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The skin is the largest organ of the human body and the primordial barrier to protect the body from the outside environment1. Consequently, it is exposed to a plethora of external challenges that compromise its barrier function. Therefore, the skin has developed complex mechanisms to restore tissue integrity and functionality following damage. Skin wound healing takes place in three overlapping stages: inflammation, proliferation, and maturation/remodeling. These three stages involve several different cell types, such as dermal fibroblasts and immune cells, that act together to restore the initial biological properties of the injured skin tissue1,2,3.
The skin is a densely innervated organ, and it is known that nerve innervation is crucial for a successful repair process4,5,6. Apart from axonal signaling4,7,8, the peripheral glia, normally ensheathing the axons, participate in successful tissue regeneration9,10,11. However, the role of underrepresented cell types, such as peripheral glial cells, remains poorly understood in dynamic processes like skin tissue regeneration. To better determine the function of these cells, it is critical to analyze the cellular microenvironment and the neighboring cell types with which they may interact during the regenerative process. Moreover, since cell proliferation is a key stage for tissue regeneration, it is important to accurately detect and classify the proliferating cell types throughout the repair process.
Multiplexed, high-content, optical imaging methods, such as IBEX12, have been developed to characterize the cellular composition, visualize and quantify cell-cell interactions, and dissect microenvironmental patterns within complex tissues at spatial resolution. Whereas other multiplexing methods require specialized instruments and proprietary reagents, a particular advantage of IBEX is that it can be established at relatively low costs using commercially available antibodies, reagents, and microscopes accessible in a standard research environment. While anti-Ki-67 antibodies, often used in IBEX panels, reliably label proliferating cell types in many tissues13,14, the number of Ki-67-positive (Ki-67+) cells was found to be underestimated compared to other methodologies in fixed frozen tissue sections of acute murine skin wounds. Therefore, we combined the Click-iT EdU chemistry with IBEX and found that the number of EdU+ cells more accurately represents the total number of proliferating cells obtained by other methodologies.
Furthermore, by employing a fully automated spinning disk confocal microscope, a high-throughput workflow was established for iterative imaging of tissue sections placed into a 24-well plate. The resulting images are then processed by combining multiple open-source Python tools into a novel image processing pipeline that corrects the images for uneven illumination, performs the stitching of the individual tiles, and ultimately, image registration. In detail, the BaSiCPy library15 was used for illumination correction, the m2stitch library for stitching the images, and phase-cross-correlation for cycle registration. The registered images are saved as OME-TIFFs and can then be loaded into conventional image analysis software, such as Fiji17 and QuPath18, where the images are then further processed, and cell type categorization and other measurements, like intensity and distance calculations, can be performed. Taken together, the present protocol allowed us to perform a detailed, highly efficient characterization of the main cell types of the regenerating skin, with a particular focus on the cellular microenvironment surrounding the peripheral glial cell population.