Dium (Lonza) containing 0.5 FCS. For blocking experiments, the following reagents were added to co-cultures: goat anti-human PDGFR-b neutralizing IgG at 1 mg/ml (R D Systems, Minneapolis, MN), mouse anti-human VEGFR-2 neutralizing IgG1 at 50 ng/ml (R D Systems) and VEGFR-3/human Fc soluble competitor at 1 mg/ml (Cell Sciences, Canton, MA). For negative control, non-specific goat IgG, mouse IgG1 and human IgG were applied at the same concentrations. Cell analysis was conducted after 24 to 72 hours. Digital images of cells were taken with an Axiovert 40CFL microscope (Zeiss, Oberkochen, Germany). Cells were subsequently released from culture plates by trypsinization and the cell count was assessed using trypan blue staining. Data shown represent mean and standard deviation of triplicate samples. Each experiment was conducted 3 times with LEC isolates from different donors.ImmunostainingImmunohistochemistry (IHC) was performed on paraffinembedded specimens fixed in 4 buffered formalin, using three mm thick histological sections. Data on lymphatic vessels assessed by the monoclonal mouse anti-podoplanin antibody D2-40 (Ventana Medical Systems, Tucson, Arizona) were available from previous studies [4,15]. For detection of thrombocytes immunostaining was performed using a monoclonal anti CD61 antibody (NCL-CD61-308, Leica Biosystems, Newcastle, UK) in a dilution of 1:1600. A Benchmark Ultra immunostainer (Ventana Medical Systems, Tucson, Arizona) was used for immunohistochemistry. Analysis of anti-podoplanin immunostaining was performed as described previously [16]: In brief, for determination of LMVD, the area 79831-76-8 web within or directly adjacent to tumor formations with the greatest number of distinctly highlighted microvessels (“hot spot”) was selected at low magnification. LMVD was then determined by counting all Pleuromutilin immunostained vessels at a total magnification of x200 in an examination area of 0.25 mm2. A case was considered as positive with regard to LVI when at scanning of the whole immunostained slide a tumor cell cluster was visible within a podoplanin decorated vascular space. For analysis of anti-CD61 immunostaining, superficial, exulcerated or bleeding tumor areas were excluded from analysis. A tumor was scored as positive for thrombocytic clusters in vessels (VTC), if at least in two vessels such clusters were seen (Fig. 1A). A tumor was considered as showing thrombocytic clusters within the tumor stroma (STC), if more than one unequivocal CD61 immunostained cluster was visible within the tumor stroma (Fig. 1B). Analysis of immunohistochemistry was performed by two independent investigators (S.F.S., P.B.) blinded to clinical data. Cases with divergent results were evaluated together using a multiheaded microscope.Platelet IsolationVenous blood was drawn from healthy volunteers into sodium citrate tubes and subjected to centrifugation at 856g and RT for 20 min. The obtained platelet-rich plasma supernatant was purified by gel filtration using sepharose 2B (Sigma-Aldrich, St. Louis, MO). Platelet activation during purification was inhibited with 100 mM prostaglandin E1. After centrifugation of gel-filtered platelets at 30006g and RT for 1.5 min, platelets were resuspended in EBM-2 medium containing 0.5 FCS and the platelet concentration was determined with a Sysmex counter (Kobe, Japan).Formazan Based Cell Proliferation AssayThe non-radioactive cell proliferation and cytotoxicity assay (EZ4UH, Biomedica, Vienna, Austria) was used to det.Dium (Lonza) containing 0.5 FCS. For blocking experiments, the following reagents were added to co-cultures: goat anti-human PDGFR-b neutralizing IgG at 1 mg/ml (R D Systems, Minneapolis, MN), mouse anti-human VEGFR-2 neutralizing IgG1 at 50 ng/ml (R D Systems) and VEGFR-3/human Fc soluble competitor at 1 mg/ml (Cell Sciences, Canton, MA). For negative control, non-specific goat IgG, mouse IgG1 and human IgG were applied at the same concentrations. Cell analysis was conducted after 24 to 72 hours. Digital images of cells were taken with an Axiovert 40CFL microscope (Zeiss, Oberkochen, Germany). Cells were subsequently released from culture plates by trypsinization and the cell count was assessed using trypan blue staining. Data shown represent mean and standard deviation of triplicate samples. Each experiment was conducted 3 times with LEC isolates from different donors.ImmunostainingImmunohistochemistry (IHC) was performed on paraffinembedded specimens fixed in 4 buffered formalin, using three mm thick histological sections. Data on lymphatic vessels assessed by the monoclonal mouse anti-podoplanin antibody D2-40 (Ventana Medical Systems, Tucson, Arizona) were available from previous studies [4,15]. For detection of thrombocytes immunostaining was performed using a monoclonal anti CD61 antibody (NCL-CD61-308, Leica Biosystems, Newcastle, UK) in a dilution of 1:1600. A Benchmark Ultra immunostainer (Ventana Medical Systems, Tucson, Arizona) was used for immunohistochemistry. Analysis of anti-podoplanin immunostaining was performed as described previously [16]: In brief, for determination of LMVD, the area within or directly adjacent to tumor formations with the greatest number of distinctly highlighted microvessels (“hot spot”) was selected at low magnification. LMVD was then determined by counting all immunostained vessels at a total magnification of x200 in an examination area of 0.25 mm2. A case was considered as positive with regard to LVI when at scanning of the whole immunostained slide a tumor cell cluster was visible within a podoplanin decorated vascular space. For analysis of anti-CD61 immunostaining, superficial, exulcerated or bleeding tumor areas were excluded from analysis. A tumor was scored as positive for thrombocytic clusters in vessels (VTC), if at least in two vessels such clusters were seen (Fig. 1A). A tumor was considered as showing thrombocytic clusters within the tumor stroma (STC), if more than one unequivocal CD61 immunostained cluster was visible within the tumor stroma (Fig. 1B). Analysis of immunohistochemistry was performed by two independent investigators (S.F.S., P.B.) blinded to clinical data. Cases with divergent results were evaluated together using a multiheaded microscope.Platelet IsolationVenous blood was drawn from healthy volunteers into sodium citrate tubes and subjected to centrifugation at 856g and RT for 20 min. The obtained platelet-rich plasma supernatant was purified by gel filtration using sepharose 2B (Sigma-Aldrich, St. Louis, MO). Platelet activation during purification was inhibited with 100 mM prostaglandin E1. After centrifugation of gel-filtered platelets at 30006g and RT for 1.5 min, platelets were resuspended in EBM-2 medium containing 0.5 FCS and the platelet concentration was determined with a Sysmex counter (Kobe, Japan).Formazan Based Cell Proliferation AssayThe non-radioactive cell proliferation and cytotoxicity assay (EZ4UH, Biomedica, Vienna, Austria) was used to det.
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