Human intestinal mucosal mast cells: evaluation of fixation and staining techniques

The staining properties of tissue mast cells are influenced by the method of fixation. Differences in fixation and staining techniques may explain the contradictory results in the published reports on the number of human mucosal mast cells (MMC) in the gastrointestinal mucosa in health and disease. We have examined the influence of fixatives on the staining properties of human MMC in operative biopsy specimens of human jejunum. Specimens were divided into pieces, each of which was fixed in one of the following fixatives: Carnoy's, basic lead acetate (BLA), Baker's, Bouin's, isotonic formol-acetic-acid (IFAA), 10% neutral buffered formalin, formol sublimate, and formol saline. Thereafter, tissues were paraffin-embedded and 5 micron sections were cut and stained with either astra-blue/safranin pH 0.3, or toluidine blue pH 0.5. Counts of the number of MMC/mm2 were obtained for each fixation method. The results show a critical influence of the fixative on the number of mast cells identified after staining. For example with astra-blue/safranin the mean MMC/mm2 count was 40 in formol-saline-fixed specimens, and 268 in Carnoy's-fixed specimens. In biopsies fixed with formalin-based fixatives, mast cells were more readily stained with toluidine blue. It is recommended that Carnoy's or BLA be used as the fixative for any light microscopic study of human MMC.     

Carnoy's fixative reduces the number of chymase-positive cells in immunocytochemical staining of cord-blood-derived human cultured mast cells

KleinJan et al, (Allergy 1996;51:614-20) reported that Carnoy's fixative reduced the number of chymase-positive mast cells in the nasal mucosa. Therefore, in the present study, we investigated whether Carnoy's fixative reduces the number of chymase-positive cells from cord-blood-derived human cultured mast cells when compared with other types of fixatives. Human mast cells were obtained by culturing cord-blood-derived CD34-positive cells in the presence of stem cell factor and interleukin-6. Staining procedures of the cells in fixation with Carnoy's fixative and with other fixatives gave no differences among the number of tryptase-positive cells, whereas fixation with Carnoy's fixative for 15 min gave a significant decrease i n the number of chymase-positive cells compared with acetone for 10 min. The number of chymase-positive cells decreased in a time-dependent manner under fixation with Carnoy's fixative, indicating that Carnoy's fixative had a negative effect on the number of chymase-positive cells from cord-blood derived human cultured mast cells.     

Sequestration of eosinophil major basic protein in human mast cells.

Previous studies showed that lung and skin mast cells do not contain eosinophil granule major basic protein (MBP). However, MBP has been localized by immunofluorescence to mast cells from a recently established human mast cell line. Analysis of MBP in human mast cell-1 cell lysates by radioimmunoassay showed immunochemical similarity to eosinophil MBP as judged by comparison of dose-response regression lines. Based on these findings and other new information about mast cell heterogeneity, we tested whether mast cells contain MBP. Mast cells were preserved in Carnoy's fixative and were identified by staining with rhodamine-conjugated avidin or for chloroacetate esterase or aminocaproate esterase activity. MBP was localized by immunofluorescence to mast cells in 6 of 7 nasal polyps, 4 of 4 ileal tissue specimens, and 12 of 14 cutaneous mastocytosis specimens. Furthermore, by immunoelectron microscopy MBP was localized to mast cell granules in cutaneous mastocytosis lesions. In contrast, normal skin mast cells preserved in Carnoy's fixative did not contain MBP. After injection of MBP into normal skin and fixation in Carnoy's fluid, mast cells became MBP-positive within 3 minutes, suggesting that endocytosis of MBP by mast cells had occurred. These results suggest that human mast cells in several tissues may sequester toxic eosinophil proteins by endocytosis.     

Immunohistochemical identification of mast cells in formaldehyde-fixed tissue using monoclonal antibodies specific for tryptase

An avidin-biotin enhanced immunoperoxidase procedure using monoclonal antibodies (AA1, AA3, and AA5) prepared against human mast cell tryptase resulted in intense staining of mast cells in paraffin-embedded tissue. The distribution of mast cells observed was similar to that seen when adjacent serial sections were stained using a standard procedure with toluidine blue, though the immunoperoxidase technique permitted the identification of significantly more mast cells. With monoclonal antibody AA1, immunostaining was entirely specific for mast cell granules, and there was negligible background staining in a range of tissues including lung, tonsil, colon, gastric mucosa, skin, and pituitary. There was no staining of antibody on basophils or on any other normal blood leukocyte. The technique was effective with tissue fixed in either Carnoy's or neutral buffered formalin, though the internal mast cell structure was better preserved with formaldehyde fixation. The immunoperoxidase staining procedure with monoclonal antibody AA1 is a highly specific and sensitive means for the detection of mast cells in routinely processed tissues.     

Mast cells in human lungs

Mast cells were stained deeply in human lung tissue with acidic toluidine blue to obtain maximum numbers possible in paraffin sections. One hundred high-power fields were counted per section, and mean and median values summarized as mast cells per mm2. Immersion-fixed samples of fresh lung tissue (not bronchi) were taken as controls from seven patients after surgery, and showed mean values of 44.7 mast cells per mm2 after formalin fixation, and 51.9 per mm2 after Carnoy's fixative. Mast cell heterogeneity may explain these differences, but so could random variation between counts. In two patients with extrinsic allergic alveolitis (hypersensitivity pneumonitis), fresh lung tissue from open lung biopsies showed raised values of 90.8 and 101.9 mast cells per mm2, matching the high mast cell counts reported in bronchopulmonary lavage fluid in the condition. Control post-mortem lung tissue from two patients dying of non-pulmonary diseases showed mean values of 26.1 and 50.6 mast cells per mm2. Post-mortem lung tissue from three patients dying of asthma showed very low mean values of 4.7, 5.7, and 5.9 mast cells per mm2. Low mast cell counts due to severe degranulation have been reported before in the bronchi in asthma deaths, but not, to our knowledge, in the lung parenchyma. This finding implies a wider area of mediator release, and helps to explain the severity of the acute attack, and the fatal outcome.     

Fixation with Carnoy's fluid reduces the number of chymase-positive mast cells: not all chymase-positive mast cells are also positive for tryptase

Mast cells in the nasal mucosa can be studied by means of monoclonal antibodies (mAb) against tryptase (T⁺MC) and chymase (CIVIC). Fixation with acetone gives more positive cells than does fixation with Carnoy's fluid. In frozen biopsy specimens of allergic nasal mucosa fixed with acetone, the number of T⁺MC equals that of C⁺MC. When fixed with Carnoy's fluid, however, the number of T⁺MC is larger than the number of C⁺MC. The decrease in both T⁺MC and C⁺MC resulting from fixation with Carnoy's fluid is time-related and depends on the type of mAb used. Carnoy fixation time gives a decrease in the number of C⁺MC within 1 min, whereas the number of T⁺MC decreases only after 10 min. Within 1 min. the number of C⁺MC decreases to a level where continued fixation no longer gives further decreases in the number of cells. Two populations of mast cells can be distinguished here: one sensitive and the other insensitive to Carnoy's fluid. When double-staining is used, fixation with acetone gives three populations of mast cells: one positive for tryptase (T⁺C⁻ MC), another positive for tryptase and chymase (T⁻C⁺MC), and a third one positive for chymase (T⁻C⁺MC). These three populations were found in lymph node, spleen, thymus, dermis, lung parenchyma, small intestinal submucosa, and nasal mucosa.     

Evidence for morphologic diversity of human mast cells. An ultrastructural study of mast cells from multiple body sites

The ultrastructural features of 502 mast cells, including 34,187 granules, were studied from seven human tissue sites (lung, skin, colon, stomach, small bowel, breast parenchyma, and axillary lymph nodes). Granule areas and substructure were detailed according to the microenvironment (lung alveoli, lung bronchi, bowel mucosa, bowel submucosa, breast skin, breast parenchyma, and axillary lymph nodes). Although completely closed, discrete scrolls were present in some mast cell granules at all tissue locations, they were present more frequently in granules from bowel mucosa and lung (scroll-rich morphology). In contrast, most of the mast cell granules from skin, breast parenchyma, axillary lymph nodes, and bowel submucosa were rimmed by incomplete scrolls forming parallel lamellae; centrally, amorphous granular material and/or grating/lattice-like structures occurred (scroll-poor morphology). In breast, the latter granules had a mean granule area almost twice that of all other sites. Individual mast cells having granules with both scroll-rich and scroll-poor features were common in all tissue sites and microenvironments. In fact, 7.8% of mast cells had granules showing at least one completely closed, discrete scroll and grating/lattice-like structures, sometimes within the same granule. These observations indicate that mixed forms occur and that there is considerable morphologic diversity between the predominant mast cell found in mucosa and lung (scroll-rich morphology) and the predominant mast cell found in skin, breast parenchyma, axillary lymph nodes, and bowel submucosa (scroll-poor morphology).     

Histochemical heterogeneity of human mast cells: disease-related differences in mast cell subsets recovered by bronchoalveolar lavage.

Fixation and staining characteristics were studied for mast cells recovered by bronchoalveolar lavage from 67 patients being investigated for lung disease. The number of toluidine blue stained mast cells in formaldehyde-fixed cytocentrifuge preparations was consistently less than in specimens fixed in Carnoy's solution, though the counts were highly dependent on the period of fixation or staining. The cellular histamine content closely correlated with total mast cell numbers in bronchoalveolar lavage fluid, but was not related to the relative proportions of mast cells which were sensitive or resistant to formaldehyde fixation when using a standard protocol. Compared with normal subjects, the numbers of formaldehyde-sensitive mast cells were significantly elevated in patients with bronchial carcinoma, sarcoidosis, extrinsic allergic alveolitis, cryptogenic fibrosing alveolitis, and mycobacterial infection and were particularly high in the cases of interstitial lung disease. An even greater increase in numbers of formaldehyde-resistant mast cells was observed in the patients with sarcoidosis and extrinsic allergic alveolitis. The associations of these mast cell subsets with disease may reflect relationships between the expansion of the formaldehyde-sensitive population and lymphocyte infiltration and between proliferation of formaldehyde-resistant mast cells and tissue fibrosis.     

Interleukin-2 receptor expression in human mast cells and basophils

Surgical human thymus, upper respiratory tract, lung and small and large bowel specimens were analyzed for the presence of interleukin 2 receptor (IL2-R)-positive cells. Histochemical (toluidine) and immunologic (anti-IL2-R monoclonal antibody) staining procedures revealed a distinct anti-IL2-R positivity in most of metachromatically staining cells. These positive cells were observed not only in tissues showing strong inflammatory reaction and mast cell hyperplasia, as in Crohn's disease, but also in those not histologically affected by pathologic conditions. This finding suggested that human mast cells, like T blast cells, express the p55 chain of IL2-R on their surface. To see whether IL2-R was being actively synthesized, a cell preparation rich in peripheral blood basophils (PBB), which are cells closely related to mast cells, was obtained. Ultrastructural analysis of PBB after indirect immunogold procedure revealed that the vast majority expressed the IL2-R. Moreover, the presence of intracellular reaction products in the cytoplasm of most membrane-positive PBB was indicative of active antigen synthesis. Furthermore, Northern blot analysis evidenced specific IL2-R mRNA in PBB, while its expression was augmented several times when PBB were cultured in the presence of stimulated T cell supernatant.     

Human mast cell heterogeneity: histamine release from mast cells dispersed from skin, lung, adenoids, tonsils, and colon in response to IgE-dependent and nonimmunologic stimuli

We have compared the ability of anti-IgE, calcium ionophore A23187, substance P, compound 48/80, poly-L-lysine, and morphine to release histamine from mast cells of human skin, lung, adenoids, tonsils, and colon. Use of a single collagenase/hyaluronidase dispersion technique for all tissues has allowed comparisons of reactivity to be made that are free from methodological variations. Mast cells from all tissues examined secreted histamine in response to anti-IgE and calcium ionophore A23187. However, only skin mast cells were responsive to substance P, compound 48/80, poly-L-lysine, and morphine. Activation of human skin mast cells by these nonimmunologic stimuli clearly distinguishes them from the mast cells of human lung, adenoids, tonsils, and colon and is indicative of functional heterogeneity within the human mast cells population. We propose that the presence of functional receptor sites for neuropeptides and basic compounds on skin mast cells that are not present in mast cell populations from mucosal or lymphoid sources reflects a specialized role for these cells in vascular homeostasis.     

绵羊肥大细胞中类胰蛋白酶的证实

用甲苯胺蓝和阿尔辛蓝常规组织化学方法及特异性酶底物鉴定人肥大细胞类胰蛋白酶的酶组织化学技术，采用小鼠抗人肥大细胞类胰蛋白酶单克隆抗体，（ＡＡ１、ＡＡ３和ＡＡ５）通过间接免疫过的经物酶技术对绵羊肥大细胞的组织化学特性进行研究，酶组织化学技术及免疫组织化学技术均首次证实了绵羊肥大细胞颗粒中含有类胰蛋白酶，且该酶可作为绵羊肥大细胞的特异性标志，对于绵羊肥大细胞的常规组织化学染色，Ｃａｒｎｏｙ液及中性缓门     

Numbers and heterogeneity of mast cells in the male genital tract of the rat

Normal adult rats were used to quantitate and characterize mast cells in the male genital tract. The tissues were either fixed in a fixative containing formalin (Schaffer solution) or with basic lead acetate (BLA) to identify 'connective-tissue mast cells' and 'mucosal mast cells', respectively. In the epididymis and seminal vesicle small numbers of mast cells were identified without any obvious heterogeneity. In the prostate, however, a mean of 45.1 +/- 9.3 and 23.0 +/- 4.0 mast cells/mm2 was found after BLA and Schaffer fixation, respectively. This difference might be of functional and clinical significance.     

Human bone marrow mast cells in systemic mast cell disease

In a case of systemic mast cell disease with moderate bone marrow involvement, we studied the sensitivity of mast cell cationic dye-binding to formaldehyde fixation, as well as the mast cell ultrastructure, so as to determine whether these cells possess characteristics of mucosal mast cells. This histochemical method has proved to be one of the few which reveal heterogeneity of the mast cells in human intestine. Even though rat bone marrow mast cells have been shown to belong to the mucosal mast cell compartment, we have found no difference in mast cell counts in samples fixed either in formaldehyde or Carnoy's fixative. The ultrastructure did not show major differences with cutaneous mast cells. A few cells presented two nuclei, suggesting mitotic division of mature mast cells in bone marrow.     

Guinea pig mast cells: comparative study on morphology, fixation and staining properties

We have studied the distribution of mast cells (MC) in different tissues of the guinea pig (GP), and certain aspects of their histochemical and cytochemical properties. In preparations fixed with Carnoy's fluid, MC were extremely well-preserved and were detected in all tissue sections and cytocentrifuge smears obtained from enzymically dispersed cells after staining with alcian blue at pH 0.5-2.2. In formol-saline-fixed preparations, there was a substantial reduction in MC counts. Most of the tissue MC were located interstitially and in the perivascular connective tissue. A small proportion of MC was located in certain organ- or tissue-specific structures. When counted manually, MC comprised 0.43-3.1% of the cell population obtained by enzymic dispersion. This proportion was higher than that obtained by the automated Technicon H6000 basophil system, but the two counting systems confirmed organ differences in MC counts. MC in different GP tissues varied in size, morphology, histamine content and degree of susceptibility to formol-saline fixation. The granules of GP connective tissue MC differed from those of rat peritoneum in failing to take the fluorescent stain berberine sulphate which has greater affinity for the highly sulphated glycosaminoglycans such as heparin, and in having some morphological and histochemical similarity to 'mucosal' MC.     

Increase of mucosal mast cells in the jejunum of patients infected with Trichinella spiralis

The mast cell response in the mucosa and connective tissue of 36 jejunal biopsies of patients with clinically diagnosed trichinellosis, teniasis and lambliasis has been studied. Biopsy material was fixed in standard formalin or Carnoy's fixative, enabling differentiation between mucosal mast cells (MMC) and connective tissue mast cells (CTMC). With both fixatives CTMC could equally well be recognized. With Carnoy's fixative an additional population of mast cells (MMC) could be visualized both in the mucosa and the connective tissue. In the mucosa small mucosal mast cells were observed as well. Compared to the numbers of mast cells in the mucosa and the connective tissue of teniasis and lambliasis patients, the number of mast cells in trichinellosis patients only visualized using Carnoy's fixative was markedly higher. It was concluded that also in man trichinellosis is accompanied by an increase of cells with MMC characteristics. Further studies are needed to clarify the morphological and histochemical features of these cells and their possible role in this parasitic infection.     

The immunocytochemical preservation of IgE and mast cells of the rat

The localisation of IgE to mast cells of rats infested with Nippostrongylus brasiliensis has been studied in an attempt to find a fixation procedure which will best preserve (a) the antigenicity of IgE for immunocytochemical demonstration, and (b) the histochemical staining properties of mast cells. A fixative comprising Carnoy's fluid and picric acid (CPA) best fulfilled these criteria, allowing localisation of IgE to both the plasma membrane and cytoplasm of mucosal mast cells of rat small intestine, but only to the plasma membrane of connective tissue mast cells of rat tongue. Formaldehyde-containing fixatives prevented labelling of IgE in the cytoplasm of mucosal mast cells.     

Enhanced mast cell chymase expression in human idiopathic interstitial pneumonia

Previous studies have shown that mast cell chymase induces and promotes fibrogenesis in injured tissues. We studied the roles of mast cell chymase in the fibritic processes of human idiopathic interstitial pneumonias. Frozen tissue sections from human lungs with usual interstitial pneumonia (n=7), nonspecific interstitial pneumonia (n=4) and normal lungs (n=10) were studied immunohistochemically. Monoclonal antibodies against mast cell chymase, tryptase, interleukin-4, and smooth muscle actin were used. Stained cells or areas were quantified by computer-aided morphometry. The numbers of both tryptase-positive mast cells and chymase-positive mast cells were significantly greater in lung tissues with idiopathic interstitial pneumonia than in normal lung tissues. The increase in the number of chymase-positive mast cells in the diseased lung tissues was closely related to an increase in interleukin-4-positive cells, and also to an accumulation of smooth muscle cells and myofibroblasts. Because smooth muscle cell and myofibroblast proliferation is a principal pathological change in idiopathic interstitial pneumonias, these observations suggest that mast cell chymase, possibly induced by interleukin-4-dependent phenotypic modulation, may be an important mediator in the inflammatory and fibrotic processes of idiopathic interstitial pneumonia in humans.     

Ultrastructural analysis of maturing human T and TC mast cells in situ

Mast cells at immature stages of development were identified in human tissues by electron microscopic techniques. General morphologic criteria of immaturity (such as a high apparent nuclear:cytoplasmic ratio and small cell size), the presence of few granules (those present being smaller than those in mature mast cells) and a lack of features of mast cell activation were used together to determine the level of maturity. Mast cells were identified as being of the T or TC type by immunogold staining with polyclonal rabbit IgG anti-chymase and murine monoclonal anti-tryptase primary antibodies and the appropriate gold-labeled secondary antibodies. Only those cells with tryptase-positive granules were recognized as mast cells. Immature T mast cell granules contained the same characteristic discrete scrolls found in their mature counterparts and all stained positive for tryptase. The presence of trace amounts of chymase in a minority of these granules, as in mature T mast cells, could not be ruled out. The majority of granules in immature TC mast cells had one or more amorphous electron-dense cores rather than the grating and lattice substructures characteristic of granules in mature TC mast cells. Secretory granules in immature TC mast cells stained positively for tryptase and chymase. Occasional immature TC mast cells contained a complete granule or a portion of a granule with the substructure characteristic of mature TC mast cells, favoring the concept that these TC mast cell forms are developmentally related. Essentially all mast cells in foreskin of newborns appeared immature, whereas 10, 5, 10, and 15% of the mast cells in adult lung, foreskin, bowel mucosa and bowel submucosa, respectively, appeared immature. The distribution of T and TC types of immature mast cells seemed to parallel that of the mature mast cell types. These compositional and ultrastructural differences between immature T and TC types of mast cells suggest that from the time granule formation begins, and possibly before this time, each type of human mast cell follows a distinct developmental pathway.     

Mast cells in cutaneous mastocytosis: accumulation of the MCTC type

Lesional (n = 15) and non-lesional (n = 10) skin of subjects with mastocytosis was analysed for the distribution and concentration of trypase positive, chymase negative mast cells (MCT) and tryptase positive, chymase positive mast cells (MCTC) cells and compared to normal skin (n = 23) and non-lesional skin of subjects with unexplained anaphylaxis or flushing episodes (n = 6). Skin biopsies were fixed in Carnoy's fluid and subjected to double immunohistochemical staining with biotinylated mouse monoclonal anti-chymase antibody followed by alkaline phosphatase-conjugated mouse monoclonal anti-tryptase antibody. MCTC cells were the only type of mast cells seen in all specimens analysed and in each case were more numerous in superficial compared to deep regions of dermis. The concentration (mean +/- s.d.) of mast cells in the superficial dermis of mastocytosis lesions (40 985 +/- 21 772 mast cells/mm3) was significantly increased over that in corresponding areas of non-lesional skin from subjects with mastocytosis (7178 +/- 3607 mast cells/mm3), skin from subjects with idiopathic anaphylaxis or flushing episodes (6974 +/- 3873 mast cells/mm3) and normal skin (7347 +/- 2973 mast cells/mm3). The exclusive presence of MCTC cells in skin lesions of mastocytosis which are characterized by non-malignant hyperplasia of mast cells suggests involvement of local tissue factors in mast cell recruitment and differentiation.