, indicating lack of aspirate contamination with plasma. 17 proteins, primarily of low molecular weight, were identified from a minimum of 2 unique peptides per protein. Spectral counts are low, consistent with prior estimates of protein in the glomerular filtrate, and known filtered proteins, such as vitamin D binding protein (VTDB), albumin (ALBU), and major urinary protein 17 (MUP17) are present.

Figure 1: Partial extrusion of the kidney with custom support and immobilization for lateral access. On the left, the parts of the imaging column and kidney support are shown, with the complete assembly in center. On the right, the kidney preparation is shown before (above) and after (below) application of the support. Please click here to view a larger version of this figure.

Figure 2: Completed kidney prep at pipette registration step of protocol. Here, DAPI excitation is being used to position the micropipette within the water column of the 2 photon microscope. Please click here to view a larger version of this figure.

Figure 3: Imaging of pipettes and the kidney after injection of FITC-dextran, demonstrating suitable and unsuitable glomeruli for micropuncture. A. A well-pulled pipette with 6 µm tip. B. A rough-edged, blunt tip. C. This glomerulus is well-defined, but too close to the coverslip for micropuncture. D. Suitably positioned glomeruli. Scale bars are all 50 µm. Please click here to view a larger version of this figure.

Figure 4: Successful pipette passage leads to placement in Bowman's space-views from 2 different procedures. A. Z-stack with orthogonal projections demonstrates pipette tip in Bowman's space abutting the glomerular tuft. Scale bar is 50 µm. B. Volume rendering from z-stack similarly demonstrates a pipette in Bowman's space abutting the glomerular tuft. Scale bar is 100 µm. Please click here to view a larger version of this figure.

Figure 5: An unsuccessful procedure due to a blunt pipette, tearing the renal capsule and leading to bleeding into the pipette lumen. FITC fluorescence from extravasated plasma, and red blood cells (arrow) are visible within the pipette. Arrow points to red blood cells visible within the pipette lumen. Scale bar is 50 µm. Please click here to view a larger version of this figure.

Figure 6: The mass spectrum for major urinary protein 17 (MUP17), obtained from nanoscale liquid chromatography/mass spectrometry analysis of Bowman's space aspirate. Please click here to view a larger version of this figure.
| Protein | MW (kD) | Mean Spectral Count |
| ACTA_MOUSE | 42 | 2 |
| ACTB_MOUSE | 42 | 1 |
| CLPX_MOUSE | 69 | 2.5 |
| DHSA_MOUSE | 73 | 1 |
| FOLR2_MOUSE | 29 | 1 |
| GBLP_MOUSE | 35 | 1 |
| ALBU_MOUSE | 66 | 6.7 |
| HBA_MOUSE | 15 | 2 |
| HBB1_MOUSE | 16 | 1 |
| MIB1_MOUSE | 110 | 1 |
| MUP17_MOUSE | 21 | 1 |
| PERI_MOUSE | 54 | 1 |
| RNAS4_MOUSE | 17 | 2 |
| SPTB1_MOUSE | 2 | 1 |
| VIME_MOUSE | 54 | 1 |
| VTDB_MOUSE | 53 | 1 |
Table 1: List of proteins identified in Bowman's space aspirate from 3 mice.
Supplemental Video 1: a volume rendering from a z-stack acquired after positioning a pipette in Bowman's space demonstrates the pipette tip within the space, abutting the capillary tuft. Please click here to download this file.