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1.IntroductionAtopic dermatitis (AD) is a chronic inflammatory disease associated with cutaneous hyperreactivity to environmental triggers.1 AD is characterized by eczematous lesions and in some cases are associated with elevated serum IgE levels. Various studies have indicated that AD has a complex etiology, with activation of multiple immunologic and inflammatory pathways.2,3 Langerhans cells (LCs) are the predominant dendritic cell (DC) population in the epidermis and are thus the first line of defense against antigens that penetrate the skin.4 In AD skin lesions, the majority of LCs exhibit surface-bound IgE, with being the critical IgE-binding receptor enabling it to capture allergens penetrating into the skin. LCs up-regulate their display of in atopy patch tests.5 In AD, LCs bearing the antigen migrate from the skin to the draining lymph nodes (DLNs) where they activate -mediated Th2 immune responses. It is possible that other undefined receptor-mediated antigen sensitization pathways might thus be responsible for allergen uptake and allergic response relevant to the pathophysiology of AD. CD207 (langerin) is a type II C-type lectin receptor (CLR) that binds mannose and related sugars in a calcium-dependent manner through its carbohydrate-recognition domain (CRD).6 Its expression is demonstrated at the surface membrane as well as in Birbeck granules, those organelles specific for LCs. Several lines of evidence have indicated that CD207 is a specific marker for the acquisition of the LC phenotype.7,8 A mouse homologue of human CD207 has also been identified.9,10 The predicted mouse CD207 displays an overall 66% sequence identity with the human CD207.9 It has been suggested that the process of antigen capture, internalization (endocytosis), the formation of Birbeck granules, processing, migration to lymphoid tissue, and maturation of LCs is a consequence of CD207 function.11 The precise role of LCs in allergic diseases is still under debate. A concordant increase in LC proliferation in patients with human AD and in a mouse AD model suggests a potential relevance of LCs in the pathophysiology of AD.12,13 LCs are in the foreground in the initial sensitization phase of AD.14,15 CD207 expression was essential for promotion of the skin allergic responses.16 However, LCs contribute to Th2 polarization by an unknown mechanism after allergen capture.17 It is not clear that whether allergen uptake by CD207 plays any role in the development of allergic sensitization in human beings.18 We set up a technique combining Alexa Fluor conjugates with Cr:forsterite laser-based multimodality nonlinear microscopy to allow for the unequivocal imaging of LCs and ovalbumin (OVA) in the skin and in the DLNs. 2.Materials and Methods2.1.Mice, Allergens, and Epicutaneous SensitizationFor the animal model of epicutaneous (EC) OVA sensitization, six- to eight-week-old female BALB/c mice were obtained from the Animal Center of the College of Medicine, National Taiwan University. All procedures performed on the mice were approved by The Animal Care and Use Committee of National Taiwan University Hospital. EC sensitization of the mice was performed as previously described.19 The protein antigens used in this study were OVA () (Sigma Chemical Co., St. Louis, MO, USA). The antigen was prepared in distilled water. In brief, 20 μl of OVA solution was first added to the paper disc insert of a Finn Chamber (Epitest Co., Tuusula, Finland), which was then applied to a patch of sterile gauze. The disc was then applied to the skin on the lateral side of the abdomen and fixed and secured with an elastic bandage to ensure skin contact and to prevent oral ingestion. The OVA patches were kept there for 24 h and freshly prepared patches were reapplied to the same skin site everyday. The course of immunization was totally for five days. 2.2.Monoclonal AntibodiesAlexa Fluor 647-rat anti-mouse CD207, and Alexa Fluor 647-rat IgG2a isotype control were purchased from eBioscience, Inc. (San Diego, CA). OVA-Alexa Fluor 647 conjugate was purchased from Invitrogen (Carlsbad, CA). Alexa Fluor 700-rat anti-mouse CD205 was obtained from AbD Serotec (Oxford, UK). 2.3.Cr:forsterite Laser-Based Multimodality Nonlinear Microscopy SystemThe imaging system used for our experiments has been described previously.19 The Cr:forsterite laser-based multimodality nonlinear microscopy system was adapted from a FluoView 300 (FV300) scanning unit (Olympus, Tokyo, Japan) combined with a BX51 microscope (Olympus, Tokyo, Japan). The light source was a home-built Cr:forsterite fs laser centered at 1230 nm with a 130 fs pulse width and a 110-MHz repetition rate. The infrared (IR) beam exiting the laser was first shaped by a telescope and then directed into the Olympus FV300 scanning unit and the Olympus BX51 microscope. Real-time scanning was accomplished with a pair of galvanometer mirrors inside the scanning unit. An IR water-immersion objective of working distance 2 mm (LUMplanFL/IR /N.A. 0.9, Olympus, Tokyo, Japan) was used to focus the laser beam into the observed skin specimen. The average illumination power applied onto the surface of the specimen was 100 mW. A mean power of 100 mW with a 110-MHz repetition rate was chosen (pulse energy of ). Different optical harmonic signals were separated with another beam-splitter (BS 1, 490DRXR, Chroma technology, Rockingham, VT). The backward-propagating harmonic signals were detected by different photomultiplier tubes (PMT) (Harmamatsu R4220P for third harmonic generation (THG); and Harmamatsu R943-02 for second harmonic generation (SHG), Bridgewater, Westport, CT, USA) with 410- and 615-nm narrowband interference filters (D410/30X and D615/10X, respectively, Chroma technology) in front, which were synchronized with the galvanometer mirrors. For in vivo observation, the laser beam exiting the objective was scanned across the specimen and the backward-propagating multimodal nonlinear signals from the specimen were collected with the same water-immersion objective. The microscope objective employed to focus the laser beam also acted as the collection lens to collect the backward propagation SHG, THG, and two-photon fluorescence (TPF). The backward-propagating TPF signals, which were not deflected with the dichroic mirror, were separated with another beam-splitter (BS 2, 865dcxru, Chroma technology) and detected by another PMT (Harmamatsu R928P). We employed long-pass emitter LF635/LP-A-000 (Semrock) and E700lp (Chroma technology) in front of the PMT for TPF to select wavelengths longer than 655 and 700 nm and block shorter wavelengths, respectively. We used short-pass emitter E700sp-2p (Chroma Technology), which transmits wavelengths shorter than 700 nm and blocks longer wavelengths. The scanning rate of the FV300 scanning unit was corresponding to two frames per second for a resolution. Spatial resolution was and for SHG and THG signals in the plane, respectively. Resolution was on the order of 1 μm in the plane. Specimens were mounted on a fixed stage within the microscope. Optical observations were made as follows:
2.4.Measurement of Cellular Numbers and CD207 Expression of Langerhans Cells Labeled with Alexa Fluor 647-Rat Anti-Mouse CD207LCs are located at an average depth of .20 We collected the acquired images from the skin at a depth of 15 μm and from the DLN specimens from the mice that received EC sensitization on day one (D1) and on day five (D5), respectively. A total of 10 images and six fields randomly chosen within each image were selected from each mouse for analysis. Multiple measurements of the same image are counted as independent samples. In brief, optical sectioned images were saved as uncompressed 8-bit grayscale tiff files and analyzed using the NIH Image software program (NIH Image J 1.44). Signal levels were converted to a numerical value using a grayscale from 0 (white) to 255 (black). The background noise was subtracted from all acquired values. Cell numbers were measured using the Particles function of ImageJ, where a single value is entered and particles smaller than that value are then ignored. We used 10 μm and particles (actually cells) smaller than that value were ignored.20 To include every possible cell, we kept circularity at the default 0.00 to 1.00. Before analysis, we checked all the counted particles shown as numbered outlines using the “show” function, and compared that with the original image. The density of LCs was also determined (). The quantitative analysis of TPF emitted from the Alexa Fluor 647-rat anti-mouse CD207 has been described previously.19 To account for variations in the grayscale intensity due to possible nonuniformity of skin and/or lymph node tissue, mean gray values (MGVs, average gray value within the region of interest) were measured to determine the levels of TPF. 2.5.Statistical AnalysisData are expressed as deviation, unless otherwise specified. The comparison of the cell counts and the relative TPF intensity among groups were expressed as median (the 50th percentile) and interquartile range (the range of values between the 25th and 75th percentile of distribution) and were statistically analyzed using a nonparametric Mann-Whitney test. All statistical analyses were performed with Prism software (Graph Pad, San Diego, CA). A value of less than 0.05 was considered to indicate a statistically significant difference. 3.Results3.1.Observation of MHC Class II Expressing Cells Labeled with Alexa Fluor 700-Rat Anti-mouse MHC Class II mAbHuman and mouse DCs in the epidermis are easily identified based on the surface expression of the MHC class II molecules. We took advantage of the nonlinear two-photon fluorescence (TPF) from Alexa Fluor 700 under an excitation wavelength of 1230 nm of the Cr:forsterite femto-second (fs) laser.19,21 A typical emission spectrum acquired from Alexa Fluor 700 conjugated mAb against MHC class II was measured [Fig. 1(a)]. We acquired sequential images along the plane from the surface of the fixed skin. We found some red spot signaling located within the epidermis [Fig. 2(a) to 2(c)]. We confirmed the nonlinear signal by verifying that the TPF signals we observed had a central emission wavelength around 703 nm. We repeated our experiment in vivo. We observed the same characteristic distribution of red spot signals outlining some cellular morphology within the epidermis [Fig. 2(d) to 2(e)]. We measured the -sectioned nonlinear images in the skin of live mice and confirmed that these red spot signals were located at the basal epidermis [Fig. 2(f)]. Next we examined intact lymph nodes by Cr:forsterite laser-based nonlinear microscopy to determine their suitability for lymph nodes imaging. We acquired sequential images along the -axis from the surface of the fixed DLN. Some red signals representing the TPF from the Alexa Fluor 700-rat anti-mouse MHC Class II molecules were present in the inner paracortex area, a T cell-rich zone (Fig. 3).22,23 Deduced from their locations, these brightly stained cells within skin and DLN might be some MHC class II expressing cells, including DCs and LCs. 3.2.Observation of CD207 Expressing LCs Labeled with Alexa Fluor 647-Rat Anti-mouse CD207 mAbCD207 is a marker that persists during LC maturation and migration and can therefore be used as a tracer.22 By intraperitoneally injecting Alexa Fluor 647-rat anti-mouse CD207 mAb into mice as our fluorescent probe, we could trace the TPF signal from Alexa Fluor 647. A typical emission spectrum acquired from the skin surface is shown in [Fig. 1(b)]. We acquired sequential sectioned images along the plane from the surface of the fixed skin and found some cells with extending dendrites located within the epidermis (Fig. 4 and Video 1). We confirmed the nonlinear signal by verifying that the TPF signals we observed had a central emission wavelength around 677 nm. To verify the specificity of the labeling of CD207 and of the imaging of LCs, we use the Alexa Fluor 647-rat IgG2a isotype control (IC) mAb. We did not observe any fluorescent signals representing the TPF from the fluorescent dye Alexa Fluor 647 in the mice group receiving IC mAb (data not shown). We found that the average size of the cell body of LCs was . The average epidermal LC density was , similar to the reported value of .20,22 We verified that our technique could specifically image and trace the LCs in situ, aiding to investigate the maturation and migration process of LCs under the real physiological and pathological conditions. 3.3.Comparison of Cellular Counts and Relative CD207 Expression of LCs Between OVA-Treated and OVA-Untreated Skin and DLNsLCs may have an important role in the initiation of AD.24 We use OVA EC sensitization to induce an inflammatory skin mimic AD to explore the role of CD207-expressing LCs in the initiation of allergen induced skin sensitization. We used the -plane nonlinear images taken from fixed skin and lymph node samples of mice received EC sensitization and Alexa Fluor 647-rat anti-mouse CD207 mAb for quantitative analysis. The LC counts and the relative expression levels of CD207 represent by relative TPF intensity measured by optical analysis of the acquired images were compared [Fig. 5(a) to 5(d)]. LC counts in skin and DLNs. We observed decreased counts of epidermal LCs in D5 OVA-treated skin compared to D1 OVA-treated skin (D5 treated versus D1 treated ) [Fig. 5(a)]. We observed an increased number of LCs in DLN of OVA-treated skin on D5 (D5 treated versus D5 untreated ) [Fig. 5(b)]. Our result indicated that both the decreased LCs within the OVA-treated skin and the increased LCs arrived the DLNs were associated with the dynamic migration of LCs after OVA-induced EC sensitization. Relative CD207 expressions in skin and DLNs. The relative CD207 expression in the OVA-treated skin was decreased compared to that in the OVA-untreated skin on D1 (D1 treated versus D1 untreated ) [Fig. 5(c)]. The relative CD207 expression levels in the DLNs of OVA-treated skin were increased on D5 (D5 treated versus D5 untreated ) [Fig. 5(d)]. Our result indicated that both the decreased CD207 expression of LCs within the OVA-treated skin and the increased CD207 expression of LCs arrived the DLNs were relevant to the functional phenotype of LCs after OVA-induced EC sensitization. 3.4.In Vivo Imaging of Cells Within Normal and D1 OVA-Treated SkinTo determine whether we could trace and image the LCs in vivo, we intraperitoneally injected Alexa Fluor 647-rat anti-mouse CD207 mAb into mice, and sectioned images were acquired 6 h later. We observed some LCs within the epidermis of OVA-untreated mice [Fig. 6(a) and Video 2], but we did not find any LCs in the epidermis of mice received injection of Alexa Fluor 647-rat IgG2a IC mAb [Fig. 6(a)]. In the following experiment we selected the long-pass emitter LF635/LP-A-000 to specifically collect the fluorescent signals of emission wavelength , e.g., those from Alexa Fluor 647-rat anti-mouse CD207 mAb ( under excitation wavelength 1230 nm), and to omit the signals from SHG with .19 Thus we were able to more specifically collect the fluorescent signals emitted from the Alexa Fluor 647-rat anti-mouse CD207 mAb; thus we were suitable for explore the physiological conditions within the dermis which were mapped by SHG. When we observed the epidermis of D1 OVA-treated skin, we found nearly no LCs in the epidermis; however, there were cells intercalated among collagen fibers [Fig. 6(b) and Video 3]. We acquired the and plane sectional images simultaneously and found that the CD207-expressing cells were located within the superficial layer of the dermis [Fig. 6(c) and Video 3]. Interestingly, Soumelis et al. reported that many LCs were found only within the epidermis of normal skin while many CD207-expressing DCs were found within the dermis of lesional skin.25 Similar patterns of distribution of cells were observed in our experiment, suggesting that these cells may be epidermal LCs that migrated to the dermis or the occurrence of dermal DCs within the OVA sensitized skin. 3.5.In Vivo Imaging of OVA Within Normal Skin and Ex Vivo Imaging of OVA in Skin DLNsIn an attempt to directly measure the antigen capturing capabilities of DCs in vivo, we administered OVA-Alexa Fluor 647 conjugate into BALB/c mice via the intraperitoneal route, and sectioned images were acquired 6 h later. Again, we use the long-pass emitter LF635/LP-A-000 to specifically collect the fluorescent signals emitted from the OVA-Alexa Fluor 647 conjugate under the physiological conditions. We did not observe any fluorescent signal from the epidermis; however, we did find many clusters of fluorescent signals from the OVA-Alexa Fluor 647 conjugate within the dermis [Fig. 7(a) and Video 4]. We acquired the and plane sectional images simultaneously and found that these OVA were located within the superficial dermis [Fig. 7(b)]. Recently, it has been reported that after subcutaneous injection of FITC-OVA probes, which accumulated in dermal cells but not in epidermal cells.26 Our approach showed the similar result that redistribution of systemic sensitizing Ag into skin were within the dermis. We then observe the excised skin DLNs ex vivo and found many signals of OVA-Alexa Fluor 647 conjugate from the cells within outer and inner paracortex (Fig. 8 and Video 5), suggesting the accumulated OVA-carrying cells within the DLNs after application of OVA-Alexa Fluor 647 conjugate.23 Thus we confirmed that Cr:forsterite laser-based nonlinear microscopy complemented with exogenous fluorescent probe could detect the antigen-carrying cells or the occurrence of antigen within skin and LNs. 3.6.Co-Localization of OVA with CD205-Expressing Dendritic Cells in Skin DLNsCD207 was frequently co-expressed with CD205.27 We first injected Alexa Fluor 700-rat anti-mouse CD205 mAb intraperitoneally and injected OVA-Alexa Fluor 647 conjugate 6 h later. We used the long-pass emitter E700lp to collect the fluorescent signals emitted from the Alexa Fluor 700-rat anti-mouse CD205 mAb ( under excitation wavelength 1230 nm), and the short-pass emitter E700sp-2p to collect the fluorescent signals emitted from the OVA-Alexa Fluor 647 conjugate. We found that the yellow signal from OVA-Alexa Fluor 647 conjugate were adjacent to the red signal from Alexa Fluor 700-rat anti-mouse CD205 mAb (Fig. 9 upper panel). When we merged the images obtained from different emitters, we observed that there was an overlap between populations of cells expressing CD205 and populations of OVA-capturing cells in most of field (Fig. 9, lower panel), implying that cells co-expressing CD207 are capable of uptake OVA-Alexa Fluor 647 conjugate and transport it to the DLN for initiation of the specific T cell immune response. 4.DiscussionThere are two major methods for in vivo imaging of live tissues, cells, or molecules. One approach is to introduce fluorescent proteins YFP or GFP, which selectively target the tissue of interest in transgenic mice to highlight various cellular or molecular features.28 The other approach is to take advantage of endogenous molecules (e.g., NADPH), which provides valuable information on the tissue architecture without the need for exogenous labeling.29 The drawback of the fluorescent proteins method is the inability to quantify the expression levels of molecules of interest. The endogenous molecules method lacks specificity, and only limited molecules are available. Our technique provides two levels of specificity. First, the molecules are specifically recognized by the mAb, and the nonspecific binding effects of the Alexa Fluor 647-rat anti-mouse CD207 were controlled because no LCs were seen within the Alexa Fluor 647-rat IgG2a isotype control mAb group [Fig. 6(a)]. Second, only the limited exogenous fluorophores (e.g., Alexa Fluor 647) are excited under Cr:forsterite laser-based nonlinear microscopy because much of the autofluorescence from endogenous fluorophores was reduced.19 Our method is a promising approach that could be used to unequivocally identify and track LCs by in vivo imaging. We were limited by the fact that the resolution of some images shown appears rather low. Besides, we could stain LCs in fixed skin samples (Fig. 4), but only a few LCs in skin of live mice (Fig. 6). The reason was fluorescence changes associated with tissue fixation.19 This discrepancy of imaging reflects the difference in biophysical properties of epidermis between the live and the dead/fixed skin of mice, hence the different TPF intensities from CD207 mAb-conjugated Alexa Fluor 647. Prerequisite roles of skin DCs and potentially of LCs in the development of AD have been suggested.24 An increase in LC proliferation has been reported to be required to induce the Th2 polarization of T cells and maintain disease.30 Our data demonstrated an increased number of LCs in the DLNs in the later sensitization phase on D5.23 The dynamic changes of LCs seen in our results are associated with the EC sensitization course. It is interesting to note that found some occurrences of migratory LCs or dermal DCs within the dermis of the mice. All published descriptions of dermal DCs have so far been in the mouse.31 In the LC paradigm, no distinctions could be drawn between epidermal LCs en route through the dermis and the novel dermal DCs in situ. It turned out that these dermal DC in the dermis were a dermis-resident population, unrelated to LC, and they can be readily detected in the draining lymphoid organs called lymph-node-resident DCs.31 Our results confirm a similar result in that a decrease and/or disappearance of LCs in the epidermis was directly correlated with the increased number of LCs or dermal DCs in the superficial dermis and in the DLNs.32 We suggest LCs play some role in the initiation of OVA induced skin sensitization use EC sensitization. Our model used here is only a model of epicutaneous sensitization induced inflammatory skin. Our study were similar to Spergel et al. that the epidermal layer was approximately three to five cell layers thick in OVA sensitized sites compared with two to three cell layers thick in saline sensitized sites.19,33 Although our model is different from the originally described model,33 the epidermal hyperkeratosis/thickening and dermal fibrosis shown here indicated that our murine model shared the characteristic cutaneous inflammatory response associated with AD. In our paper, we used Alexa Fluor fluorophores for molecular labeling and in vivo imaging, so the toxicity of Alexa fluor used should be addressed. A review of published literature on the toxicity of some widely used fluorophores was conducted by searching 26 comprehensive biomedical and chemical literature databases and analyzing the retrieved material.34 The Alexa Fluor fluorophores were searched without accompanying toxicity-related reports. Besides, no toxicity or developmental abnormalities resulting from treatment with Alexa Fluor 647 conjugate were observed in an in vivo imaging experiment of developing zebrafish.35 The Alexa fluorophores we used were administrated into mice in vivo. However, applying these fluorophores to patients and determining the safe dose of these fluorophores will require further clinical and laboratory investigation. With Alexa-Fluor 647 conjugates used as a tracer, we showed the dynamic migration and functional phenotype of cells and the existence and encounter of OVA. We showed that LCs are present in the skin and that they migrate to the DLN upon OVA induced EC sensitization. The distribution of OVA upon intraperitoneal injection and co-localization of OVA with LCs in DLN has been readily demonstrated by our data. The respective data generated by Cr:forsterite laser-based multimodality nonlinear microscopy validate our method and the sensitization model, but also give new insights into that CD207 plays any role of allergen uptake in the development of allergic sensitization in human beings such as AD. Our approach using Cr:forsterite laser-based nonlinear microscopy complemented with an exogenous fluorescent probe demonstrates the potential to do flow cytometry and to perform immunohistochemistry (IHC) in vivo, which might be applied to real-time and specific detection of antigens/allergens and to evaluate the interaction between immune cells in the skin and in the lymph node in vivo. AcknowledgmentsThe authors would like to acknowledge the support from the National Science Council of Taiwan under NSC 99-2314-B-002-024-MY3, the National Taiwan University Hospital under NTUH 099-001394 and the NTU Research Center for Medical Excellence. ReferencesD. Y. M. LeungT. Bieber,
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