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Lab Technology The Quantification of Multiple Signalling Pathway Proteins in Intact Tissue Sections By Clifford C Hoyt at Cambridge Research & Instrumentation (CRi) Correlation between signalling pathway activity and clinical outcome plays an important role in drug R&D; by enabling the accurate quantification of multiple proteins on a per-cell basis in intact tissue, a new technology platform will help researchers to better understand the signalling pathways implicated in a given disease. In order to obtain an improved determination of the specific causes of a given disease, a goal of many researchers is to achieve a better understanding of the mechanisms of various signalling pathways. Being able to reveal correlations between signalling pathway activity and clinical outcome would better support target validation, trial design, patient selection, response assessment and – if trials are successful – the diagnostic component of theranostics. Importantly, the predictive power of measurements of protein expression depends on the precision and accuracy of tissue analysis tools. For example, many techniques deployed today, such as those based on microarray detection or analysis of sample lysates, provide data that are in fact averages from volumes of tissue – including many cells that are Figure 1: Illustration of signalling pathways in a cell, in this case for apoptotic signalling in a normal cell. Reproduced from the University of Delaware (1) not of interest. These methods ‘blur-out’ key proteomic information residing at the cellular level that relates to the signalling states of individual cells. THE ROLE OF SIGNAL TRANSDUCTION PATHWAYS IN CANCER During the course of tumour progression, cancer cells acquire a number of characteristic alterations. These include the capacity to proliferate independently of exogenous growth-promoting or growth-inhibitory signals, the tendency to invade surrounding tissues and metastasise to distant sites, the inclination to elicit an angiogenic response and the ability to evade mechanisms that limit cell proliferation, such as apoptosis and replicative senescence. These properties reflect alterations in the cellular signalling pathways that in normal cells control cell proliferation, motility and survival. Many of the proteins currently under investigation as possible targets for cancer therapy are signalling proteins that are components of these pathways. The nature of these signalling pathways and their roles in tumourigenesis are the subject of intense study by pharmaceutical companies, motivated by the hope that progress in understanding cancer as a disease will accelerate drug development. This is a broad research topic and the task of identifying relevant pathways, understanding them and demonstrating correlation with outcome is a challenging one. An additional level of complexity arises from the fact that it is often the interrelationship between pathway proteins and their localisation that helps characterise the pathway, rather than the mere presence of a protein. THREE KEY PATHWAY MARKERS Three key pathway markers – AKT, ERK and S6 – are widely studied and play a vital role in cancer 48 Innovations in Pharmaceutical Technology Figure 2: Clinical tissue samples in a tissue microarray TMA are used in order to confirm that staining is specific, and labels can be reliably unmixed from autofluorescence. Row A: raw colour images of two TMA cores; Row B: same with autofluorescence unmixed away to reveal label signals; Row C: with inForm tissue and cell segmentations; and Item D: a ‘tissue cytometry’ scatter plot showing relatively expression of two signalling pathway proteins, on a per-cell basis. Samples courtesy Novartis Institutes of Biomedical Research, Cambridge, MA, US (2) A C D Finally, s6 is a ribosomal protein involved in translation. It is thought to play an important role in controlling cell growth and proliferation, is a major substrate of ribosomal protein s6 kinase and plays a role in regulating translation of RNAs that contain an RNA 5’ terminal oligopyrimidine sequence. It is regulated by ribosomal s6 kinase. pS6 versus pERK 180 160 140 pS6 (Allexa 647) AKT has recently been found to play a paradoxical role: on the one hand it increases cancer cells’ survival capability, while on the other it blocks their motility and invasion abilities, thereby preventing cancer from spreading (4). Previously, it had been presumed that one could promote cancer cell death by inhibiting AKT; yet now, with this added complexity, the role of AKT must be understood further so as not to promote metastases by inhibiting AKT expression (see Figure 1, page 48). Activation of the ERK pathway promotes cell division. This pathway is often up-regulated in human tumours and is thought to fulfil multiple roles in the acquisition of a complex malignant phenotype. Accordingly, a specific blockade of the ERK pathway is expected to result in not only an anti-proliferative effect, but also in anti-metastatic and anti-angiogenic effects in tumour cells. Recently, potent small-molecule inhibitors targeting components of the ERK pathway have been developed. Among them, BAY 43-9006 (Raf inhibitor), and PD184352, PD0325901 and ARRY-142886 (MEK1/2 inhibitors) have reached the clinical trial stage. The combination of ERK pathway inhibitors (cytostatic agents) and conventional anticancer drugs (cytotoxic agents) might provide an excellent basis for the development of new chemotherapeutic strategies against cancer. B 120 100 AUTOMATED MULTIPLEXED TISSUE CYTOMETRY 80 60 40 20 0 0 50 100 150 200 250 300 pERK (Allexa 555) 50 pathogenesis. In the example that follows, the goal is to provide a general-purpose signalling activity detection kit to assess the AKT, ERK and S6 pathways. 350 400 450 Detecting pathway markers using conventional histology or immunofluorescence is a challenge, given the need to observe many markers simultaneously (that is, to multiplex) in order to gain a full understanding of the pathways involved and the relevant phenotypes. Conversely, conventional multiplexing techniques, such as microarrays or flow cytometry, fail to provide the contextual information needed to confirm intracellular Innovations in Pharmaceutical Technology localisation; this is also a requirement in order to confirm pathway state. What is needed is simultaneous measurement of multiple proteins, on a per-cell basis, set within the context of the original anatomy. Figure 3: Spectral unmixing explained using examples of four-component fluorescence unmixing (2) Technology now offers us the opportunity to access this level of information by utilising an effective, practical and reliable platform for cytometric analysis of intact tissue sections. This can be conceptualised as ‘tissue cytometry’. The platform supports preclinical and clinical studies through the integration of multiplexed immunohistochemical (IHC) or immunofluorescent (IF) labelling strategies, robotic slide handling and automated multispectral image acquisition and analysis (see Figure 2). The ideal imaging platform integrates: a) easy-to-implement multiplexed staining protocols; b) an automated slide analysis system (such as CRi’s VectraTM system) that can isolate marker signals from one another and from autofluorescence; and c) patternrecognition based image-analysis software (such as CRi’s inFormTM software) for automatically segmenting images and extracting data from cellsof-interest. CRi’s Vectra system is a fully integrated system that offers robotic slide handling (capacity 200 slides), automated image acquisition, and the flexibility to work with IHC or IF, tissue-sections or tissue microarrays (TMAs) (see Figure 3). The principal scientific benefits of slide scanning (whether multispectral or not) can, however, only be realised when the terabytes of imagery created can be processed automatically to produce relevant and useful information. The powerful learn-by-example image analysis algorithms in CRi’s inForm software provide trainable tissue segmentation, a key component of automated image analysis and data extraction. The software can be trained to differentiate relevant tissue regions (for example, malignant and normal epithelia, stroma, necrosis, and so on) and segment cellular compartments (nuclei, cytoplasm and membrane) to allow for detailed, spatially-resolved multiparameter quantification. This is especially powerful when combined with multispectral imaging, as it provides the ability to perform tissue cytometry rapidly and on a large scale, and using many markers at once. www.iptonline.com VALIDATION STUDY For this particular study, a staining panel was developed targeting phosphoeptitopes of AKT, ERK and s6, using antibodies of three different isotypes, with secondaries conjugated to Alexa Fluor® fluorophores (Alexa Fluor 488, Alexa Fluor 555, and Alexa Fluor 647). DAPI (4’-6-diamidino-2-phenylindole) was used as a counterstain (2). Staining protocols were optimised using tissue microarrays generated from lung tissue samples prepared using methods designed to preserve phosphoepitopes. Spectral unmixing libraries were generated with single-stained control samples. Image analysis algorithms were trained to segment tissue regions (for example, malignant and normal epithelia, stroma, necrosis, and so on), and then cells and cell compartments within tumour regions, to extract per-cell data for cytological analysis. Validation of the platform’s ability to quantify changes in phosphoepitope expression was performed with cell blocks of cell lines treated with the relevant inhibitors. Pilot studies of the TMAs and cell lines revealed robust and specific signal levels, localised to tissue and 51 Figure 4: Classifying patient subtypes with cluster analysis: the 64-bins shown here contain the various combinations of expressions of pERK, pAKT and pS6 in the patient population estimated at greater than 90 per cent, based on visual review by pathologists. Data could be further analysed using cluster analysis. Signals from individual cells were divided into quartiles of pS6, pAKT and pERK expression, and placed into 64 bins. The number per bin is displayed as a heat map in Figure 4. BENEFITS OF MULTISPECTRAL IMAGING In conjunction with easy-to-use multispectral imaging systems and advanced learn-by-example software, quantitative, independent and specific multi-label protocols have been developed that can greatly accelerate clinical and pre-clinical studies (3). pAKT Multispectral imaging captures information from many narrow wavelength bands, instead of simply one band, for each fluorescence emission filter. This added information enables automated multispectral tools rapidly to isolate label emissions from each other and also from autofluorescence, which commonly obscures weak but important signals in formalin-fixed paraffinembedded tissue sections. This ability to separate signals applies even when, as is often the case, they are spatially and spectrally overlapping – whereas conventional fixedbandpass filter approaches cannot do this. pERK pS6 cellular structures appropriate for the target molecules, despite being applied in four-plex. Patternrecognition-based, automated image analysis algorithms reliably detected tumour cells and segmented associated cellular compartments, after having been trained on less than 10 per cent of pilot study images. Tissue segmentation accuracy was The imaging platform is expected to enable a better understanding of the mechanism of disease and the development of potentially better, more precise avenues of treatment. References 1. Illustration obtained from the University of Delaware website, http://udel.edu/~apickard/ Cancer%20Website_files/basics.htm Cliff Hoyt is Co-founder and Chief Technology Officer of Cambridge Research and Instrumentation Inc (CRi), a biomedical imaging company. He obtained his BA in Physics from Williams College (Williamstown, MA) in 1983, and his Masters in Mechanical Engineering from the Massachusetts Institute of Technology (MIT) in 1987. Since co-founding CRi in 1985, he has been involved in the development of many CRi core technologies, including the liquid crystal tunable filters for multispectral and polarised light imaging, and then the integration of these core technologies into analytical instruments for applications such as in vitro fertilisation, high-throughput drug screening, stem cell research, in vivo small animal imaging, live cell biology and tissue-based immunohistochemical analysis for signalling pathway research. Cliff has served on US National Institutes of Health (NIH) study sections, has been the principal investigator on ten Small Business Innovation Research (SBIR) and Small Business Technology Transfer (STTR) NIH grants, and is named inventor on approximately 20 patents. Email: [email protected] 2. Hoyt C, Wetzel RK, Yang D et al, Tissue cytometry platform for quantitating multiple signalling pathways proteins in intact tissue sections, Poster at 2009 AACR-NCI-EORTC conference. Alexa Fluor® is a registered trademark of Invitrogen Corp 3. Levenson RM, Fornari A and Loda M, Multispectral imaging and pathology: seeing and doing more, Expert Opin Med Diagn 2(9): pp1,067-1,081, 2008 4. Yoeli-Lerner M, Yiu GK, Rabinovitz I et al, Akt blocks breast cancer cell motility and invasion through the transcription factor NFAT, Mol Cell, Nov 23, 20(4): pp539-550, 2005 52 Innovations in Pharmaceutical Technology