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In representative experiments, D11 scfv with an alkaline phosphatase conjugation (D11-AP) was used in immunofluorescence to detect IsoLGs present in angiotensin II-treated mice compared to normal sham mice and humans with hypertension compared to normotensive humans. Mice were treated with angiotensin II at a dose of 490 ng/kg/min for two weeks, and hypertension was confirmed with increased systolic blood pressure compared to sham mice10. To ensure specificity of D11-AP, tissues were stained with or without the presence of D11-AP. As demonstrated by D11-AP staining, the aorta of mice with angiotensin II-induced hypertension showed elevated concentration of IsoLGs when compared to control mice (Figure 1). Background staining or autofluorescence was limited, as shown by negative controls that were not stained with D11-AP.
D11-AP was used to detect IsoLGs present in intestinal tissues of human patients with hypertension (HTN) or normotensive humans (NTN). Hypertension status was established from the hospital records as systolic blood pressure above 140 and diastolic blood pressure above 80 mmHg. Researchers developing immunofluorescence protocol for D11-AP were blinded to the hypertension status of human tissues. Sections were stained in the presence and absence of D11-AP to ensure antibody specificity and show background staining or autofluorescence. As shown in Figure 2, we found that tissues from patients with HTN had elevated concentrations of IsoLGs compared to patients with NTN. Staining without D11-AP also showed minimal background staining and autofluorescence. Endogenous alkaline phosphatase is expressed by intestinal epithelium, so the limited fluorescence of tissues stained without D11-AP shows the antigen retrieval used in this protocol was sufficient in inactivating endogenous alkaline phosphatase present in tissues. In combination with the results in mice, these results also show that the immunofluorescence protocol effectively shows elevated IsoLGs in hypertension when compared to normotensive status.
D11-AP was isolated and stored in the bacterial periplasmic extract. Mouse and human tissues were stained with D11-AP and periplasmic extract containing the AP linker without D11 to ensure that other factors that may be present in the periplasmic extract, such as excess or non-conjugated alkaline phosphatase, do not contribute to the staining observed in tissues treated with D11-AP (Figure 3). Tissues stained with D11-AP resulted in brighter staining compared to tissues stained with periplasmic extract. These results confirm that D11-AP is staining the tissues, and the staining is not due to non-conjugated bacterial alkaline phosphatase that can potentially be present in the periplasmic extract and result in false staining of IsoLGs or contribute to background staining.
A competitive control was performed by pre-incubating D11-AP with IsoLG adducted to MSA or non-adducted MSA before staining tissues to show the specificity of D11-AP to IsoLG. If D11-AP is specific for IsoLG, the antibody would bind to IsoLG-MSA, resulting in a depleted availability of D11-AP to stain tissues, and D11-AP incubated with non-adducted MSA would have similar staining to normal D11-AP. In tissues stained with D11-AP pre-incubated with the IsoLG competitor, we found diminished staining compared to tissues that were stained with D11-AP without any preincubation (Figure 4). In tissues stained with D11-AP preincubated with non-adducted MSA, we found staining to be similar to staining observed in tissues with D11-AP. These results show the specificity of D11-AP to IsoLGs due to reduced staining of tissues when D11-AP was pre-incubated with IsoLG/MSA, but not non-adducted MSA. In the final negative control, mouse tissue was stained with D11-AP or irrelevant scFv antibody, D20. Staining mouse aorta with D11-AP resulted in strong staining compared to D20 indicating the specificity of D11-AP to IsoLGs in hypertensive aortae (Figure 5).

Figure 1: Immunofluorescence of the aorta in hypertensive and normotensive mice. Arteries from angiotensin II and sham infused mice were stained with and without D11-AP (D11) to show presence of IsoLGs. (A) Artery from an angiotensin II treated mouse probed with D11-AP (green) and nuclear counterstain (magenta), (B) Artery from a control sham treated mouse probed with D11-AP, (C) Artery from an angiotensin II treated mouse without D11-AP, (D) Artery from a control sham treated mouse without D11-AP (scale bar =100 µm). Please click here to view a larger version of this figure.

Figure 2: Immunofluorescence of human intestinal tissues from hypertensive and normotensive patients. Tissues from patients with hypertension (HTN) and normotensive humans (NTN) were stained with and without D11-AP (D11) to show presence of IsoLGs in patients with HTN. (A) HTN tissues stained with D11-AP (green) and nuclear counterstain (magenta), (B) NTN tissues stained with D11-AP, (C) HTN tissues stained without D11-AP, (D) NTN tissues stained without D11-AP (scale bar =100 µm). Please click here to view a larger version of this figure.

Figure 3: Mouse and human tissues stained with periplasmic extract with and without D11-AP. Mouse and human tissues were stained with periplasmic extracts with and without D11-AP. Images show limited staining of tissues with periplasmic extract without D11-AP, which show staining is mostly due to D11-AP binding rather than another component that may be present in periplasmic extract. (A) Ang mouse aorta stained with D11-AP (green) and nuclear counterstain (magenta), (B) Ang mouse aorta stained with periplasmic extract, (C) Sham mouse aorta stained with D11-AP, (D) Sham mouse aorta stained with periplasmic extract, (E) hypertensive human intestinal tissue stained with D11-AP, (F) hypertensive human intestinal tissue stained with periplasmic extract, (G) normotensive human intestinal tissue stained with D11-AP, (H) normotensive human intestinal tissue stained with periplasmic extract (scale bar =100 µm). Please click here to view a larger version of this figure.

Figure 4: Competitive control in vessels of Ang and Sham mice. In this competitive control, D11-AP was pre-incubated with IsoLG-adducted MSA or non-adducted MSA. D11-AP without any pre-incubation was used as a control. These results show the specificity of D11-AP to IsoLGs because there is reduced staining of tissues with the IsoLG-MSA competitor compared to D11-AP. This reduction is due to IsoLG and not MSA because the non-adducted MSA pre-incubation resulted in staining similar to D11-AP control. Angiotensin II (A) and Sham (B) mouse aortae stained with D11-AP (green) and nuclear counterstain (magenta), Angiotensin II (C) and Sham (D) mouse aortae stained with D11-AP after incubating with IsoLG-MSA, Angiotensin II (E) and Sham (F) mouse aortae stained with D11-AP after incubating with non-adducted MSA (scale bar =100 µm). Please click here to view a larger version of this figure.

Figure 5: Mouse aortae stained with D11 and irrelevant scFv, D20. Mouse tissue were stained with D11-AP and compared to an irrelevant control antibody, D20, which is specific for glycoprotein A2. Staining of tissue with D11-AP (green) and nuclear counterstain (magenta) (A) resulted in intense immunofluorescence compared to D20 (green) and nuclear counterstain (magenta) (B) which indicates specificity of D11-AP to IsoLGs (scale bar =100 µm). Please click here to view a larger version of this figure.