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Cardiac fibroblasts, cells of mesenchymal origin, play a significant role in maintaining the electrical conduction and mechanical forces in the heart in addition to the maintenance of cardiac architecture during homeostasis1. Following injury, these cells are activated, expand, and produce extracellular matrix (ECM) proteins2. Many preclinical studies have revealed fibroblasts as critical cellular regulators that maintain the structural integrity of an injured heart3 as well as main effector cells responsible for unchecked production and deposition of ECM proteins, resulting in stiff scar formation and heart failure4. Fibroblasts are a heterogenous group of cells, making it challenging to dissect their reparative function from pro-fibrotic maladaptive properties. Recently, the functional heterogeneity of two distinct fibroblast subtypes following myocardial injury have been defined, indicating the possibility of isolating different fibroblast subtypes and studying their role in wound healing5.
Obtaining a pure fibroblast population is crucial in delineating their functional role in repair and fibrosis. However, the presence of multiple fibroblast markers that recognize other cell types make it challenging to isolate a substantially pure fibroblast population6. Several elegant studies have devised clever ways to isolate cardiac fibroblasts from uninjured and injured myocardium. The most popular and well-established method of enriching fibroblasts is through selective adhesion following enzymatic tissue digestion7.
Additionally, fluorescence-activated cell sorting (FACS) of fibroblasts based on cell surface antigens has been successfully described8. In the study, following enzymatic digestion, the mesenchymal cells were sorted as lineage-negative (Lin: Ter119−CD45−CD31−) and gp38-positive (gp38+) from mouse hearts. Gp38+ve cells were confirmed to be fibroblasts based on their co-expression of col1α1 and other mesenchymal markers. Although most tissue digestion is completed after dissecting out the ventricle in a Petri dish, a recent study has investigated the use of a direct needle enzyme perfusion of the left ventricle to isolate myocytes and non-myocytes which include fibroblasts9. Fibroblasts were then isolated by selective adhesion in this case.
This protocol describes the isolation and enrichment of fibroblasts using three methods. The first is an already established method involving selective adhesion of fibroblasts following enzymatic digestion. The second method is used to primarily isolate injury-induced alpha smooth muscle expressing myofibroblasts. The third method involves sequential, magnetic depletion of an enzyme-digested cardiac cell suspension of hematopoietic and endothelial cells. Following depletion, fibroblasts/myofibroblasts are isolated based on the presence of the antigen MEFSK4 using magnetic beads. Recently, MEFSK4 has been described as an antigen present on quiescent as well as activated fibroblasts, making it a suitable marker for fibroblast identification and isolation. Naturally, all the methods described here have unique limitations. It is therefore highly recommended to check the purity of the isolated cell population by flow analysis, immunostaining, and semi-quantitative real-time PCR. However, these methodologies can be expanded upon, and additional markers can be added in order to exclude other contaminating populations prior to utilizing the fibroblast and myofibroblast populations for crucial experiments.