Setting of the human triple culture BBB model
The protocol required for the setting of the human BBB in vitro model is described in Figure 1 and includes successive steps whose order must be strictly respected. First, the three cell types are cultivated individually in cell culture dishes (Figure 1A) before being assembled in an insert filter system. The triple culture setting begins with seeding the first cell type, astrocytes, in the pre-coated bottom well. The following day, pericytes and ECs are seeded on the insert filter's pre-coated abluminal and luminal surfaces, respectively. The insert filter is then transferred over the astrocytes. The model is maintained in culture for 6 days, the time necessary to induce the BBB properties in ECs, with a renewal of medium every other day according to the patented co-culture model24. The ECs are then renamed as BLECs (Figure 1B).
Characterization of the human BBB model
The triple cell culture model has been characterized for the presence of a set of BBB-specific properties. First of all, immunocytochemistry data confirmed the expression of conventional markers such as platelet-derived growth factor receptor β (PDGFR-β)25,26 and desmin for pericytes and glial fibrillary acidic protein (GFAP)26 for astrocytes (Figure 2A). Hence, after the 6 days of culture with the pericytes and astrocytes, the monolayer of BLECs, visualized with the adherent junction staining of VE-Cadherin, displays a continuous localization of TJ proteins, Claudin-5 and ZO-1, at the cell borders (Figure 2A). The setting-up of the TJs is correlated with low paracellular permeability coefficients measured using BBB integrity markers of low molecular weight, i.e., NaF (376 Da)16,27 and high molecular weight, i.e., FD20 (20 kDa)27, as shown in Figure 2B. The values measured are comparable with validated BBB in vitro models using the exact source of ECs23,24,28. Altogether, these results highlight the low paracellular permeability of the triple culture BLEC monolayer, which is characteristic of the in vivo BBB. Additionally, R123 intracellular accumulation in BLECs exhibited a significant increase in the presence of the efflux pump inhibitor Elacridar23,24 compared to the control condition with its absence (Figure 2C). This indicates the presence of active efflux pump molecules, namely P-gp and BCRP, in the BLECs.
To further characterize the BLECs, gene expression and protein level of key BBB features were studied (Figure 3). The data obtained with the triple culture model were compared with the validated and patented co-culture model consisting of ECs and pericytes24 used as a control model. The astrocytes represent the third cell type added in the initial co-culture model in the triple culture model. Hence, the gene expression analysis (Figure 3A) of triple culture BLECs, compared with co-culture BLECs, showed the maintenance of expression of key BBB features such as TJ proteins (claudin-5 and zonula occludens-1) and efflux pumps (P-gp and BCRP), and the upregulation of most studied BBB transporters (glucose transporter 1) and receptors (transferrin receptor). Protein quantification data (Figure 3B) were found to be in line with the transcriptional results. Overall, these data support the positive induction of BBB properties in the triple culture BLEC layer similar to the validated co-culture model. Altogether, the triple culture model displays the required physical and metabolic properties for an in vitro microphysiological system to model the BBB.
Applicability to drug delivery strategies - measurement of nanogel transport
To assess the possibility of using the triple culture model to study new brain delivery strategies, the transport of fluorescently-tagged NIPAM-based neutral NGs was evaluated6,15. At time 0, NGs were placed in the luminal compartment at a concentration of 0.1 mg/mL (Figure 4A). After 24 h of incubation, 5.82% of the NGs were found in the abluminal compartment (Figure 4B), proving their ability to cross the BLECs.
The results demonstrate the suitability of the model to measure the permeability of small and larger compounds, as described with the integrity markers, and evaluate the transport of nanomaterials such as polymeric NGs.

Figure 1: Representation of critical steps for the setting of the triple culture in vitro model of the human BBB. (A) Phase-contrast images of the three cell components of the BBB model: endothelial cells (EC), pericytes (PC), and astrocytes (AC). Scale bar = 250 µm. (B) Schematic and illustrative timeline for the setting of the triple culture human BBB in vitro model. The highlighted box represents the coating procedure for the inverted insert filter. Please click here to view a larger version of this figure.

Figure 2: Assessment of the properties of the triple culture BBB model. (A) Representative immunostaining images of the distinctive markers for BLECs (Claudin-5: CLD5, Zona Occludens-1: ZO1 and VE-Cadherin: Ve-Cadh), pericytes (Platelet-Derived Growth Factor Receptor-β: PDGFR-β and desmin), and astrocytes (Glial Fibrillary Acidic Protein: GFAP). Scale bar = 10 µm. (B) Paracellular permeability of BLECs to fluorescent BBB integrity markers, Sodium Fluorescein (NaF, 376 Da, Pe: 0.61 ± 0.062) and FITC-Dextran (FD20, 20 kDa, Pe: 0.04 ± 0.005). N = 3; n = 9. Mean ± SEM. (C) P-gp and BCRP functionality in ECs was assessed by quantifying intracellular R123 with (124.2% ± 3.39%) and without (100% ± 8.79%) Elacridar. N = 4; n = 12. Mean ± SEM. p = 0.017 using an unpaired t-test. Please click here to view a larger version of this figure.

Figure 3: Evaluation of BLEC gene expression and protein level of distinctive markers in the triple culture model compared with the co-culture BBB model. (A) Gene expression of tight junction proteins (Claudin-5: CLD5, and Zona Occludens-1: ZO1), transporters (Glucose Transporter-1: GLUT1, P-glycoprotein: PGP, and Breast Cancer Resistance Protein: BCRP), and large molecule-receptors (Transferrin Receptor: TRFR), normalized by the expression of RPLP0. N = 3; n = 9. (B) Protein level of tight junction proteins (CLD5 and ZO1), transporters (GLUT1, PGP, and BCRP), and large molecule-receptors (TRFR), normalized by the expression of β-actin. N = 3; n = 9. Mean ± SEM. For (A) and (B), values>1 correspond to higher gene expression or protein levels in the triple culture model. The red line corresponds to a value of 1 where the expression level (genes or proteins) of the two models is equivalent. Please click here to view a larger version of this figure.

Figure 4: Measuring nanogel transport in the triple culture model. (A) Schematic representation of the nanogel transport assay. (B) Percentage of nanogel transport after 24 h of incubation in the triple culture model (5.82% ± 0.09%). N = 2; n = 6. Mean ± SEM. Please click here to view a larger version of this figure.
| Name of the Buffer | Composition | Note |
| | Molecular Weight |
| Phosphate Buffer Saline, Calcium Magnesium Free | PBS-CMF | NaCl | 8 g/L | 58.4 | Add all the compound to sterile water and wait for complete solubilization. The pH of the obtained solution has to be in the range of 7.3-7.4. Filtrate the solution using a 0.22 µm membrane and store the sterile solution at 4 °C. |
| KCl | 0.2 g/L | 74.55 |
| KH2PO4 | 0.2 g/L | 136.09 |
| NaHPO4-12 H2O | 2.87 g/L | 358.14 |
| water | | |
| Ringer HEPES | RH | NaCl | 8.8 g/L | 58.4 | Add all the compound to sterile water and wait for complete solublization. Adjust the pH to 7.4 (starting solution pH around 6.8). Filtrate the solution using a 0.22 µm membrane and store the sterile solution at 4 °C. |
| KCl | 0.387 g/L | 74.55 |
| CaCl2 | 0.244 g/L | 110.99 |
| MgCl2 6H2O | 0.0406 g/L | 203.3 |
| NaHCO3 | 0.504 g/L | 84.1 |
| HEPES | 1.19 g/L | 238.3 |
| Glucose | 0.504 g/L | 180.16 |
| water | | |
Table 1: Composition of the different buffers used in the protocol.