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In This Article

  • Summary
  • Abstract
  • Introduction
  • Protocol
  • Results
  • Discussion
  • Disclosures
  • Acknowledgements
  • Materials
  • References
  • Reprints and Permissions

Summary

This article describes a detailed experimental protocol for measuring the carbon content of airway macrophages with the aim of assessing the internal exposure dose at the level of individual particulate matter exposure.

Abstract

Pulmonary macrophages exhibit a dose-dependent pattern in phagocytizing particles. Following engulfment, these macrophages are subsequently excreted with sputum, rendering macrophages and particles visible and quantifiable under light microscopy. Notably, elemental carbon within the mammalian body originates exclusively from external contaminants. Consequently, the carbon content in airway macrophages (CCAM) serves as a valid exposure biomarker, accurately estimating individual exposure to carbon-containing particulate matter (PM). This article delineates a protocol involving sputum collection, preservation, processing, slide preparation, and staining, as well as macrophage photo acquisition and analysis. After removing the macrophage nuclei, the proportion of cytoplasm area occupied by carbon particles (PCOC) was calculated to quantify carbon content in each macrophage. The results indicate an elevation in CCAM levels after exposure to carbon-containing PM. In summary, this non-invasive, precise, reliable, and standardized method enables the direct measurement of carbon particles within target cells and is utilized for large-scale quantification of individual CCAM through induced sputum.

Introduction

Ambient air pollution is associated with deaths due to respiratory and cardiovascular diseases, posing a serious threat to human health1,2. Epidemiological data indicate that chronic exposure to ambient particulate matter less than or equal to 2.5 Β΅m in diameter (PM2.5) is responsible for the premature deaths of between 4 and 9 million people globally. PM2.5 was ranked as the fifth most important risk factor for global mortality in the 2015 Global Burden of Disease, Injuries, and Risk Factors Study (GBD)3,4,5,6. Studies have found that adherence to WHO air pollution guidelines could prevent 51,213 deaths per year from PM2.5 exposure3. Currently, most studies lack the evaluation of intra-individual exposure and are only based on crude evaluations at larger regional monitoring sites, which are far from individual exposure levels. The available biomarkers of internal exposure, such as urinary PAHs and benzo(a)pyrene, do not reflect the associations between particulate matter exposures and health effects7,8,9. This leads to the inability to establish an accurate relationship with health effects. Therefore, the search for markers that reflect the level of particulate matter exposure in an individual is one of the keys to accurate exposure assessment for individuals.

Particles inhaled into the bronchi can be excreted with sputum through ciliary oscillations in the bronchi. The lack of a ciliated mucous flow transport system in the alveoli means that the primary clearance route for particles entering the alveoli is through phagocytosis and translocation by macrophages10,11. Based on the anatomical structure of the lung, its clearance of insoluble particulate foreign matter is slow. This allows particulate matter to interact with lung cells for extended periods and initiate various biological effects, causing damage to lung tissue and other organs12,13. Stimulation by particulate matter leads to macrophage activation, triggering a cascade of inflammatory factors in the lungs that can cause a systemic inflammatory response14. Considering the crucial role of macrophage cytophagy in eliciting cytokine storms in the lungs, it is theorized that carbon particles from lung macrophages could reflect the biologically effective dose of airborne carbon-nucleated particulate exposure15. Furthermore, since there is no aggregation of elemental carbon in mammalian cells and carbon-containing particles can be observed as black particulate matter under a light microscope, the collection of alveolar and bronchial macrophages and measurement of the carbon content in them can serve as a marker for evaluating particulate matter exposure16.

This study identified a method for accurately assessing individual particulate matter exposure levels, known as the Carbon Content of Airway Macrophages (CCAM). Specifically, population sputum samples were collected after participants inhaled hypertonic saline generated by an ultrasonic nebulizer. These samples were then preserved using a fixative solution. Airway macrophages were isolated, stained, and photographed under a light microscope to identify macrophages containing carbon-containing particles, which were then quantified. This method provides a biological marker for accurately assessing individual particulate matter exposure levels. It establishes a methodological foundation for investigating the relationship between particulate matter exposure and health effects, serving as a research basis for exploring associations between PM exposure and health outcomes such as lung diseases.

Protocol

The study received approval from the Medical Ethics Committee of the Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention (NIOHP201604), with written informed consent obtained from all subjects prior to the study and biological sample collection. For this study, carbon black packers who had been working in a carbon black factory for more than 1 year and were exposed to carbon black aerosols were selected. Waterworks workers in a waterworks factory with no significant occupational exposure to harmful factors were recruited from the local area as a control population to establish the study. The following inclusion and exclusion criteria were selected for the study population: Inclusion criteria for carbon black packers included direct contact with carbon black during most shifts and a minimum of one year's work in the carbon black exposure area. Waterworks workers were included if they had no occupational exposure to carbon black or other pollutants in their work environment. Exclusion criteria encompassed workers with chronic diseases such as cancer, those who had undergone X-ray exposure in the past three months, individuals with a history of pulmonary tuberculosis, pulmonary surgery, viral myocarditis, congenital heart disease, recent fever, or inflammation, and workers who had taken antibiotics recently. The reagents and the equipment used in the study are listed in the Table of Materials.

1. Sputum preservation

  1. Prepare the fixative solution following the steps below:
    1. Melt 2% polyethylene glycol (PEG1500) in a water bath. Take 20 mL of melted PEG1500 in a centrifuge tube. Add 20 mL of 50% ethanol to the centrifuge tube and shake the mixture thoroughly to create the mother liquor.
    2. Gradually pour 40 mL of the mother liquor into 960 mL of 50% ethanol. Shake the solution well to form the Saccomanno fixation solution. Store the solution in a cool, dark place.
  2. Add 20-30 mL of the prepared fixative solution to a centrifuge tube containing approximately 2 mL of sputum. Mix the contents thoroughly.
    NOTE: Ensure the total volume does not exceed 40 mL.
  3. Seal the centrifuge tube with a sealing film. Store it in a cool, dark place. Transport the tube to the laboratory for further processing when ready.
    NOTE: Always melt PEG1500 in a water bath and use as per the prescribed dosage.

2. Preparation of cell suspension in sputum

  1. Prepare the digestive solution by dissolving 0.1 g of dithiothreitol in 100Β mL of saline as per the actual dosage. Store the prepared solution at 4 Β°C for up to 48 h.
  2. Centrifuge the tube containing the sputum at 1,998 x g for 30 min at 4 Β°C.
  3. Discard the supernatant. Add an equal volume of sputum digest to the precipitate. Vortex and shake the mixture thoroughly.
    1. Place the tube in a 37 Β°C water bath until complete liquefaction (10-15 min).
      NOTE: Continuously shake the tube during the liquefaction process.
  4. Filter the liquefied mixture with a 70 Β΅m filter membrane.
  5. Centrifuge the filtered solution at 500 x g for 7 min at 4 Β°C.
  6. Discard the supernatant, retaining the cell precipitate.
  7. Resuspend the cell precipitate in Duchenne phosphate buffer. Centrifuge the resuspended solution at 500 x g for 7 min at 4 Β°C to obtain a pure cell precipitate.

3. Preparation of cell smear

  1. Add 200-600 Β΅L of phosphate buffer to the cell sediment. Mix the contents thoroughly; adjust the buffer volume based on cell counting results (aim for >1.0 Γ— 105 cells).
  2. Take 20 Β΅L of the cell suspension and create a cell smear using the hematocrit method17.
  3. Let the smear air-dry naturally (within 48 h). Fix the smear with a commercially available staining solution for 10 s.
  4. Immerse the smear in A staining solution for 8 s. During staining, gently lift the slide up and down, and rinse off excess stain with running water.
  5. Stain the smear in B staining solution for 8 s. Lift the slide during staining and rinse off excess stain under running water.
    NOTE: Staining solutions A and B are available in the commercially available staining kit.
  6. Dip the slide in anhydrous ethanol twice, each time for 2-3 s.
  7. Once dry, apply an appropriate amount of neutral gum. Seal the slide with coverslips.

4. Quantitative analysis of CCAM

  1. Use a light microscope with a 100x oil lens objective. Capture images of randomly selected, well-stained, and morphologically intact macrophages. Take 50 macrophage pictures randomly for each sample.
  2. Perform image analysis in the Image J software following the steps below:
    1. Measure the scale and determine the actual length and pixel-to-pixel conversion (282 pixels = 10 Β΅m). Set the scale in Image J (Analyze > Set scale), input Distance in pixels, actual length, unit of length (Β΅m), and tick Global.
    2. Use an irregular shape to outline the cells. Remove the background (freehand selections, Edit > Clear outside). Measure the total area of the cells (Analyze > Measurement).
    3. Cut out the nucleus (Edit > Cut). Convert the grayscale image to black and white (Image > Type > 8 bit).
    4. Adjust the grayscale value specific to each cell staining for accurate carbon particle counting (Image > Adjust > Threshold > Apply, Analyze >> Measurement).
    5. Calculate the carbon content of 50 macrophages per sample based on the measured area and image analysis in Image J software.

Results

The sputum, preserved and processed with the fixative solution, displayed intact macrophage morphology under an optical microscope during morphological examination. The macrophages exhibited clear, round, or kidney-shaped, easily stainable cell nuclei. Following staining, the cell nuclei appeared bluish-purple, while the cytoplasm was light pink or light blue. The microscopic field showed minimal impurities, which facilitated easy cell identification. Within the cells, black carbon particles were distinctly visible in sm...

Discussion

This study presents a detailed experimental protocol for using induced sputum-derived CCAM as a biological marker for internal exposure to atmospheric particulate matter. CCAM can be detected and quantified through optical microscopy, serving as a precise internal exposure biomarker reflecting the relationship with health effects. Therefore, there is a need to establish and optimize a convenient, reliable, and efficient induced sputum preservation method and a CCAM quantification method to standardize the methodological ...

Disclosures

The authors declare no conflicts of interest.

Acknowledgements

This work was financially supported by the National Natural Science Foundation of China (82273669, 82241086, 42207488), the Taishan Scholars Program of Shandong Province (No. tsqn202211121), and the Innovation and Technology Program for the Excellent Youth Scholars of Higher Education of Shandong Province (2022KJ295).

Materials

NameCompanyCatalog NumberComments
3 mL sterile strawsShanghai YEASEN Biotechnology Co., LTD84202ES03
50 mL centrifuge tubeThermo Fisher Scientific, USA339652
Absolute ethyl alcoholSinopharm Group Chemical Reagent Co. LTD64-17-5
Cedar oilShanghai McLean Biochemical Technology Co., LTDC805296
Diff-quick staining solutionShanghai YEASEN Biotechnology Co., LTD40748ES76
DithiothreitolSolebo Bio Co., LTDD8220
Duchenne phosphate buffer (DPBS)Thermo Fisher Scientific, USA14190144
Microscope cameraOlympus Corporation of JapanDP72
Neutral tree gumSolebo Bio Co., LTDG8590
Nylon filter membrane 70umBD Falcon Bioscience, USA211755
Optical microscopeOlympus Corporation of JapanBX60
Polyethylene glycolSinopharm Group Chemical Reagent Co. LTD25322-68-3
UltracentrifugeThermo Fisher Scientific, USASL40R
Viscous slideJiangsu SHitAI EXPERIMENTAL Equipment Co. LTD188105

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Carbon ContentAirway MacrophagesParticulate MatterExposure BiomarkerSputum CollectionMacrophage AnalysisElemental CarbonCarbon ParticlesQuantitative MeasurementPhagocytizing ParticlesNon invasive MethodLight MicroscopyCytoplasm AreaResearch Protocol

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