Strategies To Identify and Eliminate Background Interference in IHC and IF Tissue Section Applications

Craig Pow, Ph.D. Director, Technical Service [email protected]

16th Annual Tri-State Plus One Histology Symposium Des Moines, IA May 8-10, 2019

2019 Annual Tri-State Plus One Histology Symposium Objectives

Upon completion of this workshop, participants will be responsible to: ▪ Identify Sources of Non-Specific in Tissue Based Assays

▪ Evaluate Options Particular to the Background Source(s)

▪ Implement Techniques to Reduce or Eliminate Unwanted Staining

2019 Annual Tri-State Plus One Histology Symposium 2 Introduction

Overview PART 1:

▪ Background / Issues ▪ IHC Workflow ▪ Sources of Background ▪ Strategies to Eliminate Background ▪ Summary

PART 2: Immunofluorescence

2019 Annual Tri-State Plus One Histology Symposium 3 What is Background?

Unwanted non-specific staining observed on the test specimen. ▪ Trace ▪ Moderate ▪ Severe

Arise from one or more sources: ▪ Inherent to the specimen ▪ Detection reagents ▪ Combination of tissue & reagents

Oxidized/polymerized substrate reaction product deposited on the specimen.

2019 Annual Tri-State Plus One Histology Symposium 4 Problems Arising From Background Staining

Assay Validation ▪ What is specific?

Interference with specific staining ▪ Confusion with antigen expression

False positives ▪ Staining in same cell type

Goal: Clear, Unambiguous View of Target Antigen

2019 Annual Tri-State Plus One Histology Symposium 5 Background – Now What?

2019 Annual Tri-State Plus One Histology Symposium 6 IHC Workflow

Step 1: Tissue Preparation/Antigen Retrieval

Step 2: Quenching / Blocking

Step 3: Primary Incubation

Step 4: Secondary Detection Reagent

Step 5: Substrate / Chromogen

Step 6: Counterstain / Mount

Step 7: Visualize

2019 Annual Tri-State Plus One Histology Symposium 7 IHC Workflow

Step 1: Tissue Preparation/Antigen Retrieval – Protocol Optimization

Step 2: Quenching / Blocking

Step 3: Primary Antibody Incubation

Step 4: Secondary Detection Reagent Main Focus

Step 5: Substrate / Chromogen

Step 6: Counterstain / Mount

2019 Annual Tri-State Plus One Histology Symposium 8 Identify the Source(s) of the Background

Run Defined Controls ▪ Positive (Protocol Optimization) ▪ Negative (Deletions)

Key Steps in One-Step Polymer IHC Detection Procedure / Workflow

Primary Antibody Incubation Enzyme Polymer Incubation React with Substrate

2019 Annual Tri-State Plus One Histology Symposium 9 But …..

“..nothing has changed.”

2019 Annual Tri-State Plus One Histology Symposium 10 Well something has …

1. Antigen Retrieval Protocol Optimization 2. Times, Temperature, Washes (Positive Control)

3. Heterogenous Tissue Block ▪ Cell Type ▪ Antigen Expression ▪ Vascularization ▪ Inflammation ▪ Necrosis

2019 Annual Tri-State Plus One Histology Symposium 11 First Deletion Negative Control

Apply Substrate Working Solution Only (Omit Other Detection Reagents) ▪ Treat section(s) as per SOP. ▪ Just prior to applying primary antibody, add substrate working solution. ▪ Apply substrate for “pre-determined” time. ▪ Do not counterstain (i.e. no hematoxylin). ▪ View.

Determines Effectiveness of Quenching Step Reagents (Endogenous Enzyme Activity)

2019 Annual Tri-State Plus One Histology Symposium 12 Staining with First Deletion Control

Issues arising from: ▪ Lack of quenching (omitted; diluted/old reagent; time) ▪ Inappropriate enzyme (HRP or AP) quench

Endogenous alkaline phosphatase (AP) and peroxidase (HRP) activities in frozen, acetone-fixed intestine section revealed with AP substrate (magenta) and HRP substrate (brown). Hematoxylin counterstain (blue).

2019 Annual Tri-State Plus One Histology Symposium 13 Quenching Endogenous Enzyme Activity in Tissue Sections

WITHOUT WITH

Presence of endogenous peroxidase activity indicated by application of substrate (DAB) alone, no other detection reagents. Acetone-fixed frozen tonsil sections, hematoxylin counterstain (blue).

2019 Annual Tri-State Plus One Histology Symposium 14 Quenching Endogenous Enzyme Activity in Tissue Sections

WITHOUT WITH

Presence of endogenous alkaline phosphatase activity indicated by application of substrate (Fast Red) alone, no other detection reagents. Acetone-fixed frozen tonsil sections, hematoxylin counterstain (blue).

2019 Annual Tri-State Plus One Histology Symposium 15 Quenching Methods

Endogenous peroxidase:

1) Hydrogen peroxide (H2O2) – Most commonly used ▪ 3% H2O2 in water Home brew / ▪ 0.3% in Methanol (MeOH) Commercial

2) Alternative methods: ▪ Andrew S.M., Jasani, B. (1987) Histochem J. 19: 426-430. ▪ Malorny, U. et al (1988) J. Immunol. Meth. 111(1):101-107

2019 Annual Tri-State Plus One Histology Symposium 16 Quenching Methods

Endogenous Alkaline Phosphatase: Primarily an issue for frozen sections as the AP enzyme is heat labile, hence not as greater an issue for paraffin embedded material.

1) Add Levamisole (1 – 5 mM) to AP Substrate Working Solution. 2) Acidic solution ▪ Ponder, B. A. and Wilkinson, M. M. (1981) J. Histochem. Cytochem. 29(8):981-984

2019 Annual Tri-State Plus One Histology Symposium 17 Enzyme Substrates

1) Not All (HRP/AP) Substrates Are Equal

Differences: ▪ Concentration ▪ Reaction kinetics Varying Sensitivity Could Generate ▪ Solvents Excessive Color Deposition (background) ▪ Stability of working solution

2) Converting from HRP to AP (vice versa) Requires Re-Optimization

3) Be Aware of Inherent Pigment and Tissue Elements Interpreted in Tissue Section as “Background” (Hematoxylin Counterstain)

2019 Annual Tri-State Plus One Histology Symposium 18 Second Deletion Negative Control

Apply Substrate & Enzyme Conjugated Detection Reagent (No primary antibody)

▪ Treat section(s) as per SOP. ▪ Just prior to applying primary antibody, apply HRP polymer. ▪ Apply (DAB) substrate for usual time. ▪ Do not counterstain (i.e. no hematoxylin). ▪ View. Background staining in Absence of Primary Antibody. (Note counterstain).

Determines Whether Detection Reagent is Binding Non-Specifically (Not Sourced from Specimen – Introduced/Exogenous Source)

2019 Annual Tri-State Plus One Histology Symposium 19 Staining with Second Deletion Control

Issues Attributed to:

▪ Species cross-reactivity ▪ Inadequate blocking ▪ Inadequate buffer washes ▪ Concentration too high ▪ Decrease incubation time

Background staining in absence of primary antibody (Hematoxylin counterstain)

2019 Annual Tri-State Plus One Histology Symposium 20 Staining with Second Deletion Control

Species Cross-Reactivity: Without Specific Mouse Ig Block ▪ Species on species ➢ Mouse on mouse / Xenograft model ✓ Commercial (block) options ✓ Change primary antibody species ✓ Conjugate primary antibody

With Specific Mouse Ig Block ▪ Closely related species ➢ Anti-mouse IgG on rat tissue (vice versa) ✓ Use pre-adsorbed reagent ✓ Dilute in serum from specimen

2019 Annual Tri-State Plus One Histology Symposium 21 Staining with Second Deletion Control

Blocking: ▪ Verify appropriate serum (dilution, time) ▪ Alternatives to normal sera (e.g. gelatin or animal free) ▪ Add detergent to wash buffer (0.1% - 0.5%)

WITHOUT Animal-Free Block WITH Animal-Free Block

Adjacent tissue sections stained with HRP/DAB method without protein block and with protein block (sera alternative animal-free block). No counterstain.

2019 Annual Tri-State Plus One Histology Symposium 22 Staining with Second Deletion Control

Other Contributing Factors:

▪ Inadequate buffer washes ▪ Concentration too high Protocol Optimization Check with Positive Control Data ▪ Decrease incubation time

Shorter Wash Time Longer Wash Time Adjacent sections exposed to varying buffer wash times after polymer incubation step. Hematoxylin Counterstain.

2019 Annual Tri-State Plus One Histology Symposium 23 Staining with Second Deletion Control

Avidin/Biotin (non-polymer) based Deletion Controls ▪ Substrate Only ▪ Substrate & (Strept)Avidin enzyme Conjugate ➢ 0.05% avidin + 0.005% biotin in buffer for effective blocking ▪ Substrate & (Strept)Avidin enzyme Conjugate & Biotinylated Secondary Key Steps in Two-Step (Strept)Avidin/Biotin IHC Detection Procedure

Primary Antibody Biotinylated Enzyme conjugated React with Substrate Incubation Secondary Incubation (Strept)Avidin / ABC

2019 Annual Tri-State Plus One Histology Symposium 24 Complete Detection System

Inappropriate Staining ▪ Ensure primary antibody has been validated (commercial source / purified?) ➢ Recommended guidelines: ✓ Titer ✓ Time Check positive ✓ Temperature control tissue ✓ Diluent

▪ Non-purified primary antibody (e.g. ascites, culture media, whole sera) ➢ Run titer series ➢ Dilute in buffer with blocking agent (e.g. serum and/or detergent) ➢ Incubate in buffer containing 2% - 5% normal serum derived from the same species as the tissue. ~ 1 hr at R/Temp prior to applying to tissue.

2019 Annual Tri-State Plus One Histology Symposium 25 What Is An Appropriate Negative Control?

Appropriate Negative Controls: 1) Substituting primary antibody for a non-immune Ig.

2) Preadsorption of the primary antibody with the immunogen used to generate the primary antibody.

3) Use an irrelevant primary antibody.

4) Removal of target antigen (digestion). Treated vs Untreated.

Simply omitting the primary antibody

2019 Annual Tri-State Plus One Histology Symposium 26 Further Tools and Resources

Resource Tools IHC Literature Texts / Journals Workflows Product Selection Guides Troubleshooting Guides Vendor Websites Protocols Data Sheets Technical Support Video Tutorials JOVE YouTube

2019 Annual Tri-State Plus One Histology Symposium 27 Summary

GOAL: Clear, Unambiguous View of Target Antigen

Implement Adjustments

Troubleshooting

Negative Controls

Positive Controls

Familiar with IHC Workflow

2019 Annual Tri-State Plus One Histology Symposium 28 Questions?

2019 Annual Tri-State Plus One Histology Symposium 29 Introduction

Part 2: Immunofluorescence

▪ Introduction to

▪ Introduction to immunofluorescence ▪ Sources of background fluorescence (autofluorescence) in immunofluorescence

▪ Conventional solutions to reduce autofluorescence ▪ New solutions to reduce autofluorescence

2019 Annual Tri-State Plus One Histology Symposium 30 Fluorescence

Definition: Absorption of electromagnetic radiation at one wavelength and re-emission at another lower energy wavelength.

Fluorescein (or FITC) Absorption 492 nm Emission 515 nm Wavelength (nm)

2019 Annual Tri-State Plus One Histology Symposium 31 Immunofluorescence

▪ Determination of the location of an antigen using an antibody labelled with a fluorescent dye () (direct)

▪ Usually, a primary antibody that is not labelled is used to bind the antigen, and a secondary antibody follows that is labelled with a fluorophore (indirect)

2019 Annual Tri-State Plus One Histology Symposium 32 Fluorescence

▪ Standard (epifluorescence) vs. laser scanning ▪ Light sources (LED, metal halide, mercury, xenon, laser) have different spectral distributions. Some will illuminate brighter in the UV region than others for example.

Figure: http://zeisscampus.magnet.fsu.edu/ articles/lightsources/metalhalide.html

2019 Annual Tri-State Plus One Histology Symposium 33 Sources of Background Fluorescence

Unwanted non-specific fluorescence observed on the test specimen.

Arise from one or more sources: ▪ Inherent to the specimen – “Autofluorescence” ▪ Detection reagents – e.g. Primary / Secondary ▪ Combination of tissue & reagents Fluorescent compounds endogenous and/or introduced on the specimen

Don’t be like this guy. Get a clue and identify the background source(s)

2019 Annual Tri-State Plus One Histology Symposium 34 Basic IF Workflow

Untreated Step 1: Tissue Preparation (Antigen Retrieval)

Step 2: Protein Blocking

Step 3: Primary Antibody Incubation

Step 4: Secondary Antibody Fluorophore Conjugated Sodium borohydride Sudan Black B Step 5: Coverslip with Antifade Medium

Step 6: Visualize

2019 Annual Tri-State Plus One Histology Symposium 35 IF Workflow

Step 1: Tissue Preparation (Antigen Retrieval)

Step 2: Protein Blocking ▪ Protocol Optimization Step 3: Primary Antibody Incubation ▪ Positive Controls ▪ Negative Controls Step 4: Secondary Detection Reagent As per IHC Step 5: Coverslip / Visualize

Background Fluorescence Arising from the Detection Reagents

2019 Annual Tri-State Plus One Histology Symposium 36 What is Autofluorescence?

Autofluorescence:

Unwanted, background fluorescent signal arising from endogenous tissue components and/or induced through the use of a fixative. Adversely affects signal to noise ratio.

Three main sources: Formalin fixation Red blood cells 1. – tissue pigment/granules

2. Aldehyde fixed material (i.e. formalin, paraformaldehyde) 3. Endogenous tissue elements (RBCs, Collagen)

2019 Annual Tri-State Plus One Histology Symposium 37 Tissue Autofluorescence

Fixation:

▪ Formalin/formaldehyde ➢ Most common for IF, leads to blue and green fluorescence (FFPE)

▪ Glutaraldehyde ➢ Leads to more extensively crosslinked tissue and higher fluorescence in yellow and red spectral region

2019 Annual Tri-State Plus One Histology Symposium 38 Endogenous Fluorescence

Endogenous fluorescence that is particularly problematic in animal tissue

Source Fluorescent Channels Reason Red Blood Cells Green and Red Hemoglobin and (RBCs) Oxidative Stress Connective Tissue Blue, Green and Red Protein Cross-Links (, collagen) Lipofuscin Green and Red Lipid Cross-Links

2019 Annual Tri-State Plus One Histology Symposium 39 Endogenous Fluorescence

Figure: Monici, M. (2005) Biotechnol. Ann. Rev., 11:227-256

Fluorescent molecules, protein side chains, protein cross-links: NAD(P)H, chlorophyll, porphyrins, collagen, elastin, , , phenylalanine, , flavin, , indoleamine, melanin, lipofuscin

2019 Annual Tri-State Plus One Histology Symposium 40 Endogenous Fluorescence

A retinal lipofuscin fluorophore molecule

Conjugated double bonds

Aromatic group

2019 Annual Tri-State Plus One Histology Symposium 41 Differences Among Tissue Types

Fixed tissue More problematic than frozen

Spleen, Kidney, Pancreas Especially problematic for autofluorescence

Brain Tissue Significant amount of fluorescence due to lipofuscin; punctate bright signals

2019 Annual Tri-State Plus One Histology Symposium 42 Far-Red and Near-IR Dyes

Far-Red Dyes: Used to avoid the autofluorescence of tissue elements

Figure: http://www.biomedima.org/?modality=5&slide=396

2019 Annual Tri-State Plus One Histology Symposium 43 Conventional Solutions

▪ Chemical treatments

▪ Photo treatments

▪ Masking treatments

▪ Quenching treatments

2019 Annual Tri-State Plus One Histology Symposium 44 Chemical Treatments

▪ Potassium permanganate (KMnO4); oxidative reaction

▪ Hydrogen peroxide (H2O2); oxidative reaction

▪ Sodium borohydride (NaBH4); reductive reaction

▪ Glycine; addition reaction

▪ Ammonia/ethanol; addition reaction

2019 Annual Tri-State Plus One Histology Symposium 45 Chemical Treatments

▪ Can be destructive to tissue (KMnO4, H2O2)

▪ Can be inconvenient and not reproducible (NaBH4)

▪ Generally not very effective for most autofluorescence

▪ Most autofluorescence is due to cross-links in tissue, and these are difficult to break once fixed and mounted

2019 Annual Tri-State Plus One Histology Symposium 46 Photo Treatments

UV or Visible Light Exposure: ▪ Illuminating with high intensity light to irreversibly photo-oxidize fluorescent elements ▪ Reasonably effective for some tissue types, however requires 24-48 hours of treatment, and requires lamps and equipment that many laboratories do not possess ▪ Not convenient for large numbers of slides ▪ Not effective for lipofuscin

2019 Annual Tri-State Plus One Histology Symposium 47 Masking Treatments

A hydrophobic dye molecule binds to the tissue and absorbs (masks) incident radiation (also called dark quenching)

▪ Sudan Black: good for lipofuscin; introduces fluorescence in far-red

▪ Trypan Blue: somewhat effective in flow cytometry; introduces far-red fluorescence

▪ Eriochrome Black T: somewhat effective for FFPE tissue

2019 Annual Tri-State Plus One Histology Symposium 48 Quenching Treatments

Copper Sulfate ▪ Can be used to quench the fluorescence of the tissue. Copper in the +2 oxidation state can readily accept electrons from excited state molecules and quench them.

▪ However the same mechanism quenches the fluorophore on the secondary if copper is remaining in the sample.

▪ When tissue is washed with buffer, most of the copper washes away.

2019 Annual Tri-State Plus One Histology Symposium 49 Previous Investigations

Untreated Eriochrome Black T

FFPE Human Tracheal Tissue.

Reference: Sodium Borohydride Sudan Black B Davis, et al., (2014) J. Histochem Cytochem, 62(6):405-423

2019 Annual Tri-State Plus One Histology Symposium 50 Previous Investigations

Yang J, Yang F, Campos LS et al. Quenching autofluorescence in tissue immunofluorescence. Wellcome Open Res 2017, 2:79 (doi: 10.12688/wellcomeopenres.12251.1)

(UV) ▪ Ammonia (NH3) ▪ Copper (II) sulfate (CuSO4) ▪ Trypan Blue (TB), ▪ Sudan Black B (SB), ▪ Commercial Ink Based Reagent & combinations of these treatments could reduce AF in paraffin and frozen sections of placenta and teratoma in FITC, Texas Red and Cy5.5 channels.

2019 Annual Tri-State Plus One Histology Symposium 51 Vendor AF Quenching Products

Company Product Target Compound

MaxVision MaxBlock AFR Kit Lipofuscin & Ink based Aldehyde induced Neuromics FluoMute AF Blocking Lipofuscin & CuS04 based Agent Aldehyde induced Millipore/Sigma AutoFlu. Eliminator Lipofuscin Ink based Reagent Biotium TrueBlack Lipofuscin Ink based

“Home Brews” Target Compound Sodium Borohydride Aldehyde Induced Chemical based

Sudan Black Lipofuscin Ink based

2019 Annual Tri-State Plus One Histology Symposium 52 Reduction of Lipofuscin

Ink based reagents are effective against lipofuscin.

Differences in effectiveness may be apparent across the spectrum.

Imaged sourced directly from Biotium website: https://biotium.com/product/trueblack- lipofuscin-autofluorescence-quencher/

2019 Annual Tri-State Plus One Histology Symposium 53 Latest Advances

Most RecentUntreated Technology: ▪ A solution based on hydrophilic molecules binding to tissue that combines the effects of masking and quenching.

TrueVIEW Autofluorescence Quenching Reagent: ▪ Aqueous, Non-Fluorescent

▪ ShortSodium Treatment borohydride (2-5 minutes)Sudan Black B ▪ Short Wash After Treatment (2-5 minutes) ▪ Can Be Scaled Up For Increased Slide Volume

2019 Annual Tri-State Plus One Histology Symposium 54 Comparison of Autofluorescence Reduction (AFR) Treatments

UntreatedUntreated Human Pancreas

Collagen TrueVIEW

Formalin fixation Red blood cells Sodium borohydride Copper Sulfate Sudan Black B Sodium Borohydride

2019 Annual Tri-State Plus One Histology Symposium 55 Mode of TrueVIEW Treatment

Untreated Specific signal (fluorophore labelled secondary antibody)

Fluorescent endogenous “elements”

AFR Treatment Sodium borohydride Sudan Black B

Specific signal retained, with background signal reduced

2019 Annual Tri-State Plus One Histology Symposium 56 Human Spleen

Without Treatment With AFR Treatment

Autofluorescence in TrueVIEW Treatment green channel

Sodium borohydride

Adjacent human spleen tissue sections double stained using primary antibodies against CD20 (red) and Ki67 (green) antigens. Left, untreated; right treated. White arrowsAutofluorescence indicated true antigen in staining. TrueVIEW Treatment red channel 2019 Annual Tri-State Plus One Histology Symposium 57 If You Encounter AF …

2019 Annual Tri-State Plus One Histology Symposium 58 …Glove Up and Pinpoint the Source

AF Source Treatment

Tissue elements and/or TrueVIEW AFR use of aldehyde fixative (Vector)

MaxBlock AFR Kit (MaxVision)

FluoMute AF Blocking Agent (Neuromics) Lipofuscin AutoFlu. Eliminator Reagent (Millipore/Sigma)

TrueBlack (Biotium)

2019 Annual Tri-State Plus One Histology Symposium 59 Conclusions

1) Beyond the detection reagents, fixation and endogenous tissue elements can introduce significant autofluorescence (AF) background in an immunofluorescence (IF) assay.

2) Determine the source of the AF – lipofuscin, tissue elements, aldehyde induced.

Sodium3) Once borohydride the source has been identified, apply appropriate measures to reduce the AF.

4) Run assay again and ensure AF has been reduced in the part(s) of the spectrum you are targeting. Autofluorescence in red channel 2019 Annual Tri-State Plus One Histology Symposium 60 Questions?

Autofluorescence in TrueVIEW Treatment green channel

Sodium borohydride

Autofluorescence in TrueVIEW Treatment red channel 2019 Annual Tri-State Plus One Histology Symposium 61 Thank you

Craig Pow, Ph.D. Director, Technical Service [email protected]

2019 Annual Tri-State Plus One Histology Symposium