Previously, two intraperitoneal (IP) methods have been employed for the administration of doxorubicin in adult zebrafish4,10. In method I, also known as the Classic IP injection method as described by Kinkel et al.4, the needle was inserted at a 45° angle to the midline between the pelvic fins with the abdomen facing upward. In method II, or the Alternative IP injection method as described by Ma et al.10, the needle was inserted through the dorsal side of the fish (Figure 2A(i,ii)). By contrast, our method III has two major changes. First, the position of the injection is altered, with the abdomen facing upward and the needle directed from the midpoint of the pectoral fin toward the abdomen. The penetration site is guided by a natural hole in this area. Second, the angle of the needle is reduced, which should be close to 0° (Figure 2A(iii), Figure 1).
Comparison among three intraperitoneal injection methods
To compare the three IP injection methods, data obtained from Researcher I is presented, who did not have previous experience with zebrafish. When methods I and II were used for IP injection, significant fish mortality in the initial two weeks following IP injection was noted. In method I, death was observed three days post-injection, while in method II, it occurred after two days post-injection. 70% of the injected fish exhibited visible body damage, especially around the injection site, manifesting as drastically reduced body size and curved body shape one to two months post IP injection (Figure 2A (iv,v)). It was reasoned that the mortality and observed damage could be attributed to the toxicity of doxorubicin12, which might leak from the opening end of the injection needle during the injection process, damaging the internal organ along the route of the injection. In method I, the tip of the injection needle could touch the gut (Figure 2A(i)), while in method II, it could touch the swim bladder (Figure 2A(ii)). It was postulated that one could prevent the tip of the needle from touching any internal organ by using method III (Figure 2A(iii)). Indeed, a significantly improved survival rate was noted, with 80% of the fish surviving at 1 month post-injection (Figure 2B). This signifies a remarkable improvement compared to the survival rates for methods I and II, which were 53.33% and 33.33%, respectively. Importantly, 80% of the survived fish exhibited a normal body shape, in contrast to those generated by methods I and II (Figure 2A(vi)). To validate the successful generation of the DIC model, cardiac function was evaluated by measuring ejection fraction percentage (EF%). Indeed, a significant reduction in EF% was observed at 56 days post-injection in the group using method III (Figure 2C).
Reproducibility of method III by different researchers
To prove that method III can be easily mastered by different researchers, 3 researchers were recruited to the study who had never worked with zebrafish before. Upon their first several tries with method III, all researchers were able to achieve 85.71%, 95%, and 83.33% survival rates 56 days after injection and a markedly decreased EF (Figure 3A,B). Of note, three researchers repeated their experiment 3 times, 3 times, and 2 times, respectively, and consistently obtained successful results. These data confirmed the repeatability of method III, allowing researchers without prior experience working with fish to generate reliable DIC models.
In one of the initial attempts using method III, researcher II tested a deviation of method III: instead of 0°, a 45° angle was used while penetrating the needle through the skin (Figure 2A(iii), dashed arrow). Only 15% of the fish survived two months after injection (Figure 3A), with 80% of the survived fish displaying considerable body damage. The data indicated that the angle of the penetration is a critical step for the success of method III.
Method III enables the establishment of a chronic DIC model
It was postulated that significantly reduced body damage might enable multiple IP injections in the same fish, mimicking the chronic DIC model in mice13,14. Hence, method III was used to do a series of injections for 4 consecutive weeks, with 5 µg/g Dox per week (Figure 4A). In this experiment, 100% of injected fish survived, and 80% of them exhibited no signs of body damage. Importantly, a significantly reduced ejection fraction was noted at 56 dpi, indicating the successful generation of a chronic DIC model in adult zebrafish (Figure 4B).

Figure 1: Location and angle of needle insertion for the new IP injection method. (A) The location of the needle insertion. The fish is upside down, exposing the abdominal side. The head is to the right. A natural hole is located between pectoral fins that makes penetration of the skin simpler. (B) The angle of needle insertion. It is near to zero degrees to the surface of the fish. (C) The track of the needle under the skin. The tip of the needle is continuously monitored once inside the abdominal cavity. The entry point appears different from Figure 1A because of the skin distortion during the penetration process. (D) A fish after Dox is released. The abdominal cavity becomes red after releasing the Dox. (E) A fish after IP injection. There is no sign of leakage after withdrawing the needle. Please click here to view a larger version of this figure.

Figure 2: Comparison of three IP injection methods in adult zebrafish. (A) Schematics of three IP injection methods. (i-iii) Shown are schematics of the classic IP injection (method I), alternative IP injection (method II), and the new method (method III). Arrows indicate the sites of penetration and angle of the needle for three injection methods. Dashed arrow, an unsuccessful angle of needle penetration. Scale bar: 5 mm. (iv-vi) Reduced body size and curved body shape in DIC models. Shown are representative fish from DIC fish at 56 dpi. (B) Comparison of survival curves among three IP injection methods. The number of survived fish was recorded weekly. (The experiment began with a total of n = 15). (C) Cardiac function assessment of fish at 56 dpi following Dox stress. n = 6 fish in the 1x HBSS control group, and the experiment began with a total of n = 15 fish in each 3 batches injected with Dox. Values are shown as the mean ± standard error. Please click here to view a larger version of this figure.

Figure 3: Method III enables the zebrafish DIC model to be established consistently in the hands of 3 different investigators. (A) Survival curves of DIC fish using Method III by three different researchers. A high survival rate was noted in all three investigators. The numbers of live fish are recorded weekly. A low survival rate was noted for researcher II when an unsuccessful method III was used (45° needle penetration angle, as shown by a dashed arrow in Figure 2A). (B) Cardiac function assessment of DIC fish using Method III by three different researchers. In total, Researcher II, for 45° needle penetration angle, used 3 batches (9, 12, 14) fish for Dox injection. For 0° needle penetration angle n = 6 fish were employed in the 1x HBSS as shared control group. The experiment began with a total of n = 85 fish with RII (9, 12, 14), RIII (8, 6, 6), and RIV (12, 18) employed in each of the 8 batches injected with Dox by three researchers (II, III, IV), respectively. Values are shown as the mean ± standard error. Please click here to view a larger version of this figure.

Figure 4: Method III enables multiple injections of Dox in an adult zebrafish, recapitulating chronic DIC models in rodents. (A) Schematics of multiple injection model. 5 µg/g Dox (5 µL) was injected in four consecutive weeks. (B) The chronic DIC model manifests reduced EF% at 56 dpi. Values are shown as the mean ± standard error. Please click here to view a larger version of this figure.