The protocol presented here provides a step-by-step approach for the isolation of cardiac resident macrophages from the sinoatrial node (SAN) and atrioventricular node (AVN) region of mouse hearts.
Resident cardiac macrophages have been demonstrated to facilitate the electrical conduction in the heart. The physiologic heart rhythm is initiated by electrical impulses generated in sinoatrial node (SAN) and then conducted to ventricles via atrioventricular node (AVN). To further study the role of resident macrophages in cardiac conduction system, a proper isolation of resident macrophages from SAN and AVN is necessary, but it remains challenging. Here, we provide a protocol for the reliable microdissection of the SAN and AVN in murine hearts followed by the isolation and culture of resident macrophages.
Both, SAN which is located at the junction of the crista terminalis with the superior vena cava, and AVN which is located at the apex of the triangle of Koch, are identified and microdissected. Correct location is confirmed by histologic analysis of the tissue performed with Masson’s trichrome stain and by anti-HCN4.
Microdissected tissues are then enzymatically digested to obtain single cell suspensions followed by the incubation with a specific panel of antibodies directed against cell-type specific surface markers. This allows to identify, count, or isolate different cell populations by fluorescent activated cell sorting. To differentiate cardiac resident macrophages from other immune cells in the myocardium, especially recruited monocyte-derived macrophages, a delicate devised gating strategy is needed. First, lymphoid lineage cells are detected and excluded from further analysis. Then, myeloid cells are identified with resident macrophages being determined by high expression of both CD45 and CD11b, and low expression of Ly6C. With cell sorting, isolated cardiac macrophages can then be cultivated in vitro over several days for further investigation. We, therefore, describe a protocol to isolate cardiac resident macrophages located within the cardiac conduction system. We discuss pitfalls in microdissecting and digesting SAN and AVN, and provide a gating strategy to reliably identify, count and sort cardiac macrophages by fluorescence-activated cell sorting.
The sinoatrial node (SAN) physiologically initiates the electrical impulse and is, therefore, the primary pacemaker of the heart. The atrioventricular node (AVN) conducts the electrical impulse from the atria to the ventricles and also acts as a subsidiary pacemaker1. In general, generation and conduction of electrical impulses is a complex process that can be modulated by various factors2, including resident macrophage in SAN/AVN regions. A recent study by Hulsmans et al. demonstrates a specific population of cardiac resident macrophages which are enriched in the AVN and function as key players in keeping a steady heartbeat3. They found that macrophages are electrically coupled to the cardiomyocytes and could change the electrical properties of coupled cardiomyocytes. The authors also note that such conducting cells interleaving with macrophages are also present in other components of the cardiac conduction system, such as the SAN.
Currently, it is not fully known if the phenotype of resident cardiac macrophages differs between the cardiac regions. However, it has been shown that the tissue microenvironment can affect transcription and proliferative renewal of tissue macrophages4. Furthermore, since the cardiomyocyte phenotype has been demonstrated to be different between regions, the functional effects of macrophages on cardiomyocytes may also be region-specific, even if the macrophage phenotype itself may be the same. Therefore, further studies on specific cardiac regions are needed.
Recent studies have demonstrated that, at steady state, the tissue resident macrophages are established prenatally, arising independently of definitive hematopoiesis, and persist into adulthood5. However, after macrophage depletion or during cardiac inflammation, Ly6chi monocytes contribute to replenish cardiac macrophage population6. Studies involving genetic lineage tracing, parabiosis, fate mapping, and cell tracking showed the coexistence of a variety of tissue resident macrophages populations in organs and tissues, and, also, different cellular behavior of macrophage subsets that are potentially associated with their ontogeny7,8,9.
Characterization of resident cardiac macrophages has benefited from the use of magnetic activated cell sorting (MACS) and fluorescent activated cell sorting. These methods are particularly useful for isolating specific cell populations from multiple tissue fractions by labeling them with their cell surface markers. This not only leads to a higher purity of the isolated immune cell type, but also allows for phenotypic analysis. Here, we present a protocol including magnetic beads-coated cells followed with fluorescent activated cell sorting for the enrichment of cardiac resident macrophages specifically isolated from the SAN and AVN region.
To explore the characteristics of cardiac resident macrophages in conduction system and their function for cardiac conduction and arrhythmogenesis, precise localization and dissection of SAN and AVN are critical. For microdissection of SAN and AVN, anatomical landmarks are used for the region identification10. In brief, SAN is located at the junction of the superior vena cava and right atrium. AVN is located within the triangle of Koch, which is anteriorly bordered by the septal leaflet of the tricuspid valve, and posteriorly by the tendon of Todaro11. We also provide an accurate microdissection procedure of SAN and AVN in mice which is confirmed by histology and immunofluorescence staining.
Isolated resident macrophages could be used for further experiments such as RNA sequencing or could be recovered and cultivated for more than two weeks allowing various in vitro experiments. Therefore, our protocol describes a highly valuable procedure for the immuno-rhythmologist. Table 1 shows the composition of all the solutions needed, Figure 1 shows the microdissection landmarks for SAN and AVN. Figure 2 is schematic illustration of SAN and AVN localization. Figure 3 shows the histological staining of SAN and AVN (Masson's trichrome and immunofluorescence staining). Figure 4 shows a step-by-step gating strategy to isolate cardiac resident macrophages by fluorescence-activated cell sorting.
Animal care and all experimental procedures were conducted in accordance with the guidelines of the Animal Care and Ethics committee of the University of Munich and all the procedures undertaken on mice were approved by the Government of Bavaria, Munich, Germany. C57BL6/J mice were commercially obtained.
1. Preparations
2. Animal sacrifice and heart excision
3. Microdissection of SAN and AVN
4. Digestion
5. Magnetic enrichment of CD45 and sample staining
NOTE: To isolate the cardiac macrophages with high sorting efficiency, exclusion of undesired cells including lymphocytes was performed with CD45 microbeads according to the manufacturer's protocol. Based on the sorting panel, cardiac resident macrophages were identified as CD45highCD11bhighCD64high Ly6Clow/int F4/80high.
6. Samples for compensation
7. Running on the cell sorter and gating strategy
8. Resident macrophages culture
We describe a practical procedure for the isolation of cardiac resident macrophages specifically from the SAN and AVN region. To confirm a correct dissection, Masson's Trichrome staining and immunofluorescent HCN4-staining is performed (Figure 3)12. With this protocol, we could collect approximately 60,000 macrophages from one whole heart. Figure 4 shows the gating strategy for sorting cardiac macrophages. Live resident cardiac macrophages were identified as CD45+CD11b+F4/80+CD64+Ly6C–. Figure 5 shows freshly sorted cardiac macrophages which were identified by their surface antigens CD45, F4/80 and CD11b. Freshly sorted cells were observed under brightfield view of microscope (Figure 5A). The sorted cells were positive for CD45 (CD45+) when observed under the fluorophore-PE channel (Figure 5B). The same view of the sorted cells when observed under fluorophore-APC-Cy7 channel showed CD11b+ phenotype (Figure 5C). The same view of the sorted cells when observed under fluorophore-PE-Cy7 channel showed F4/80+ phenotype (Figure 5D). Figure 5E is the merged image obtained with the fluorescent microscope for the sorted cells. These triple positive cells were identified as cardiac resident macrophages. Figure 6 shows isolated cardiac macrophages cultured in medium up to 6 days. White arrows indicate macrophages, black arrows indicated floating round-shape dead cells.
Figure 1: Anatomy of the SAN and AVN under the dissection microscope. (A) Anatomy of the SAN under the dissection microscope. The location of the SAN is indicated by red dashed line within the inter-caval region (black dashed lines). (B) Anatomy of the AVN under the dissection microscope. This figure has been modified from previously published article10. The AVN (red dashed circle) is located at the apex of the triangle of Koch (white dashed triangle) near the bottom of the membranous septum. The triangle of Koch is formed by the tendon of Todaro (TT, green dashed line), tricuspid valve (TV, blue dashed line) and the orifice of the coronary sinus (CS, yellow dashed line). SVC, superior vena cava; IVC, inferior vena cava; IAS, interatrial septum; RA, right atrium; RAA, right atrial appendage; RV, right ventricle; CT, Crista terminalis; IVS, interventricular septum; OF, oval fossa. PA, pulmonary artery; RV, right ventricle; LV, left ventricle. Please click here to view a larger version of this figure.
Figure 2: Schematic illustration of SAN and AVN localization. (A) schematic illustration of SAN localization. SAN is indicated by a red dashed circle within the inter-caval region besides the CT (black dashed line). (B) schematic illustration of AVN localization. AVN is indicated by a red dashed circle inside the Koch triangle (grey dashed triangle) composed of TV and the orifice of CS. SVC, superior vena cava; IVC, inferior vena cava; IAS, interatrial septum; RA, right atrium; RAA, right atrial appendage; CT, Crista terminalis; IVS, interventricular septum; OF, oval fossa; IVS, interventricular septum. Please click here to view a larger version of this figure.
Figure 3: Identification of the SAN and AVN with histological stain. Identification of the SAN (A,B) and AVN (C,D). Immunofluorescent staining of HCN4 positive conduction system cells in SAN (A) and AVN (C) as well as Masson's trichrome staining of SAN (B) and AVN (D). Red arrows indicate sinus node artery (SNA, B), black arrow and black dashed line indicate compact AVN, blue arrow indicates the central fibrous body (CFB). CT, crista terminalis; CFB, central fibrous body; CN, compact AVN; RA, right atrium; RV, right ventricle; IAS, interatrial septum; IVS, interventricular septum; TV, tricuspid valve; MV, mitral valve. Please click here to view a larger version of this figure.
Figure 4: Gating strategy for cell sorting of resident cardiac macrophages. Mononuclear cells are identified, doublets are excluded by FSC-W vs. FSC-A and dead cells are excluded by DAPI (A-D). Live cells are gated on CD45+ leukocytes (E), and then gated on CD11b+ myeloid cells (F). Cardiac macrophages were identified by the expression of both F4/80 and CD64 (G), and then finally stratified by Ly6C expression (H). Live resident cardiac macrophages are identified as CD45+CD11b+F4/80+CD64+Ly6C–. Please click here to view a larger version of this figure.
Figure 5: Freshly sorted cardiac macrophages and immunofluorescent staining. (A) Freshly sorted cardiac macrophages. Immunofluorescent staining of specific surface antigens such as CD45 (B), CD11b (C), or F4/80 (D). According to the gating strategy, cardiac macrophages are identified as triple positive cells (E). Scale bar represents 50 µm. Please click here to view a larger version of this figure.
Figure 6: Culture of sorted macrophages. Culture of sorted macrophages in culture medium for 48h (A, B), 96 h (C,D) and 6 days (E,F) respectively. Two individual culture dishes per time point are shown (dish 1: A, C, E; dish 2: B, D, F). White arrows indicate live macrophages with spindle-like shape and typical protrusions3. Black arrows indicate floating round-shape dead cells. Please click here to view a larger version of this figure.
Compound | Final concentration | g or ml required |
FACS buffer | ||
BSA | 0.50% | |
EDTA | 2 mM | |
PBS (1X) | 500ml | |
Digestion buffer | ||
Collagenase I | 450 U/mL | |
Collagenase XI | 125 U/mL | |
DNase I | 60 U/mL | |
Hyaluronidase | 60 U/mL | |
HEPES buffer | 20 µl per 1 ml | |
PBS (1X) | Add up to 1 ml for 2 samples | |
Culture medium | ||
DMEM | 79 ml | |
Penicillin/streptomycin | 1% | 1 ml |
FBS | 20% | 20 ml |
TAE (50x) | ||
Tris-base | 24.20% | 24.2 g |
100 % acetic acid | 5.71% | 5.71 ml |
0.5 M EDTA | 0.05 M | 10 ml |
dH2O | Add up to 100ml |
Table 1: Composition of solutions needed.
In this manuscript, we describe a protocol for the enrichment of cardiac resident macrophages specifically from the SAN and AVN regions at high purity.
Macrophages are divided into subpopulations based on their anatomical location and functional phenotype. They can also switch from one functional phenotype to another in response to variable microenvironmental signals13. Compared to other organs such as bone marrow and liver, cardiac tissue contains a lower percentage of immune cells and lower absolute numbers of each cellular subpopulation14. Therefore, cell sorting, enrichment and purification methods are necessary tools to obtain sufficient amounts of the cell population of interest. Fluorescence-activated cell sorting, and MACS allow to obtain pure, sorted cell populations as it permits simultaneous measurement of various properties of the cells.
Different flow cytometry panels have been described for the identification of subpopulations of cardiac macrophages3,6,15. The function of macrophages in steady state and disease not only depend on their developmental origin but also on the tissue environment. In general, the adult heart contains two major subsets of Ly6Clow/CCR2– resident macrophages that express different levels of MHC-II and which can maintain themselves via local proliferation at steady state whereas during disease classical Ly6Chigh monocytes are recruited to sites of inflammation, where they differentiate into macrophages16. During development, different subpopulations of macrophages occupy different cardiac locations associated with distinct functions17. We aimed to study the resident macrophages specifically from the cardiac conduction system, especially the resident macrophages from the SAN and AVN regions. According to Hulsmans et al. cardiac resident macrophages are identified as CD45high CD11bhighCD64highF4/80highLy6Clow/int.
The harvest of cardiac resident macrophages from one adult mouse for cell sorting requires approximately 3 hours. It is important to arrange the experimental procedures logically and to allow incubation in parallel to save time and to minimize handling of the possibly fragile macrophages in the suspension. As the sorting procedure could exert pressure on the sorted cells, we recommended to reduce the sorting time by using magnetic beads which could increase the sorting efficiency tremendously and also allows to obtain higher purity of resident macrophages.
The application of this protocol includes but is not limited to purification of macrophages and/or any other non-cardiomyocyte cell type from the cardiac tissue and any other mice strains. The sorted macrophages could be used for subsequent experiments, for example cell motility assays, gene or protein expression studies, etc. Single-cell RNA sequencing is also possible by collecting cells one-by-one directly from the collecting tube of the cell sorter.
However, flow cytometry-based cell sorting has its limitations. A precisely designed antibody panel is important and must consider the expression of antigens on the cell population of interest and the fluorophore conjugated to the antibodies. Cells function and viability might be altered by the binding antibodies, which might affect the outcomes of subsequent experiments. In addition, the complex cell sorting instruments are expensive, sophisticated, and also prone to problems with fluidics system blockages and laser calibration. Hence maintenance by highly trained specialist and properly operation by an experienced professional technician are required. Even though cell sorting could provide a pure cell population of interest, the overall efficiency is still relatively low.
The authors have nothing to disclose.
This work was supported by the China Scholarship Council (CSC, to R. Xia), the German Centre for Cardiovascular Research (DZHK; 81X2600255 to S. Clauss, 81Z0600206 to S. Kääb, 81Z0600204 to C.S.), the Corona Foundation (S199/10079/2019 to S. Clauss), the SFB 914 (project Z01 to S. Massberg), the ERA-NET on Cardiovascular Diseases (ERA-CVD; 01KL1910 to S. Clauss) and the Heinrich-and-Lotte-Mühlfenzl Stiftung (to S. Clauss). The funders had no role in manuscript preparation.
Anesthesia | |||
Isoflurane vaporizer system | Hugo Sachs Elektronik | 34-0458, 34-1030, 73-4911, 34-0415, 73-4910 | Includes an induction chamber, a gas evacuation unit and charcoal filters |
Modified Bain circuit | Hugo Sachs Elektronik | 73-4860 | Includes an anesthesia mask for mice |
Surgical Platform | Kent scientific | SURGI-M | |
In vivo instrumentation | |||
Fine forceps | Fine Science Tools | 11295-51 | |
Iris scissors | Fine Science Tools | 14084-08 | |
Spring scissors | Fine Science Tools | 91500-09 | |
Tissue forceps | Fine Science Tools | 11051-10 | |
Tissue pins | Fine Science Tools | 26007-01 | Could use 27G needles as a substitute |
General lab instruments | |||
Orbital shaker | Sunlab | D-8040 | |
Pipette,volume 10ul, 100ul, 1000ul | Eppendorf | Z683884-1EA | |
Magnetic stirrer | IKA | RH basic | |
Microscopes | |||
Dissection stereo- zoom microscope | vwr | 10836-004 | |
Leica microscope | Leica microsystems | Leica DM6 | |
Flow cytometry machine | |||
Beckman Coulter | Beckman coulter | MoFlo Astrios | |
Software | |||
FlowJo v10 | FlowJo | ||
General Lab Material | |||
0.2 µm syringe filter | sartorius | 17597 | |
100 mm petri dish | Falcon | 351029 | |
27G needle | BD Microlance 3 | 300635 | |
50 ml Polypropylene conical Tube | FALCON | 352070 | |
Cover slips | Thermo scientific | 7632160 | |
Eppendorf Tubes | Eppendorf | 30121872 | |
5ml Syringe | Braun | 4606108V | |
Chemicals | |||
0.5 M EDTA | Sigma | 20-158 | |
Acetic acid | Merck | 100063 | Component of TEA |
Agarose | Biozym | 850070 | |
Bovine Serum Albumin | Sigma | A2153-100G | |
Collagenase I | Worthington Biochemical | LS004196 | |
Collagenase XI | Sigma | C7657 | |
DNase I | Sigma | D4527 | |
Hyaluronidase | Sigma | H3506 | |
HEPES buffer | Sigma | H4034 | |
Bovine Serum Albumin | Sigma | A2153-100G | |
DPBS (1X) Dulbecco's Phosphate Buffered Saline | Gibco | 14190-094 | |
Fetal bovine serum | Sigma | F2442-500ml | |
Penicillin − Streptomycin | Sigma | P4083 | |
DMEM | Gibco | 41966029 | |
Drugs | |||
Fentanyl 0.5 mg/10 ml | Braun Melsungen | ||
Isoflurane 1 ml/ml | Cp-pharma | 31303 | |
Oxygen 5L | Linde | 2020175 | Includes a pressure regulator |
Antibodies | |||
Anti-mouse Ly6C FITC (clone HK1.4) | BioLegend | Cat# 128006 | diluted to 1:100 |
Anti-mouse F4/80 PE/Cy7(clone BM8) | BioLegend | Cat# 123114 | diluted to 1:100 |
Anti-mouse CD64 APC (clone X54-5/7.1) | BioLegend | Cat# 139306 | diluted to 1:100 |
Anti-mouse CD11b APC/Cy7(clone M1/70) | BioLegend | Cat# 101226 | diluted to 1:100 |
Anti-mouse CD45 PE (clone 30-F11) | BioLegend | Cat# 103106 | diluted to 1:100 |
Hoechst 33342, Trihydrochloride, Trihydrate (DAPI) | Invitrogen | H3570 | diluted to 1:1000 |
Animals | |||
Mouse, C57BL/6 | Charles River Laboratories |