Optical clearing techniques have received wide attention for 3-D visualization and quantification of microanatomy in various organs. Here, solvent-based clearing method (ECi) was combined with immunolabeling for 3-D imaging of whole tubules in kidney slices. This method is simple, inexpensive, and quick. However, other research questions may be best answered with other clearing protocols5. It is also important to keep in mind that solvent-based methods cause tissue-shrinkage at variable degrees, mainly due to the dehydration step14,18. Most solvent-based methods (e.g., ECi14) also at least partially quench endogenous fluorescence of reporters such as GFP or tdTomato; thus, FDISCO32, CLARITY12, or CUBIC11 may serve as alternative protocols. However, the quenching effect of ECi is variable and depends on individual constructs of each reporter mouse28. In addition, use of 1) a fluorescent antibody against GFP and other reporters or 2) modified solvent-based protocols that preserve endogenous fluorescence signals30,32 can also be an alternative approach in this context. It is worth mentioning that several groups have tested the compatibility of aqueous-based protocols24,33,34 to visualize RNA in 3-D, while solvent-based clearing methods have not yet been tested. Thus, aqueous-based clearing methods such as the modified version of CLARITY33 should be preferred when RNA analysis is considered.
Cells or gene products of interest can be visualized using transgenic mice with endogenous fluorescent protein expression, but the generation of genetically engineered mouse lines is time-consuming and expensive. Therefore, antibody labeling is more practical and provides more flexibility, although the immunolabeling of large tissue is challenging. In contrast to the original ECi protocol14, our approach combines a modified ECi optical clearing method and immunolabeling, which uses an antigen-retrieval step. Heat-induced antigen-retrieval will denature proteins, but helps to recover loss of antigenicity during PFA-fixation35 and improves antibody-binding.
There are a few critical steps in this protocol. First, it is important to perform good perfusion of the kidney. Hemoglobin containing red blood cells limits the imaging depth7 and expanded tubules with open lumen enhance antibody penetration. The opening of tubules also allows better distinguishing of proteins expressed in the epithelial apical membrane from other apically expressed proteins on the contralateral side. However, artificially expanded tubules may negatively influence tubule structure and mask specific pathophysiological response of the kidney (e.g. dilation of injured proximal tubules,) but not of healthy tubules36. Second, antibody incubation at 37 °C rather than 4 °C or RT improves antibody penetration27. However, each antibody has unique properties; thus, temperature during antibody incubation needs to be optimized for individual probes. Third, the use of Alexa Fluor-647 (far-red spectrum) secondary antibodies helps increase the signal-to-noise ratio, especially since kidneys emit a large amount of autofluorescence in the blue-green spectrum37.
Retro-orbital injection14 or perfusion of kidney38 with fluorophore-conjugated antibodies against proteins expressed in blood vessels is an elegant and fast way to label kidney vasculature. However, proteins in the apical membrane of tubules remain inaccessible by intravascular injection since antibodies cannot cross the glomerular filtration barrier with its cut-off molecular weight for filtration of proteins in the range of 60-65 kDa. Therefore, the use of small antibody fragments and engineered variants such as Fab fragments (~55 kDa), diabodies (~50 kDa), tandem scFv (~28 kDa) or nucleic-acid aptamers (~6-30 kDa) with preserved molecular recognition properties of antibodies may provide an opportunity to access the apical membrane of tubules38,39. In addition, the combination of small antibody fragments with electric fields40 or pressure13 or the use of sodium dodecyl sulfate (SDS)-based clearing protocols to remove lipids24,41,42 may enable fast and efficient antibody penetration of tissue.
Several groups demonstrated that perfusion with clearing reagent not only reduces the protocol time, but also increases tissue transparency19,24,43,44. Therefore, cannulation of the abdominal aorta or the renal artery with subsequent perfusion of the kidney with dehydrating and refractive index matching solutions should be considered to achieve better and faster tissue clearing. However, we did not perfuse the whole kidney with clearing reagents and used sliced kidneys for several reasons. First, different antigens can be visualized by antibody labeling of multiple kidney slices from one kidney. Second, less time and antibody are needed to perform immunolabeling of a kidney slice compared to a whole kidney. Third, 3-D imaging of large samples generates data sets up to several terabytes, which can be challenging to manage for most workstations. Therefore, data from tissue slices or subsets of bigger files are more convenient to perform complex operations such as automated counting or distance measurements.
In this protocol, confocal microscopy is used to perform imaging with single-cell resolution, which is particularly relevant in colocalization studies. However, confocal imaging requires laser scanning, since its imaging speed is only practical for small pieces of cleared tissue. To perform 3-D morphometric analysis of multicellular structures such as long tubule segments or even whole organs, faster microscope techniques such as light sheet fluorescent microscopes (LSFM) are necessary. LSFM allow fast imaging when the highest cellular resolution is not essential. For example, the lengths of distal convoluted tubules were recently assessed by combining whole-mount immunolabeling, optical clearing based on CLARITY12, and LSFM29. Unfortunately, commercial LSFM is expensive and not always compatible with solvent-based clearing protocols. In fact, CLARITY was chosen for this study, since our particular LSFM with an objective customized for CLARITY was not compatible with ECi29. However, Klingberg et al. demonstrated that ECi is in principle compatible with LSFM14.
In conclusion, a simple ECi-based optical clearing method is demonstrated, which can be applied to any research project using fixed tissue slices ranging from ~100 μm to several millimeters in thickness. It also allows feasible analyses that previously required almost exhaustive efforts to complete, and eliminates the required assumptions and inferences associated with two-dimensional analysis of morphology. The combination of whole-mount immunolabeling, optical clearing, and advanced light microscopy will help advance the understanding of cellular function in health and disease.