Xenotransplantation
A comprehensive view of the entire experiment and analysis is depicted in Figure 1, spanning from embryo production to the assessment of disease progression by both survival and disease burden analysis by flow cytometry. This approach brings several improvements that enhance the reproducibility and scalability of xenotransplantation, as well as adding a new way to assess disease burden. The success of these experiments is highly dependent upon the health of the transplanted cells, as cells that are not healthy and in log phase fail to propagate upon transplantation. The duration of the injection session is also a critical parameter. After tumor cells are prepared, it is critical to complete injection into zebrafish within 3-4 h. The approach used in this study enables larger numbers of embryos to be injected during this time frame through the simple modification of staging them directly on their side on an agarose plate and injecting them in the yolk (Figure 2C,D). Moreover, it is imperative that the optimum needle orifice is selected so that enough cells are injected (400-600 cells) but that the orifice is not so large that the embryos are injured. Another consideration is the injection pressure. We find that pressures greater than 12-13 psi disrupt the yolk of embryos, causing death. Finally, another variability inherent to this procedure is the consistency of injection. Cells to be injected settle into the end of the injection needle, making precise control in the injection bolus challenging. When the cells are xenotransplanted, all embryos have the potential to receive the same injection bolus, but in practice, they do not (Figure 3). The number of cells transferred can differ widely depending on the behavior of the tumor cells (e.g., clumping) and the skill level of the operator. We have addressed this uncertainty through CM-Dil staining/mCherry labeling, which enables post-injection categorization of animals that have received an appropriate and consistent cell bolus, as well as those receiving an inferior bolus. The CM-Dil staining, but more effectively marking with a fluorescent protein, has the added benefit of facilitating the monitoring of disease progression, either by microscopy or by flow cytometry (Figure 4 and Figure 5).
Tumor behavior analysis
Tumor progression can easily be monitored using simple fluorescence microscopy focused on RFP (Figure 4A). Likewise, traditional survival monitoring can be performed by Kaplan-Meier analysis (Log-rank and Wilcoxon test) (Figure 4B). Impressively, in contrast to mouse-based xenotransplantation studies where there are typically 8-10 animals per study arm, using the zebrafish method described here, it is not difficult to achieve study arms with greater than 60 animals each (Figure 4B). This markedly enhances the resolving power of in vivo studies. Finally, we have implemented another approach for disease burden analysis using flow cytometry. This entails the disruption of equivalent numbers of embryos and analyzing the tumor cell content of the resulting single-cell suspension by flow cytometry. By combining a tumor-specific cell surface marker with the fluorescent protein indicator, the xenotransplanted mice/human cells can be confidently identified by flow cytometry as an approach to assess disease burden (Figure 5). For this purpose, red fluorescent proteins are superior since the green fluorescent proteins failed to provide a signal over the autofluorescence of host zebrafish cells. Here, mCherry was employed for cell labeling and monitoring through the course of xenotransplantation for FACS analysis along with CD45. The dual labeling allowed us to measure differences in the tumor burden between good versus inferior bolus inoculation (Figure 5B,C).

Figure 1: Schematic of the entire xenotransplantation and post-injection analysis procedures. (A) Breeding setup, embryo collection and 2 days post fertilization (dpf) morphology is schematized. (B) Preparation, staining, and injections of leukemia cells for xenotransplantation in the yolk of zebrafish embryos. (C) Post-xenotransplantation analyses, including survival and flow cytometry. Please click here to view a larger version of this figure.

Figure 2: Representative images of the tools used for the injections. (A) Pulled needles in a petri plate. (B) The agarose plate for embryo staging. (C,D) A plate showing embryos staged (representative diagram in panel C and real embryos (encircled in red) in panel D) for injections on the embryo loading plate. The inset on the bottom right corner of panel D shows a higher magnification view of the staged embryos. Please click here to view a larger version of this figure.

Figure 3: Representative images of xenotransplanted embryos. Bright-field and immunofluorescent images are shown of CM-Dil stain (red)-positive cells in the yolk of the casper embryos at 1 dpi (clutch image). Embryos with an inferior bolus are indicated with a yellow arrow, while those with disturbed morphology are indicated with an asterisk. Please click here to view a larger version of this figure.

Figure 4: Assessment of disease progression by fluorescence imaging and survival analysis. (A) Representative image of xenotransplanted embryos at 4 dpi and 7 dpi. (B) The Kaplan Meier plot showing the survival analysis of embryos with two genetically distinct leukemia lines. Please click here to view a larger version of this figure.

Figure 5: Flow cytometric analysis of disease burden in xenotransplanted zebrafish. (A) Schematic representation of preparation of cell suspension and flow cytometry analysis. Briefly, embryos at 4 dpi are disaggregated into single-cell suspensions using trypsin and collagenase, followed by flow cytometry. (B) Representative plots for the flow cytometry analysis where the left image in each panel is FSC-A v/s SSC-A plot and the right image is CD45 v/s mCherry signals. (C) Bar graph showing the cell statistics for xenotransplanted cells as obtained from CD45 v/s mCherry plot for uninjected, good, and inferior embryos (n = 45, 40, and 40 for each replicate (n = 3); p value * ≤ 0.05, calculated using unpaired t-test with Welch's correction in GraphPad Prism 9). Please click here to view a larger version of this figure.