Vorremmo ringraziare Jill Narciso, UCLA Immunogenetics Center, per la sua assistenza con la preparazione del manoscritto.

Samples were collected according to the ethical guidelines established by the UCLA Human Research Protection Program and IRB approved.
1. Preparation of reagents
NOTE: Unless otherwise stated, all reagents should be allowed to equilibrate at room temperature prior to use. All reagents must remain sterile.
<ol>
	<li>Prepare a 2x working solution of Tween-20 (i.e., 0.2%) by adding 10&#160;&#181;L of Tween-20 solution to 5 mL of phosphate-buffered saline (PBS) without calcium and magnesium with a p20 pipette.
	<ol>
		<li>Given the high viscosity of Tween-20, take the following steps to ensure accuracy: collect slowly to avoid bubble formation, do not submerge the entire tip to avoid carry-over, and pipette up and down several times in PBS to wash out all Tween-20 from the tip.</li>
	</ol>
	</li>
	<li>Add 2 &#181;L of IL-2 stock solution (2.1E6 IU/mL) to 198 &#181;L of complete media (i.e., 1:100 dilution), which is RPMI with 1% penicillin-streptomycin and 10% fetal bovine serum (FBS), then proceed to an additional 1:100 dilution by adding 2 &#181;L of IL-2 intermediate solution to 198 &#181;L of complete media to prepare a 7x working solution (210 IU/mL).</li>
	<li>Add 2 &#181;L of CFSE stock solution (5 mM) to 500 &#181;L of plain media (RPMI). Vortex, spin down to remove drops from the cap, then proceed with an additional 1:20 dilution by adding 50 &#181;L of the CFSE intermediate solution to 950 &#181;L of plain RPMI to obtain a 2x working solution of 1 &#181;M. Vortex well and keep protected from light.</li>
</ol>
2. Isolation of PBMCs as effector cells
NOTE: This assay has been validated for effective use with total PBMCs from healthy controls. However, it is recommended that NK cell content be verified with each PBMC preparation (Figure 1). Also, the volume of whole blood for collection is based on the frequency of NK cells in peripheral whole blood and this may vary from person to person, particularly between healthy donors and patients.
<ol>
	<li>Collect a minimum of 4 mL of human whole blood in sodium or lithium heparinized blood collection tubes. Store blood samples at room temperature upon collection and use within 30 h of collection.</li>
	<li>Dilute whole blood with 4 mL of PBS (i.e. equal volume of PBS to whole blood).</li>
	<li>Add 4 mL of density gradient solution (see table of materials) to a 15-mL conical tube. Carefully overlay diluted whole blood over the density gradient solution by tilting the tube.</li>
	<li>Centrifuge at 650 x g for 24 min with the brake off.</li>
	<li>Carefully collect the layer of mononuclear cells, which is the thin white layer below the top layer of plasma and platelets, into a new 15-mL conical tube. Bring the volume to 15 mL with PBS.</li>
	<li>Centrifuge at 450 x g for 10 min with the brake on. Aspirate the supernatant and resuspend cells in 0.5 mL of complete media.</li>
	<li>Use an automated cell counter or hemocytometer to count the cells, and adjust the PBMC&#160;concentration to 5x106 cells/mL with complete media.</li>
	<li>Check the NK cell content by flow cytometry (see step 4).</li>
	<li>Start the assay within 30 min. Keep cells at room temperature for up to 10 min, or place in a humidified 5% CO2 incubator at 37 &#176;C until ready for use.</li>
</ol>
3. Isolation of NK cells as effector cells
NOTE: This portion of the protocol is an alternative to using total PBMCs as effector cells. The typical yield from 4 mL of whole blood from a healthy individual is approximately 4x105 NK cells, or approximately 5-15% of PBMCs, though this frequency varies between donors 21. It is recommended that a purity check be performed after the isolation.
<ol>
	<li>Collect a minimum of 4 mL of human whole blood in sodium or lithium heparinized blood collection tubes. Take 50 &#181;L of whole blood to stain as a pre-enrichment sample.</li>
	<li>Add the enrichment cocktail to blood samples at 50 &#181;L/mL (see table of materials). Mix well and incubate for 10 min at room temperature.</li>
	<li>Add an equal volume of PBS + 2% FBS to dilute the sample and gently mix well.</li>
	<li>Add 4 mL of density gradient solution to a 15-mL conical tube. Carefully overlay the diluted sample on top of the density gradient medium.</li>
	<li>Centrifuge at 1,200 x g for 10 min with the brake off.</li>
	<li>Carefully collect the layer of enriched cells into a new 15-mL conical tube. Wash the cells by bringing the volume up to 50 mL with PBS + 2% FBS.</li>
	<li>Centrifuge at 300 x g for 10 min. Discard the supernatant and repeat the wash.</li>
	<li>Aspirate the supernatant and resuspend cells in 0.5 mL of complete media.</li>
	<li>Using an automated cell counter or hemocytometer, count the cells and adjust the concentration to 5x105 cells/mL. Take 50 &#181;L of purified cell suspension to stain as a post-enrichment sample.</li>
	<li>Keep cells at room temperature for up to 10 min, or place in a humidified 5% CO2 incubator at 37 &#176;C until ready for use.</li>
</ol>
4. Immunophenotyping for assessment of NK cell content
<ol>
	<li>Using 50 &#181;L total isolated PBMCs, pre-enrichment whole blood, or purified NK cells, stain with anti-CD56 fluorochrome-conjugated antibody as an NK cell marker. Markers for other cell types and lineages (i.e. CD3+ T cells, CD19+ B cells) may also be included to assess the origin of contamination, if any.</li>
	<li>Incubate for 20 min at 4 &#176;C, and wash by adding 2 mL of PBS + 2% FBS.</li>
	<li>Centrifuge at 450 x g for 5 min.</li>
	<li>For PBMCs or NK cells, aspirate supernatant and resuspend cells in 100 &#181;L of PBS + 2% FBS.</li>
	<li>For whole blood samples, perform red blood cell (RBC) lysis:
	<ol>
		<li>After centrifugation, aspirate the supernatant and resuspend in 2 mL red blood cell lysis buffer (31.75 g of ammonium chloride + 4.16 g of Tris base + 6.65 g of EDTA, dissolved in 5000 mL of deionized water).</li>
		<li>Incubate for 10 min at room temperature.</li>
		<li>Repeat wash twice, aspirate the supernatant, and resuspend lysed sample in 100 &#181;L of PBS + 2% FBS. 
		NOTE: RBC lysis may also be performed prior to staining.</li>
		<li>Proceed with flow cytometric analysis.</li>
	</ol>
	</li>
</ol>
5. Thawing, culturing, and harvesting of K562 target cells
<ol>
	<li>Aliquot 10 mL of complete media into a 15-mL conical tube and allow to warm in a 37 &#176;C water bath. For the thawing and culturing of K562 cells, use only media pre-warmed to 37 &#176;C for all steps.</li>
	<li>Place one vial of frozen K562 cells in the 37 &#176;C water bath until most of it is thawed.</li>
	<li>Transfer the semi-thawed K562 cells to the complete media, pre-warmed to 37 &#176;C, in the 15-mL conical tube. Wash the inside of the cryogenic vial with some pre-warmed media, and add the wash to the 15-mL tube.</li>
	<li>Centrifuge at 140 x g for 7 min with the brake on. Remove the supernatant and resuspend the pellet in 1 mL of complete media.</li>
	<li>Aliquot an appropriate amount of cell suspension to count cells using an automated cell counter or hemocytometer.</li>
	<li>Adjust the concentration to 1x105-2x105 cells/mL&#160;and culture in a humidified 5% CO2 incubator at 37 &#176;C for at least 2 days before use. Maintain the culture at this density range for no longer than 3 months, then thaw a new aliquot.&#160;Never exceed a cell concentration of 1x106 cells/mL in culture.</li>
	<li>For use in the assay, mix the K562 cell culture well with a 10-mL serological pipette and remove an aliquot to count and assess cell viability using an automated cell counter or hemocytometer and Trypan Blue staining.
	<ol>
		<li>If the viability is less than 85%, proceed with the following dead cell removal steps.
		<ol>
			<li>Add 15 mL of density gradient solution to 50-mL conical tubes, as needed. Collect all cells from culture and slowly overlay the cell suspension over the density gradient solution by tilting the tube.</li>
			<li>Centrifuge at 650 x gfor 24 min with brake off. Carefully collect the layer of live cells into a new 15-mL conical tube. Bring the volume to 50 mL with PBS.</li>
			<li>Centrifuge at 450 x g for 10 min with the brake on. Remove the supernatant and resuspend the pellet in 1 mL of complete media. Count the cells and check cell viability (as in 5.7).</li>
			<li>Culture in a humidified 5% CO2 incubator at 37 &#176;C for at least 2 days before use.</li>
		</ol>
		</li>
	</ol>
	</li>
	<li>Collect 5x105 K562 target cells and centrifuge at 140 x g for 7 min. Aspirate the supernatant and resuspend the cell pellet in 500 &#181;L in media with 1% FBS.</li>
</ol>
6. Labeling of K562 target cells
NOTE: Make sure the K562 cells are well resuspended before adding the CFSE working solution.
<ol>
	<li>Pipette 500 &#181;L of the CFSE working solution to the 500 &#181;L of K562 cells for a final concentration of 0.5 &#181;M. Using the same 1000-1250 &#181;L tip, mix immediately by gently pipetting up and down 3-5 times.</li>
	<li>Incubate in the 37 &#176;C water bath or in a humidified 5% CO2 incubator at 37 &#176;C for 10 min in the dark. 
	NOTE: Since the temperature equilibration lag time is longer in the incubator compared to the water bath, incubation time might need to be adjusted especially for volumes &#62; 1 mL.</li>
	<li>Quench the labeling reaction with 10 mL of complete media for 10 min in the dark at room temperature.</li>
	<li>Centrifuge the labeled K562 cells at 140 x g for 7 min. Remove the supernatant and resuspend in 1 mL of complete media.</li>
	<li>Count the cells using an automated cell counter or hemocytometer and bring the concentration to 1x105 cells/mL in complete media.</li>
	<li>Place cells in a humidified 5% CO2 incubator at 37 &#176;C until ready for use. Cells can be kept at room temperature for up to 10 min, or in in a humidified CO2 incubator at 37 &#176;C until ready for use. Do not refrigerate.</li>
</ol>
7. Plating
NOTE: If NK cells are limiting, the concentration of both K562 and NK cells can be halved, so that half of the cells are plated in the assay. The assay yields comparable results with half the amount of cells (as long as the ratios are kept consistent).
<ol>
	<li>If using total PBMCs, label a 96-well, U-bottom, tissue culture-treated plate for the following conditions per well: (1) Effector (E) : Target (T) = 50 : 1 + IL-2 - positive control for NK cell cytotoxicity; (2) E : T = 50 : 1; (3) E : T = 25 : 1; (4) E : T = 12.5 : 1; (5) E : T = 6.25 : 1; (6) T - target cells only - negative control for K562 death; (7) E - effector cells only; (8) T + Tween - Positive control for K562 death</li>
	<li>If using purified NK cells, label a 96-well, U-bottom, tissue culture treated plate for the following conditions per well: (1) Effector (E) : Target (T) = 5: 1&#160;+ IL-2 - positive control for NK cell cytotoxicity; (2) E : T = 5 : 1; (3) E : T = 2.5 : 1; (4) E : T = 1.25 : 1; (5) E : T = 0.625: 1; (6) T - target cells only - negative control for K562 death; (7) E - effector cells only; (8) T + Tween - positive control for K562 death</li>
	<li>Add 100 &#181;L of complete media to conditions 3, 4, 5, 6, 7. For this and all subsequent steps, (recommended) use a multichannel pipette.</li>
	<li>Add 100 &#181;L of effector cells (PBMCs at 5x106 cells/mL or purified NK cells at 5x105 cells/mL) to conditions 1, 2, 3. Add effector cells for conditions 4-7 by serial dilution. Do not change tips from condition to condition.
	<ol>
		<li>Mix condition 3, take 100 &#181;L, and transfer to condition 4.</li>
		<li>Mix condition 4, take 100 &#181;L, and transfer to condition 5.</li>
		<li>Mix condition 5, take 100 &#181;L, and transfer to condition 7; Condition 6 does not have effector cells.</li>
	</ol>
	</li>
	<li>Add 100 &#181;L of prepared 2x 0.2% Tween working solution to condition 8 (final concentration: 0.1% Tween-20); condition 8 does not have effector cells.</li>
	<li>Add 30 &#181;L of IL-2 working solution to condition 1. IL-2 should be added to the effector cell suspension prior to the addition of target cell suspension (final concentration: 27 IU/mL).</li>
	<li>Add 100 &#181;L of target cells (labeled K562 cells at 1x105 cells/mL) to conditions 1, 2, 3, 4, 5, 6, 8. Condition 7 does not have target cells.</li>
	<li>Mix all wells with a multichannel pipette and centrifuge the plate at 120 x g for 2 min.</li>
	<li>Incubate in a humidified CO2 incubator at 37 &#176;C for 4 h. At the end of the incubation, place the plate on ice and proceed to viability staining within 30 min.</li>
</ol>
8. Staining for viability and acquisition
<ol>
	<li>Prepare dead cell stain (see table of materials) by adding 3 &#181;L of the 5 &#181;M stock solution to 600 &#181;L of PBS.</li>
	<li>Add 50 &#181;L of diluted dead cell stain to each well for a final volume of 250 &#181;L and a final concentration of 0.005 &#181;M. Mix well with a multichannel pipette.</li>
	<li>Proceed with flow cytometric analysis. Using a flow cytometer, collect at least 1,000 events in the target cell gate (Figure 2) for statistically meaningful results.</li>
</ol>

<ol>
	<li>Iannello, A., Debbeche, O., Samarani, S., Ahmad, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Antiviral+NK+cell+responses+in+HIV+infection:+I.+NK+cell+receptor+genes+as+determinants+of+HIV+resistance+and+progression+to+AIDS.">Antiviral NK cell responses in HIV infection: I. NK cell receptor genes as determinants of HIV resistance and progression to AIDS.</a> J Leukoc Biol. 84 (1), 1-26 (2008).</li><li>Caligiuri, M. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Human+natural+killer+cells.">Human natural killer cells.</a> Blood. 112 (3), 461-469 (2008).</li><li>Topham, N. J., Hewitt, E. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Natural+killer+cell+cytotoxicity:+how+do+they+pull+the+trigger?.">Natural killer cell cytotoxicity: how do they pull the trigger?.</a> Immunology. 128 (1), 7-15 (2009).</li><li>Warren, H. S., Smyth, M. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=NK+cells+and+apoptosis.">NK cells and apoptosis.</a> Immunol Cell Biol. 77 (1), 64-75 (1999).</li><li>Tognarelli, S., Jacobs, B., Staiger, N., Ullrich, E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Flow+Cytometry-based+Assay+for+the+Monitoring+of+NK+Cell+Functions.">Flow Cytometry-based Assay for the Monitoring of NK Cell Functions.</a> J Vis Exp. (116), (2016).</li><li>Somanchi, S. S., McCulley, K. J., Somanchi, A., Chan, L. L., Lee, D. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+Novel+Method+for+Assessment+of+Natural+Killer+Cell+Cytotoxicity+Using+Image+Cytometry.">A Novel Method for Assessment of Natural Killer Cell Cytotoxicity Using Image Cytometry.</a> PLoS One. 10 (10), e0141074 (2015).</li><li>Alter, G., Malenfant, J. M., Altfeld, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=CD107a+as+a+functional+marker+for+the+identification+of+natural+killer+cell+activity.">CD107a as a functional marker for the identification of natural killer cell activity.</a> J Immunol Methods. 294 (1-2), 15-22 (2004).</li><li>Atkinson, E. A., Gerrard, J. M., Hildes, G. E., Greenberg, A. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Studies+of+the+mechanism+of+natural+killer+(NK)+degranulation+and+cytotoxicity.">Studies of the mechanism of natural killer (NK) degranulation and cytotoxicity.</a> J Leukoc Biol. 47 (1), 39-48 (1990).</li><li>Kim, G. G., Donnenberg, V. S., Donnenberg, A. D., Gooding, W., Whiteside, T. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+novel+multiparametric+flow+cytometry-based+cytotoxicity+assay+simultaneously+immunophenotypes+effector+cells:+comparisons+to+a+4+h+51Cr-release+assay.">A novel multiparametric flow cytometry-based cytotoxicity assay simultaneously immunophenotypes effector cells: comparisons to a 4 h 51Cr-release assay.</a> J Immunol Methods. 325 (1-2), 51-66 (2007).</li><li>Kane, K. L., Ashton, F. A., Schmitz, J. L., Folds, J. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Determination+of+natural+killer+cell+function+by+flow+cytometry.">Determination of natural killer cell function by flow cytometry.</a> Clin Diagn Lab Immunol. 3 (3), 295-300 (1996).</li><li>Jang, Y. Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=An+improved+flow+cytometry-based+natural+killer+cytotoxicity+assay+involving+calcein+AM+staining+of+effector+cells.">An improved flow cytometry-based natural killer cytotoxicity assay involving calcein AM staining of effector cells.</a> Ann Clin Lab Sci. 42 (1), 42-49 (2012).</li><li>Korzeniewski, C., Callewaert, D. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=An+enzyme-release+assay+for+natural+cytotoxicity.">An enzyme-release assay for natural cytotoxicity.</a> J Immunol Methods. 64 (3), 313-320 (1983).</li><li>Karimi, M. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Measuring+cytotoxicity+by+bioluminescence+imaging+outperforms+the+standard+chromium-51+release+assay.">Measuring cytotoxicity by bioluminescence imaging outperforms the standard chromium-51 release assay.</a> PLoS One. 9 (2), e89357 (2014).</li><li>Oppenheim, D. E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Glyco-engineered+anti-EGFR+mAb+elicits+ADCC+by+NK+cells+from+colorectal+cancer+patients+irrespective+of+chemotherapy.">Glyco-engineered anti-EGFR mAb elicits ADCC by NK cells from colorectal cancer patients irrespective of chemotherapy.</a> Br J Cancer. 110 (5), 1221-1227 (2014).</li><li>West, W. H., Cannon, G. B., Kay, H. D., Bonnard, G. D., Herberman, R. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Natural+cytotoxic+reactivity+of+human+lymphocytes+against+a+myeloid+cell+line:+characterization+of+effector+cells.">Natural cytotoxic reactivity of human lymphocytes against a myeloid cell line: characterization of effector cells.</a> J Immunol. 118 (1), 355-361 (1977).</li><li>Jedema, I., van der Werff, N. M., Barge, R. M., Willemze, R., Falkenburg, J. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=New+CFSE-based+assay+to+determine+susceptibility+to+lysis+by+cytotoxic+T+cells+of+leukemic+precursor+cells+within+a+heterogeneous+target+cell+population.">New CFSE-based assay to determine susceptibility to lysis by cytotoxic T cells of leukemic precursor cells within a heterogeneous target cell population.</a> Blood. 103 (7), 2677-2682 (2004).</li><li>Lecoeur, H., Fevrier, M., Garcia, S., Riviere, Y., Gougeon, M. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+novel+flow+cytometric+assay+for+quantitation+and+multiparametric+characterization+of+cell-mediated+cytotoxicity.">A novel flow cytometric assay for quantitation and multiparametric characterization of cell-mediated cytotoxicity.</a> J Immunol Methods. 253 (1-2), 177-187 (2001).</li><li>Carotta, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Targeting+NK+Cells+for+Anticancer+Immunotherapy:+Clinical+and+Preclinical+Approaches.">Targeting NK Cells for Anticancer Immunotherapy: Clinical and Preclinical Approaches.</a> Front Immunol. 7, 152 (2016).</li><li>Mandal, A., Viswanathan, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Natural+killer+cells:+In+health+and+disease.">Natural killer cells: In health and disease.</a> Hematol Oncol Stem Cell Ther. 8 (2), 47-55 (2015).</li><li>Rezvani, K., Rouce, R. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+Application+of+Natural+Killer+Cell+Immunotherapy+for+the+Treatment+of+Cancer.">The Application of Natural Killer Cell Immunotherapy for the Treatment of Cancer.</a> Front Immunol. 6, 578 (2015).</li><li>Angelo, L. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Practical+NK+cell+phenotyping+and+variability+in+healthy+adults.">Practical NK cell phenotyping and variability in healthy adults.</a> Immunol Res. 62 (3), 341-356 (2015).</li><li>Zons, P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comparison+of+europium+and+chromium+release+assays:+cytotoxicity+in+healthy+individuals+and+patients+with+cervical+carcinoma.">Comparison of europium and chromium release assays: cytotoxicity in healthy individuals and patients with cervical carcinoma.</a> Clin Diagn Lab Immunol. 4 (2), 202-207 (1997).</li><li>Yovel, G., Shakhar, K., Ben-Eliyahu, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+effects+of+sex,+menstrual+cycle,+and+oral+contraceptives+on+the+number+and+activity+of+natural+killer+cells.">The effects of sex, menstrual cycle, and oral contraceptives on the number and activity of natural killer cells.</a> Gynecol Oncol. 81 (2), 254-262 (2001).</li><li>Laue, T., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Altered+NK+cell+function+in+obese+healthy+humans.">Altered NK cell function in obese healthy humans.</a> BMC Obes. 2, 1 (2015).</li><li>Hazeldine, J., Lord, J. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+impact+of+ageing+on+natural+killer+cell+function+and+potential+consequences+for+health+in+older+adults.">The impact of ageing on natural killer cell function and potential consequences for health in older adults.</a> Ageing Res Rev. 12 (4), 1069-1078 (2013).</li></ol>

Gli autori non dichiarano conflitti di interesse finanziario.

Il metodo qui descritto fornisce un'alternativa semplice e conveniente per il test di rilascio di Cr tradizionale 51per valutare l'attività citotossica delle cellule NK. Questo metodo è sensibile, riproducibile e richiede meno tempo rispetto ai metodi standard precedenti, come CRA e può essere usato per entrambi clinici e applicazioni di ricerca.
Mentre il dosaggio funziona sia con totale PBMCs e arricchito le cellule NK, l'opzione per utilizzare PBMCs senza la necessità di purificare le popolazioni delle cellule è un grande vantaggio quando si tratta di piccoli volumi di sangue prelevato o celle di pochi o di scarsa qualità da campioni dei pazienti. Questo test utilizza solo CFSE e cellula morta esclusione attuabilità macchia. Guardando questi due parametri da solo fornisce informazioni succinte e sufficiente per scopi diagnostici, con l'ulteriore vantaggio di non richiedere un'ulteriore compensazione in analisi cytometric di flusso.
Questo metodo può essere utilizzato anche per studiare la biologia delle cellule NK e testare nuove terapie di targeting delle cellule NK. A questo proposito, le capacità di espansione di citometri a flusso introducono un elemento prezioso della versatilità di questo test, consentendo analisi multiparametrica delle cellule NK e la loro attività non possibile in precedenza con dosaggi come CRA. Alternativa cellulare tracciamento e coloranti di vitalità, che reagiscono in altri canali, sono disponibili per soddisfare le esigenze degli investigatori.
Questo protocollo è ottimizzato per l'utilizzo con l'obiettivo di cellule NK prototipo linea cellulare K562. Tuttavia, può essere adattato alle linee di cellule bersaglio alternativo sospensione con vari gradi di sensibilità alla citotossicità delle cellule NK, come HL-60, DiPietro, U937 e Ruffo. A questo proposito, è importante notare che la concentrazione di colorante fluorescente e di siero utilizzato durante destinazione cella etichettatura potrebbe dover essere ottimizzata per ogni linea cellulare di destinazione, come diverse linee cellulari potrebbero prendere l'etichetta fluorescente in modo diverso e per ogni citometro a flusso. Mentre in genere si raccomanda di evitare l'uso del siero durante etichettatura, abbiamo optato per tempra leggera con 0,5% di FBS per due motivi. In primo luogo, aiuta a ridurre lo stress di cella di destinazione e quindi sfondo macchia; in secondo luogo, essa porta segnale CFSE entro l'intervallo appropriato di rilevazione del nostro citometro a flusso senza richiedere regolazioni impostazioni quotidiana, aiutando così la riproducibilità del dosaggio. Variazioni del protocollo aggiuntivo potrebbero includere il test E:T diversi rapporti e tempi di incubazione per adattare il dosaggio alle condizioni di attivazione differente. La durata della co-cultura di cellule effettrici e destinazione per testare la citotossicità NK ha storicamente variava da 4-16 h, anche se periodi più lunghi tendono a provocare il rilascio spontaneo aumentato 9,16. Nel nostro metodo, incubazione più lungo potrebbe anche comportare perdita di fluorescente etichettatura da parte delle cellule bersaglio a causa di uccisione o proliferazione, come questi coloranti fluorescenti sono diluiti al momento della divisione cellulare. Così, le incubazioni nella parte bassa della finestra temporale sono generalmente preferite e non devono superare una notte incubazione 6,16,22.
È importante prendere nota di quali variabili potenzialmente possono influenzare l'esito di questo test. Nella nostra esperienza, le cellule bersaglio K562 sono particolarmente sensibili alle variazioni di temperatura. Pertanto, le cellule K562 dovrebbero non essere refrigerate ma piuttosto conservate a temperatura ambiente o messo in un incubatore CO2 , a 37 ° C prima del loro utilizzo. Per lo stesso motivo, tutti i reagenti devono essere portati a temperature appropriate come indicato nel protocollo. Un altro parametro che colpisce queste cellule è la velocità di centrifugazione, che dovrebbe essere ridotto al minimo stress cellulare. Inoltre, limitando il tempo di ritardo tra preparazione dell'effettore/obiettivo e l'inizio co-dell'incubazione a meno di 30 min è essenziale per garantire attività massima uccisione e la riproducibilità del test. Allo stesso modo, come segnale CFSE è generalmente robusto, pipettaggio accurata, corretta miscelazione delle cellule e incubazione preciso tempo quando etichettatura e tempra sono cruciali per garantire la coerenza nella macchiatura. Infine, capacità citotossica delle cellule NK è molto variabile anche in individui in buona salute ed è influenzato da una serie di fattori, tra cui Stadio di sviluppo, sesso, età e peso 23,24,25. Inoltre, fino al 30% dei controlli sani display una riduzione significativa o perdita completa della capacità citotossica se testato più di 24 ore dopo il prelievo del sangue. Pertanto, si consiglia di PBMCs uso appena purificato o NK cellule quando possibile.

An erratum was issued for: <a href="https://www-jove-com.remotexs.ntu.edu.sg/video/56191/a-flow-cytometry-based-cytotoxicity-assay-for-assessment-human-nk">A Flow Cytometry-Based Cytotoxicity Assay for the Assessment of Human NK Cell Activity</a>. Figure 4 has been corrected to show background-corrected data.
Figure 4 was updated from:
<img alt="Figure 4" src="/files/ftp_upload/56191/56191fig4v1.jpg" />
to:
<img alt="Figure 4" src="/files/ftp_upload/56191/56191fig4v2.jpg" />

An erratum was issued for: <a href="https://www-jove-com.remotexs.ntu.edu.sg/video/56191/a-flow-cytometry-based-cytotoxicity-assay-for-assessment-human-nk">A Flow Cytometry-Based Cytotoxicity Assay for the Assessment of Human NK Cell Activity</a>. Figure 4 has been corrected to show background-corrected data.

Erratum: A Flow Cytometry-Based Cytotoxicity Assay for the Assessment of Human NK Cell Activity

Cellule natural killer (NK) sono un sottoinsieme sofisticato dei linfociti umani innati criticamente coinvolti nell'eliminazione delle cellule infettate viralmente, cellule trasformate e altri patogeni minacce 1,2. Granuli litici delle cellule di NK casa proteine citotossiche, come perforine e granzimi. Al momento dell'attivazione, le cellule NK formano una complessa interazione con i loro obiettivi conosciuto come sinapsi immunologica, per cui queste molecole citolitiche localmente vengono rilasciate, con conseguente lisi delle cellule bersaglio diretto e apoptosi, insieme al rilascio di citochine e chemochine e, infine, l'induzione di un infiammatorio stato 1,3,4.
Attivazione delle cellule NK coinvolge una stringa complessa di attivazione e inibitorie interazioni tra NK delle cellule recettori e ligandi espressi sulla superficie delle cellule bersaglio, formando un sistema strettamente regolato. Uno dei più studiati meccanismi di attivazione delle cellule NK è il "sé mancante". Infatti, mancanza di rilevazione di classe che maggiore istocompatibilità (MHC), o umano del leucocita (HLA) l'antigene molecole, il infetti o trasformato la citotossicità delle cellule NK di cellule trigger. Tumore e cellule infettate da virus generalmente downregulate questi antigeni di fuggire immunità comunicata per cellule di T, diventando così NK primario delle cellule target 1,3,4.
Valutazione della funzione delle cellule NK è principalmente suddivise in degranulazione o citotossicità saggi. Tuttavia, test di degranulazione, quali il rilevamento di cytometric di flusso del marcatore associato degranulazione CD107a, sono indicativi dell'attivazione delle cellule NK e non della loro funzione finale, l'uccisione diretta di destinazione celle 5,6,7,8. Quindi, questa limitazione ha attirato gli investigatori a saggi di citotossicità come un'alternativa più eloquente e più diretto.
Da sempre "gold standard" per la valutazione della attività citotossica cellulo-mediata delle cellule NK e T è il test di rilascio di cromo (CRA). CRA coinvolge radioattivo etichettatura delle cellule bersaglio con 51Cr e co-incubarle con cellule effettrici. Questo test è immersa nel principio che la lisi delle cellule provoca il rilascio di legato alle proteine 51Cr nel surnatante, che può essere misurato contando gamma. Questo test, mentre efficaci, è problematico per una serie di motivi: costi elevati di materiale, manipolazione e smaltimento di radioattivo 51Cr, rilascio spontaneo di 51Cr e difficile standardizzazione - rendendolo del tutto impraticabile 9,10.
Una serie di saggi non radioattivo, che coinvolgono etichettatura fluorescente, rilascio di enzimi e anche bioluminescenza, allora è stata sviluppata come alternative al CRA 11,12,13,14. Descriviamo qui un metodo di basato su citometria di flusso per la misura di attività delle cellule NK citotossica sulle cellule bersaglio K562 che è semplice, sensibile e riproducibile. Le cellule K562 sono una cellula umana eritroleucemiche linea con riduzione dell'espressione di molecole HLA di classe I ed espressione intensificata di ligandi per recettori NK attivatori, che li rende particolarmente suscettibili a NK Citotossicità cellulo-mediata 15. In questa analisi, le cellule K562 sono pre-etichettate con carboxyfluorescein diacetate succinimidyl ester (CFSE) e co-coltivate a vari rapporti con entrambi cellule mononucleari del sangue periferico (PBMCs) o purificata di cellule NK 1. CFSE è un colorante fluorescente stabile, legame che consente di discriminazione delle cellule bersaglio da effettore NK cellule 16,17. Dopo la co-incubazione, una macchia di acido nucleico, specificamente che permea la membrana di cellule morte, viene utilizzata per identificare le celle di destinazione ucciso (Vedi tabella dei materiali). I campioni vengono quindi acquisiti su un citometro a flusso per determinare la percentuale di morti (cioè, macchia +) CFSE + cellule bersaglio.
Questa analisi può essere usata come uno screening diagnostico per malattie monogenici difetti che interessano il compartimento cellulare NK, di cui ci sono circa 30 difetti noti causando carenza di cellule NK o funzionale o classica, e per il lymphohistiocytosis hemophagocytic primario o secondario. È anche utile indagare l'attività delle cellule NK in pazienti con infezioni virali da herpes ricorrente, grave, di valutare la ricostituzione immunitaria dopo trapianto di cellule ematopoietiche o post immunomodulatori terapia 18,19,20e per una miriade di applicazioni di ricerca di base.

<table>
	<tbody>
		<tr>
			<td>Phosphate-buffered Saline (1x, w/o Ca2+ and Mg2+)</td>
			<td>Corning (Cellgro)</td>
			<td>21-040-CM</td>
			<td></td>
		</tr>
		<tr>
			<td>Ficoll-Paque PLUS</td>
			<td>GE Healthcare</td>
			<td>17-1440-02</td>
			<td></td>
		</tr>
		<tr>
			<td>Tween-20</td>
			<td>Sigma</td>
			<td>BP337-100</td>
			<td></td>
		</tr>
		<tr>
			<td>RPMI 1640 Media</td>
			<td>Corning (Cellgro)</td>
			<td>10-040-CV</td>
			<td></td>
		</tr>
		<tr>
			<td>Heat-inactivated Fetal Bovine Serum</td>
			<td>Omega Scientific</td>
			<td>FB-02</td>
			<td></td>
		</tr>
		<tr>
			<td>Penicillin Streptomycin</td>
			<td>Life Technologies</td>
			<td>15140-163</td>
			<td>Stock solution at 10,000 U/mL</td>
		</tr>
		<tr>
			<td>IL-2</td>
			<td>R&#38;D Systems</td>
			<td>202-IL-050</td>
			<td>Lyophilized from a 0.2 &#956;m filtered solution in Acetonitrile and TFA with BSA as a carrier protein. Reconstitute with 500 ul at 100 &#956;g/mL in sterile 100 mM Acetic Acid containing at least 0.1% bovine serum albumin (2.1x10E6 IU/ml)</td>
		</tr>
		<tr>
			<td>K562 Cells</td>
			<td>ATCC</td>
			<td>CCL-243</td>
			<td>Cancer cell line&#160;</td>
		</tr>
		<tr>
			<td>T-75 cell culture flasks</td>
			<td>Corning</td>
			<td>431464</td>
			<td></td>
		</tr>
		<tr>
			<td>CFSE cell proliferation kit</td>
			<td>Life Technologies (CellTrace)</td>
			<td>C34554</td>
			<td>Reconstitute I vial with 18 ul DMSO to prepare a 5mM stock solution. Do not freeze/thaw.</td>
		</tr>
		<tr>
			<td>Sytox Red</td>
			<td>Life Technologies</td>
			<td>S34859</td>
			<td>Stock solution is provided at 5 &#956;M in 1 mL DMSO. The DMSO solution may be subjected to multiple freeze-thaw cycles without reagent degradation.</td>
		</tr>
		<tr>
			<td>Sodium/lithium heparin blood collection tubes</td>
			<td>BD</td>
			<td>02-687-95</td>
			<td></td>
		</tr>
		<tr>
			<td>U-bottom 96-well plate</td>
			<td>Corning</td>
			<td>CLS3897</td>
			<td></td>
		</tr>
		<tr>
			<td>Serological pipettes</td>
			<td>BD Falcon</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Polystyrene round-bottom tubes (5mL)</td>
			<td>BD Falcon</td>
			<td>14959-5</td>
			<td></td>
		</tr>
		<tr>
			<td>50 mL polypropylene conical tube</td>
			<td>BD Falcon</td>
			<td>352070</td>
			<td></td>
		</tr>
		<tr>
			<td>15 mL polypropylene conical tube</td>
			<td>BD Falcon</td>
			<td>352097</td>
			<td></td>
		</tr>
		<tr>
			<td>Reagent reservoir</td>
			<td>USA Scientific</td>
			<td>2321-2230</td>
			<td></td>
		</tr>
		<tr>
			<td>Human NK cell enrichment cocktail</td>
			<td>StemCell Technologies (RosetteSep)</td>
			<td>15065</td>
			<td></td>
		</tr>
	</tbody>
</table>

a flow cytometry-based cytotoxicity assay for the assessment of human nk cell activity

All'interno del sistema immunitario innato, linfociti effettori conosciuti come cellule natural killer (NK) svolgono un ruolo essenziale nella difesa dell'ospite contro le cellule aberranti, in particolare eliminando tumorali e cellule infette viralmente. Circa 30 difetti noti monogenici, insieme a una serie di altre condizioni patologiche, causano la mancanza delle cellule NK sia funzionale o classica, che si manifesta ridotta o assente attività citotossica. Storicamente, la citotossicità è stata studiata con metodi radioattivi, che sono ingombranti, costosi e potenzialmente pericolose. Questo articolo viene descritto un metodo di base di cytometry di flusso aerodinamico, clinicamente applicabile per quantificare l'attività citotossica delle cellule NK. In questo saggio, cellule mononucleari del sangue periferico (PBMCs) o preparazioni purificate di cellule NK sono co-incubate a diversi rapporti con una linea cellulare di tumore destinazione conosciuta ad essere sensibili alla citotossicità cellulo-mediata NK (NKCC). Le cellule bersaglio sono pre-etichettate con un colorante fluorescente per permettere la loro distinzione dalle cellule effettrici (cellule NK). Dopo il periodo di incubazione, le cellule bersaglio uccisi sono identificate da una macchia di acido nucleico, che permea in modo specifico le cellule morte. Questo metodo è favorevole alla sia diagnostico e applicazioni di ricerca e, grazie alle funzionalità multi-parametro di citometria a flusso, presenta il vantaggio aggiunto di potenzialmente consentire un'analisi più approfondita del fenotipo delle cellule NK e funzione.

Prima di impostare il dosaggio, si consiglia vivamente che contenuto delle cellule NK essere valutata nella popolazione dell'effettore di scelta. La figura 1 Mostra una tipica colorazione CD56 prima (luce blu) e dopo arricchimento di cellule NK (rosso). Le cellule NK comprendono fino a 15% di PBMCs e devono essere almeno 80% puro dopo arricchimento.
Analisi cytometric di flusso in questo test comporta la rilevazione di due parametri: CFSE, rilevabile nella stessa canalina di FITC; e una macchia di cellula morta, rilevabile nel canale stesso come APC (Figura 2AB). Dopo l'acquisizione di dati, la strategia di gating nella Figura 2 viene utilizzata per analizzare i dati. Le cellule K562 destinazione morti (cioè, cellule morte macchia +) sono gated fuori CFSE + popolazione, fornendo la % di cellule uccise all'interno della popolazione bersaglio.
Condizioni di controllo sono fondamentali nel garantire l'efficacia del test stesso e dei suoi componenti separati. In ordine per il dosaggio può essere considerata valida, il seguente dovrebbe essere previsto in condizioni di controllo (6-8): cellule solo (condizione 6) dovrebbe provocare la morte delle cellule bersaglio &#60; 15% (Figura 3A). Dovrebbe essere rilevato alcun segnale CFSE per cellule effettrici solo (condizione 7), e la morte delle cellule dovrebbe essere &#60; 5% (Figura 3B). Per interpolazione l'uccisione delle cellule bersaglio (condizione 8), dovrebbe essere la morte delle cellule &#62; 85% (Figura 3).
Un paziente con difetto nella funzione delle cellule NK è previsto di aver ridotto al massimo attività uccisione o tutti i rapporti testato rispetto ad un individuo sano. Il parallelo di donatore sano e paziente cellule nella Figura 4 viene illustrato il differenziale, significativa riduzione nella morte delle cellule bersaglio con la diminuzione del rapporto delle cellule effettrici-destinazione.
<img alt="Figure 1" class="xfigimg" src="/files/ftp_upload/56191/56191fig1.jpg"> 
Figura 1: valutazione del contenuto delle cellule NK all'interno della popolazione di effector. Rappresentanza istogramma dopo colorazione totale PBMCs (blu chiaro) o purificato le cellule NK (rosse) per CD56. <a href="//ecsource-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/56191/56191fig1large.jpg" target="_blank">Clicca qui per visualizzare una versione più grande di questa figura.</a>
<img alt="Figure 2" class="xfigimg" src="/files/ftp_upload/56191/56191fig2.jpg"> 
Figura 2: strategia per la rilevazione delle cellule bersaglio di Gating. A) il cancello iniziale è impostato in una trama di FITC-A/SSC-A. Le cellule K562 sono gated come CFSE + eventi. B) cellule K562 morto (cioè, macchia positiva per cellule morte) sono gestita la trama di APC-A/SSC-A successive all'interno della popolazione di cellule bersaglio CFSE +. <a href="//ecsource-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/56191/56191fig2large.jpg" target="_blank">Clicca qui per visualizzare una versione più grande di questa figura.</a>
<img alt="Figure 3" class="xfigimg" src="/files/ftp_upload/56191/56191fig3.jpg"> 
Figura 3: dati rappresentativi per controllare le condizioni. A) percentuale di cellule morte macchia + K562 cellule all'interno di CFSE + cancello (gating strategia come in Figura 2) nella condizione 6 (solo cellule bersaglio) - controllo negativo per la morte di cellule K562. B) macchia di CFSE e cellula morta rilevamento in condizione 7 (effettrici cellule solo - PBMCs totale). C) percentuale di cellule morte macchia + K562 cellule all'interno del cancello CFSE + (gating strategia come in Figura 2) in condizione 8 (cellule bersaglio + Tween) - controllo positivo per la morte di cellule K562. <a href="//ecsource-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/56191/56191fig3large.jpg" target="_blank">Clicca qui per visualizzare una versione più grande di questa figura.</a>
<img alt="Figure 4" class="xfigimg" src="/files/ftp_upload/56191/56191fig4.jpg"> 
Figura 4: dati rappresentativi per l'effetto di diluizione di rapporto delle cellule dell'effettore-obiettivo di vari. I rapporti di cellule effettrici: destinazione testati sono come segue: 50: 1, 25: 1; 12.5: 1; 6.25:1. dati sono sfondo (condizione #6)-rimosso. <a href="//ecsource-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/56191/56191fig4large.jpg" target="_blank">Clicca qui per visualizzare una versione più grande di questa figura.</a>
<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>Campione</td>
			<td>Condizione</td>
			<td>Effettrici (E): Target (T)</td>
		</tr>
		<tr>
			<td rowspan="8">PBMC</td>
			<td>1 - controllo positivo per citotossicità delle cellule NK</td>
			<td>50:1 + IL-2</td>
		</tr>
		<tr>
			<td>2</td>
			<td>50: 1</td>
		</tr>
		<tr>
			<td>3</td>
			<td>25: 1</td>
		</tr>
		<tr>
			<td>4</td>
			<td>12.5: 1</td>
		</tr>
		<tr>
			<td>5</td>
			<td>6.25: 1</td>
		</tr>
		<tr>
			<td>6</td>
			<td>Solo T</td>
		</tr>
		<tr>
			<td>7 - controllo negativo per la morte di K562</td>
			<td>E solo</td>
		</tr>
		<tr>
			<td>8 - controllo positivo per la morte di K562</td>
			<td>T + Tween</td>
		</tr>
		<tr>
			<td rowspan="8">Cellule NK (purificate)</td>
			<td>1 - controllo positivo per citotossicità delle cellule NK</td>
			<td>5:1 + IL-2</td>
		</tr>
		<tr>
			<td>2</td>
			<td>5: 1</td>
		</tr>
		<tr>
			<td>3</td>
			<td>2.5: 1</td>
		</tr>
		<tr>
			<td>4</td>
			<td>1.25: 1</td>
		</tr>
		<tr>
			<td>5</td>
			<td>0.625: 1</td>
		</tr>
		<tr>
			<td>6</td>
			<td>Solo T</td>
		</tr>
		<tr>
			<td>7 - controllo negativo per la morte di K562</td>
			<td>E solo</td>
		</tr>
		<tr>
			<td>8 - controllo positivo per la morte di K562</td>
			<td>T + Tween</td>
		</tr>
	</tbody>
</table>
Tabella 1

Watch this Scientific Journal Video about A Flow Cytometry-Based Cytotoxicity Assay for the Assessment of Human NK Cell Activity at JoVE.com

A Flow Cytometry-Based Cytotoxicity Assay for the Assessment of Human NK Cell Activity

Un metodo di basato su citometria di flusso per determinare quantitativamente l'attività citotossica delle cellule natural killer di umane è mostrato qui.

Un'analisi di citotossicità di base di citometria a flusso per la valutazione dell'attività delle cellule NK umane

Within the innate immune system, effector lymphocytes known as natural killer (NK) cells play an essential role in host defense against aberrant cells, ...

a-flow-cytometry-based-cytotoxicity-assay-for-assessment-human-nk

Nanyang Technological University

Research

JoVE Journal

Immunology and Infection

23.6K Views.  University of California, Los Angeles. Un metodo di basato su citometria di flusso per determinare quantitativamente l'attività citotossica delle cellule natural killer di umane è mostrato qui.

Video: A Flow Cytometry-Based Cytotoxicity Assay for the Assessment of Human NK Cell Activity

Expansion, Purification, and Functional Assessment of Human Peripheral Blood NK Cells

Natural killer (NK) cells play an important role in immune surveillance against a variety of infectious microorganisms and tumors. Limited availability of NK cells and ability to expand in vitro has restricted development of NK cell immunotherapy. Here we describe a method to efficiently expand vast quantities of functional NK cells ex vivo using K562 cells expressing membrane-bound IL21, as an artificial antigen-presenting cell (aAPC).
NK cell adoptive therapies to date have utilized a cell product obtained by steady-state leukapheresis of the donor followed by depletion of T cells or positive selection of NK cells. The product is usually activated in IL-2 overnight and then administered the following day 1. Because of the low frequency of NK cells in peripheral blood, relatively small numbers of NK cells have been delivered in clinical trials.
The inability to propagate NK cells in vitro has been the limiting factor for generating sufficient cell numbers for optimal clinical outcome. Some expansion of NK cells (5-10 fold over 1-2 weeks) has be achieved through high-dose IL-2 alone 2. Activation of autologous T cells can mediate NK cell expansion, presumably also through release of local cytokine 3. Support with mesenchymal stroma or artificial antigen presenting cells (aAPCs) can support the expansion of NK cells from both peripheral blood and cord blood 4. Combined NKp46 and CD2 activation by antibody-coated beads is currently marketed for NK cell expansion (Miltenyi Biotec, Auburn CA), resulting in approximately 100-fold expansion in 21 days.
Clinical trials using aAPC-expanded or -activated NK cells are underway, one using leukemic cell line CTV-1 to prime and activate NK cells5 without significant expansion. A second trial utilizes EBV-LCL for NK cell expansion, achieving a mean 490-fold expansion in 21 days6. The third utilizes a K562-based aAPC transduced with 4-1BBL (CD137L) and membrane-bound IL-15 (mIL-15)7, which achieved a mean NK expansion 277-fold in 21 days. Although, the NK cells expanded using K562-41BBL-mIL15 aAPC are highly cytotoxic in vitro and in vivo compared to unexpanded NK cells, and participate in ADCC, their proliferation is limited by senescence attributed to telomere shortening8. More recently a 350-fold expansion of NK cells was reported using K562 expressing MICA, 4-1BBL and IL159.
Our method of NK cell expansion described herein produces rapid proliferation of NK cells without senescence achieving a median 21,000-fold expansion in 21 days.

Here we describe a method to efficiently expand and purify large numbers of human NK cells and assess their function.

Espansione, di purificazione, e la valutazione funzionale delle cellule del sangue umano periferico NK

Natural killer (NK) cells play an important role in immune surveillance against a variety of infectious microorganisms and tumors. Limited availability of ...

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Immunologia e infezioni

Human In Vitro Suppression as Screening Tool for the Recognition of an Early State of Immune Imbalance

Regulatory T cells (Tregs) are critical mediators of immune tolerance to self-antigens. In addition, they are crucial regulators of the immune response following an infection. Despite efforts to identify unique surface marker on Tregs, the only unique feature is their ability to suppress the proliferation and function of effector T cells. While it is clear that only in vitro assays can be used in assessing human Treg function, this becomes problematic when assessing the results from cross-sectional studies where healthy cells and cells isolated from subjects with autoimmune diseases (like Type 1 Diabetes-T1D) need to be compared. There is a great variability among laboratories in the number and type of responder T cells, nature and strength of stimulation, Treg:responder ratios and the number and type of antigen-presenting cells (APC) used in human in vitro suppression assays. This variability makes comparison between studies measuring Treg function difficult. The Treg field needs a standardized suppression assay that will work well with both healthy subjects and those with autoimmune diseases. We have developed an in vitro suppression assay that shows very little intra-assay variability in the stimulation of T cells isolated from healthy volunteers compared to subjects with underlying autoimmune destruction of pancreatic &beta;-cells. The main goal of this piece is to describe an in vitro human suppression assay that allows comparison between different subject groups. Additionally, this assay has the potential to delineate a small loss in nTreg function and anticipate further loss in the future, thus identifying subjects who could benefit from preventive immunomodulatory therapy1. Below, we provide thorough description of the steps involved in this procedure. We hope to contribute to the standardization of the in vitro suppression assay used to measure Treg function. In addition, we offer this assay as a tool to recognize an early state of immune imbalance and a potential functional biomarker for T1D.

Human In Vitro Suppression as Screening Tool for the Recognition of an Early State of Immune Imbalance

Tregs are potent suppressors of the immune system. There is a lack of unique surface markers to define them, hence, definitions of Tregs are primarily functional. Here we describe an optimized in vitro assay capable of identifying immune imbalance in subjects at risk to develop T1D.

Umano In Vitro</emSoppressione> come strumento di screening per il riconoscimento di uno Stato precoce di squilibrio immunitario

Regulatory T cells (Tregs) are critical mediators of immune tolerance to self-antigens. In addition, they are crucial regulators of the immune response ...

Quantitative High-throughput Single-cell Cytotoxicity Assay For T Cells

Cancer immunotherapy can harness the specificity of immune response to target and eliminate tumors. Adoptive cell therapy (ACT) based on the adoptive transfer of T cells genetically modified to express a chimeric antigen receptor (CAR) has shown considerable promise in clinical trials1-4. There are several advantages to using CAR+ T cells for the treatment of cancers including the ability to target non-MHC restricted antigens and to functionalize the T cells for optimal survival, homing and persistence within the host; and finally to induce apoptosis of CAR+ T cells in the event of host toxicity5.
Delineating the optimal functions of CAR+ T cells associated with clinical benefit is essential for designing the next generation of clinical trials. Recent advances in live animal imaging like multiphoton microscopy have revolutionized the study of immune cell function in vivo6,7. While these studies have advanced our understanding of T-cell functions in vivo, T-cell based ACT in clinical trials requires the need to link molecular and functional features of T-cell preparations pre-infusion with clinical efficacy post-infusion, by utilizing in vitro assays monitoring T-cell functions like, cytotoxicity and cytokine secretion. Standard flow-cytometry based assays have been developed that determine the overall functioning of populations of T cells at the single-cell level but these are not suitable for monitoring conjugate formation and lifetimes or the ability of the same cell to kill multiple targets8.
Microfabricated arrays designed in biocompatible polymers like polydimethylsiloxane (PDMS) are a particularly attractive method to spatially confine effectors and targets in small volumes9. In combination with automated time-lapse fluorescence microscopy, thousands of effector-target interactions can be monitored simultaneously by imaging individual wells of a nanowell array. We present here a high-throughput methodology for monitoring T-cell mediated cytotoxicity at the single-cell level that can be broadly applied to studying the cytolytic functionality of T cells.

We describe a single-cell high-throughput assay to measure cytotoxicity of T cells when incubated with tumor target cells. This method employs a dense, elastomeric array of sub-nanoliter wells (~100,000 wells/array) to spatially confine the T cells and target cells at defined ratios and is coupled to fluorescence microscopy to monitor effector-target conjugation and subsequent apoptosis.

Quantitativa High-throughput cella singola test di citotossicità per le cellule T

Cancer immunotherapy can harness the specificity of  immune response to target and eliminate tumors. Adoptive cell therapy (ACT)  based on the adoptive ...

Cell-based Flow Cytometry Assay to Measure Cytotoxic Activity

Cytolytic activity of CD8+ T cells is rarely evaluated. We describe here a new cell-based assay to measure the capacity of antigen-specific CD8+ T cells to kill CD4+ T cells loaded with their cognate peptide. Target CD4+ T cells are divided into two populations, labeled with two different concentrations of CFSE. One population is pulsed with the peptide of interest (CFSE-low) while the other remains un-pulsed (CFSE-high). Pulsed and un-pulsed CD4+ T cells are mixed at an equal ratio and incubated with an increasing number of purified CD8+ T cells. The specific killing of autologous target CD4+ T cells is analyzed by flow cytometry after coculture with CD8+ T cells containing the antigen-specific effector CD8+ T cells detected by peptide/MHCI tetramer staining. The specific lysis of target CD4+ T cells measured at different effector versus target ratios, allows for the calculation of lytic units, LU30/106 cells. This simple and straightforward assay allows for the accurate measurement of the intrinsic capacity of CD8+ T cells to kill target CD4+ T cells.

This protocol describes a sensitive, cell-based cytotoxicity assay. By enumerating the decrease in frequency of live target CD4+ T cells in the presence of an increasing number of effector CD8+ T cells, this assay allows for the direct assessment of cytolytic activity of antigen-specific CD8+ T cells.

Cytolytic activity of CD8+ T cells is rarely evaluated. We describe here a new cell-based assay to measure the capacity of antigen-specific CD8+ T cells ...

Fast and Specific Assessment of the Halogenating Peroxidase Activity in Leukocyte-enriched Blood Samples

In this paper a protocol for the quick and standardized enrichment of leukocytes from small whole blood samples is described. This procedure is based on the hypotonic lysis of erythrocytes and can be applied to human samples as well as to blood of non-human origin. The small initial sample volume of about 50 to 100 &#181;l makes this method applicable to recurrent blood sampling from small laboratory animals. Moreover, leukocyte enrichment is achieved within minutes and with low material efforts regarding chemicals and instrumentation, making this method applicable in multiple laboratory environments.
Standardized purification of leukocytes is combined with a highly selective staining method to evaluate halogenating peroxidase activity of the heme peroxidases, myeloperoxidase (MPO) and eosinophil peroxidase (EPO), i.e., the formation of hypochlorous and hypobromous acid (HOCl and HOBr). While MPO is strongly expressed in neutrophils, the most abundant immune cell type in human blood as well as in monocytes, the related enzyme EPO is exclusively expressed in eosinophils. The halogenating activity of these enzymes is addressed by using the almost HOCl- and HOBr-specific dye aminophenyl fluorescein (APF) and the primary peroxidase substrate hydrogen peroxide. Upon subsequent flow cytometry analysis all peroxidase-positive cells (neutrophils, monocytes, eosinophils) are distinguishable and their halogenating peroxidase activity can be quantified. Since APF staining may be combined with the application of cell surface markers, this protocol can be extended to specifically address leukocyte sub-fractions. The method is applicable to detect HOCl and HOBr production both in human and in rodent leukocytes.
Given the widely and diversely discussed immunological role of these enzymatic products in chronic inflammatory diseases, this protocol may contribute to a better understanding of the immunological relevance of leukocyte-derived heme peroxidases.

This protocol describes the quick enrichment of leukocytes from small blood samples for a subsequent specific determination of the halogenating peroxidase activity within the cells. The method can be applied to human and non-human material and may contribute to the evaluation of new inflammatory markers.

La valutazione rapida e specifica del alogenazione perossidasi attività in campioni di sangue leucociti arricchita

In this paper a protocol for the quick and standardized enrichment of leukocytes from small whole blood samples is described. This procedure is based on ...

Flow Cytometry-based Assay for the Monitoring of NK Cell Functions

Natural killer (NK) cells are an important part of the human tumor immune surveillance system. NK cells are able to distinguish between healthy and virus-infected or malignantly transformed cells due to a set of germline encoded inhibitory and activating receptors. Upon virus or tumor cell recognition a variety of different NK cell functions are initiated including cytotoxicity against the target cell as well as cytokine and chemokine production leading to the activation of other immune cells. It has been demonstrated that accurate NK cell functions are crucial for the treatment outcome of different virus infections and malignant diseases. Here a simple and reliable method is described to analyze different NK cell functions using a flow cytometry-based assay. NK cell functions can be evaluated not only for the whole NK cell population, but also for different NK cell subsets. This technique enables scientists to easily study NK cell functions in healthy donors or patients in order to reveal their impact on different malignancies and to further discover new therapeutic strategies.

A simple and reliable method is described here to analyze a set of NK cell functions such as degranulation, cytokine and chemokine production within different NK cell subsets.

Citometria a flusso basato su test per il monitoraggio delle funzioni delle cellule NK

Natural killer (NK) cells are an important part of the human tumor immune surveillance system. NK cells are able to distinguish between healthy and ...

Assessing Retinal Microglial Phagocytic Function In Vivo Using a Flow Cytometry-based Assay

Microglia are the tissue resident macrophages of the central nervous system (CNS) and they perform a variety of functions that support CNS homeostasis, including phagocytosis of damaged synapses or cells, debris, and/or invading pathogens. Impaired phagocytic function has been implicated in the pathogenesis of diseases such as Alzheimer's and age-related macular degeneration, where amyloid-&#946; plaque and drusen accumulate, respectively. Despite its importance, microglial phagocytosis has been challenging to assess in vivo. Here, we describe a simple, yet robust, technique for precisely monitoring and quantifying the in vivo phagocytic potential of retinal microglia. Previous methods have relied on immunohistochemical staining and imaging techniques. Our method uses flow cytometry to measure microglial uptake of fluorescently labeled particles after intravitreal delivery to the eye in live rodents. This method replaces conventional practices that involve laborious tissue sectioning, immunostaining, and imaging, allowing for more precise quantification of microglia phagocytic function in just under six hours. This procedure can also be adapted to test how various compounds alter microglial phagocytosis in physiological settings. While this technique was developed in the eye, its use is not limited to vision research.

Assessing Retinal Microglial Phagocytic Function In Vivo Using a Flow Cytometry-based Assay

Microglial phagocytosis is critical for the maintenance of tissue homeostasis and inadequate phagocytic function has been implicated in pathology. However, assessing microglia function in vivo is technically challenging. We have developed a simple but robust technique for precisely monitoring and quantifying the phagocytic potential of microglia in a physiological setting.

La valutazione della retina microglia fagocitaria Funzione<em&gt; In Vivo</em&gt; Usando un test citometria a flusso basato su

Microglia are the tissue resident macrophages of the central nervous system (CNS) and they perform a variety of functions that support CNS homeostasis, ...

Flow Cytometric Analysis of Particle-bound Bet v 1 Allergen in PM10

Flow cytometry is a method widely used to quantify suspended solids such as cells or bacteria in a size range from 0.5 to several tens of micrometers in diameter. In addition to a characterization of forward and sideward scatter properties, it enables the use of fluorescent labeled markers like antibodies to detect respective structures. Using indirect antibody staining, flow cytometry is employed here to quantify birch pollen allergen (precisely Bet v 1)-loaded particles of 0.5 to 10 &#181;m in diameter in inhalable particulate matter (PM10, particle size &#8804;10 &#181;m in diameter). PM10 particles may act as carriers of adsorbed allergens possibly transporting them to the lower respiratory tract, where they could trigger allergic reactions.
So far the allergen content of PM10 has been studied by means of enzyme linked immunosorbent assays (ELISAs) and scanning electron microscopy. ELISA measures the dissolved and not the particle-bound allergen. Compared to scanning electron microscopy, which can visualize allergen-loaded particles, flow cytometry may additionally quantify them. As allergen content of ambient air can deviate from birch pollen count, allergic symptoms might perhaps correlate better with allergen exposure than with pollen count. In conjunction with clinical data, the presented method offers the opportunity to test in future experiments whether allergic reactions to birch pollen antigens are associated with the Bet v 1 allergen content of PM10 particles &#62;0.5 &#181;m.

Here, we present a protocol to quantify allergen-loaded particles by flow cytometry. Ambient particulate matter particles may act as carriers of adsorbed allergens. We show here that flow cytometry, a method widely used to characterize suspended solids &#62;0.5 &#181;m in diameter, can be used to measure these allergen-loaded particles.

Flusso analisi di citometria di Particle-bound Bet v 1 allergene in PM10

Flow cytometry is a method widely used to quantify suspended solids such as cells or bacteria in a size range from 0.5 to several tens of micrometers in ...

Flow Cytometric Analysis of Natural Killer Cell Lytic Activity in Human Whole Blood

NK cell cytotoxicity is a widely used measure to determine the effect of outside intervention on NK cell function. However, the accuracy and reproducibility of this assay can be considered unstable, either because of user&#39;s errors or because of the sensitivity of NK cells to experimental manipulation. To eliminate these issues, a workflow that reduces them to a minimum was established and is presented here. To illustrate, we obtained blood samples, at various time points, from runners (n = 4) that were submitted to an intense bout of exercise. First, NK cells are simultaneously identified and isolated through CD56 tagging and magnetic-based sorting, directly from whole blood and from as little as one milliliter. The sorted NK cells are removed of any reagent or capping antibodies. They can be counted in order to establish an accurate NK cell count per milliliter of blood. Secondly, the sorted NK cells (effectors cells or E) can be mixed with 3,3&#39;-Diotadecyloxacarbocyanine Perchlorate (DiO) tagged K562 cells (target cells or T) at an assay-optimal 1:5 T:E ratio, and analyzed using an imaging flow-cytometer that allows for the visualization of each event and the elimination of any false positive or false negatives (such as doublets or effector cells). This workflow can be completed in about 4 h, and allows for very stable results even when working with human samples. When available, research teams can test several experimental interventions in human subjects, and compare measurements across several time points without compromising the data&#39;s integrity.

This work describes an advanced workflow for the accurate and fast determination of NK (Natural Killer) cell count and NK cell cytotoxicity in human blood samples.

Flusso analisi di citometria di Natural Killer cellulare Lytic attività nel Sangue umano intero

NK cell cytotoxicity is a widely used measure to determine the effect of outside intervention on NK cell function. However, the accuracy and ...

Dextran Enhances the Lentiviral Transduction Efficiency of Murine and Human Primary NK Cells

The efficient transduction of specific genes into natural killer (NK) cells has been a major challenge. Successful transductions are critical to defining the role of the gene of interest in the development, differentiation, and function of NK cells. Recent advances related to chimeric antigen receptors (CARs) in cancer immunotherapy accentuate the need for an efficient method to deliver exogenous genes to effector lymphocytes. The efficiencies of lentiviral-mediated gene transductions into primary human or mouse NK cells remain significantly low, which is a major limiting factor. Recent advances using cationic polymers, such as polybrene, show an improved gene transduction efficiency in T cells. However, these products failed to improve the transduction efficiencies of NK cells. This work shows that dextran, a branched glucan polysaccharide, significantly improves the transduction efficiency of human and mouse primary NK cells. This highly reproducible transduction methodology provides a competent tool for transducing human primary NK cells, which can vastly improve clinical gene delivery applications and thus NK cell-based cancer immunotherapy.

The goal of this study was to formulate technologies that allow for successful gene transduction in primary natural killer (NK) cells. The dextran-mediated lentiviral transduction of human or mouse primary NK cells results in higher gene expression efficiencies. This method of gene transduction will vastly improve NK cell genetic manipulation.

Destrano migliora l'efficienza di trasduzione lentivirale di cellule NK primarie Murine ed umane

The efficient transduction of specific genes into natural killer (NK) cells has been a major challenge. Successful transductions are critical to defining ...