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To illustrate the differences in optimal cell concentration for the assay, 5 million T-cells were loaded into one 0.5 mL chamber (10 million cells/mL), and 1.25 million cells were loaded into another chamber (2.5 million cells/mL) containing 1 µM TMRM (Figure 3A-G). Three blank experiments were also included to calculate the TMRM background. We found that a higher concentration of T-cells resulted in a more distinguishable change in TMRM fluorescence relative to the background (Figure 3B,D). In addition, a higher cell concentration allowed us to detect the expected increase in oxygen consumption and simultaneous depletion of the mMP in response to the addition of FCCP (Figure 3E,F). Using a low concentration of cells yielded a weak change in fluorescence that paralleled the background. Since the calculation of mMP subtracts the background from the signal, a low cell concentration does not allow for the determination of changes in mMP in response to substrates and uncouplers. In addition to using the higher concentrations of cells in this assay, we recommend keeping the cell concentration constant for each cell type between experiments.
To validate the influence of ATP-synthase in the dissipation of mMP with ADP titrations, we ran parallel experiments on PBMCs and T-cells where one chamber received oligomycin before ADP titration (Figure 4). We found no dissipation of mMP in response to ADP in cells treated with oligomycin, suggesting that the gradual decrease in mMP with ADP is a result of proton flux through ATP-synthase (Figure 4A-F). We also compared ADP sensitivity between T-cells and PBMCs of the same participant and found ADP sensitivity to be lower (higher EC50) in the T-cell fraction (Figure 4G,H).
We conducted a series of blank experiments to determine the influence of time or the SUIT protocol on TMRM fluorescence. We found that the TMRM signal in blank experiments is mostly influenced by SUIT titrations (Figure 5A) as opposed to the timing of the titrations (Figure 5B).
We compared ADP-driven changes in oxygen consumption rates (OCR) and in mMP in T-cells and monocytes from 11 healthy, community-dwelling volunteers (Figure 6A-H). Similar to the results of previously published experiments using extracellular flux and enzymatic assays, monocytes exhibited a greater mitochondrial respiratory capacity than lymphocytes26,27 (Figure 6A,H). However, we did not detect a typical dose-response increase in OCR with ADP in either cell type (Figure 6C,D), contrary to what this method shows when using highly metabolic tissues like mouse liver (Figure 7A-H). On the other hand, the use of TMRM allowed us to detect a gradual decline in mMP with ADP in human immune cells (Figure 6E-G) and in splenic T-cells from mice (Figure 7E-H). While we did not directly compare human and mouse T-cells using the same titration protocol, we did find that the IC50 of mouse T cells was lower by a factor of 10 compared with that of circulating T-cells from human subjects.

Figure 3: High-resolution fluorespirometry experiments. (A-D) Trace of high-resolution fluorespirometry experiments using T-cell concentrations of 10 million cells/mL and 2.5 million cells/mL in 0.5 mL chambers. (A) 10 million cells/mL in 0.5 mL chambers. (C) 2.5 million cells/mL in 0.5 mL chambers. Oxygen flux (pmol/s/mL) is shown in the top panel (red), and the calibrated TMRM signal is shown in the bottom panel (black). Changes in TMRM throughout the SUIT for the sample and its calculated background were plotted for the chambers containing (B) 10 million cells/mL and (D) 2.5 million cells/mL. (E) For each cell concentration, oxygen flux (pmol/s/million cells) and (F) mitochondrial membrane potential were calculated. (G) ADP sensitivity curve was plotted and fit to a non-linear regression model (solid lines). Abbreviations: mMP, mitochondrial membrane potential; TMRM, tetramethylrhodamine methyl ester; SUIT, substrate-uncoupler-inhibitor titrations; ADP, adenosine diphosphate; Dig, digitonin; Mal, malate; Pyr, pyruvate; Glut, glutamate; D1-11, 11 consecutive ADP titrations; U, uncoupler FCCP of 0.5 and 1.0 μM; AMA, antimycin A. Please click here to view a larger version of this figure.

Figure 4: ATP-synthase drives ADP-driven decrease in membrane potential in T-cells and PBMCs. (A-H) The protocol described here was tested in PBMCs and T-cells. Two O2K chambers were injected with PBMCs, and two chambers of an additional O2K were injected with T-cells from the same participant. After injecting substrates malate, pyruvate, and glutamate in all chambers, one chamber of PBMCs and T-cells received oligomycin. Oligomycin prevented any ADP-driven rise in respiration in (A) PBMCs and (D) T-cells or decline in mitochondrial membrane potential in (B,C) PBMCs and (E,F) T-cells. (G,H) ADP sensitivity was greater in PBMCs compared to T-cells. Please click here to view a larger version of this figure.

Figure 5: Blank experiments show the change in TMRM fluorescence in response to time and titrations of substrates, uncouplers, and inhibitors (SUIT). (A) Change in TMRM fluorescence in response to titration. (B) Change in TMRM fluorescence in response to time. Experiments were conducted in 0.5 mL chambers filled with Mir05 containing 1 μM TMRM. One chamber did not receive any SUIT titrations (no injection); two chambers in two different instruments received a standard suit protocol (standard injection); one chamber received the same SUIT titrations but with a delay between each injection (delayed injection). Please click here to view a larger version of this figure.

Figure 6: Differences in ADP sensitivity between T-cells and monocytes using OCR and mMP. (A) Trace of high-resolution fluorespirometry experiment from a subject's monocyte and T-cell sample. (B) Oxygen consumption in monocytes (n= 11) and T-cells (n= 13) from the blood of healthy volunteers. (C,D) Non-linear regression fitting of the plotted rise in respiration with ADP titrations to calculate an EC50. (E) Simultaneous measurement of mitochondrial membrane potential. (F,G) Non-linear regression fitting of the plotted decline in mitochondrial membrane potential with ADP titrations to calculate an IC50. (H) Parameters of respiratory capacity of monocytes and T-cells. Data are expressed as mean ± SEM for line graphs and mean ± SD for bar graphs. Statistically significant differences following t-tests are expressed as *p < 0.05. **p < 0.01, and ****p < for 0.0001. Please click here to view a larger version of this figure.

Figure 7: Comparing ADP response in respiration and mitochondrial membrane potential (mMP) in permeabilized mouse splenic T-cells and liver. (A-D) Response in respiration in permeabilized mouse splenic T-cells and liver. (E-H) Response in mMP in permeabilized mouse splenic T-cells and liver. Fresh liver and spleen were dissected from three mice following cervical dislocation. Splenic Pan T-cells were isolated using antibody-conjugated magnetic bead separation. Both samples underwent the same SUIT protocol in the presence of 1 μM TMRM. (I,J) Comparison of EC50 calculated from the increase in oxygen consumption (OCR) and IC50 from the decrease in mMP in response to ADP. N = 3 per group. Data are expressed as mean ± SEM. Please click here to view a larger version of this figure.
Table 1: Example SUIT protocol to assess mitochondrial membrane potential in freshly isolated T-cells and monocytes using the 0.5 mL chambers. Please click here to download this Table.
Table 2: Recommended ADP titration for 0.5 mL chamber. Please click here to download this Table.
Table 3: Calculating the average background ratio using five independent blank experiments. Please click here to download this Table.
Table 4: Calculating mitochondrial membrane potential (mMP) from sample experiment. Please click here to download this Table.
Supplementary Figure 1: Effect of Mir05 and DMSO on mitochondrial respiration and membrane potential. Please click here to download this File.
Supplementary File 1: Reagent preparation and protocol for isolating T-cells from mouse spleen. Please click here to download this File.