Careful preservation of the morphology of clinical biopsy samples is an essential factor for tissue analysis. Given the particular difficulties in handing skeletal muscle biopsies, with their unique multinucleate cellular morphology, the first goal of this study was to explore and refine preservation methods for skeletal muscle tissues, while assessing structural integrity using histological and immunohistochemical staining methods.
The initial phase of our study involved handling of human needle biopsies. Variation in freezing conditions can lead to disruption of cells, organelles and connective tissue. Therefore, our first objective was to examine these biopsies in detail. In our study, immersion of human needle biopsies (originally frozen in LN2 and stored at -80°C) into formaldehyde or OCT, both at room temperature, resulted in the thawing of skeletal muscle samples, and consequent refreezing before cryosectioning. This effectively created a freeze-thaw cycle, leading to damage to tissue architecture. This damage presented as cellular and connective tissue streaks with no identifiable myofibres. Increasing concentrations of formaldehyde to levels much higher than the standard recommendations preserved the myofibres, as the fixating power of formaldehyde ultimately overcomes the degenerating capacity of freeze-thaw. However, even with such high fixative concentrations, we still observed structural alterations within the tissue, with widely spaced cells and disrupted endomysium/perimysium. We also observed the formation of ice crystals. This is due to the high endogenous water content of skeletal muscles, which was not prevented using elevated concentrations of formaldehyde.
The next phase of our study used rat skeletal muscle to enable experimental optimisation. This approach allowed us to compare various cryopreservation techniques, while affording greater control and flexibility. The initial decision to work on whole muscle samples, much larger than needle biopsies, provided an opportunity to develop a deeper understanding of the localisation of ice crystals and what conditions might facilitate their development. The observation of differential ice crystal distribution between sections obtained from the edge and belly of the whole muscle sample, as well as differences in the area occupied by crystals between core and periphery within the same section (Fig. 3b-e), suggested against the use of OCT. The employment of OCT has been advocated in various tissue repository guidelines for maximum preservation of cell morphology and structure (17, 36, 37). However, the presence and extent of ice crystals in different regions of the tissue suggested that OCT may contribute to uneven crystal distribution. Muscle biopsy handling studies recommend against the use of OCT before cryosectioning since OCT can add moisture of its own to the tissue sample, as well as compromise adequate freezing (5). Only an OCT base is required to allow the tissue specimen to stick to the metal holder of the cryostat (38). Here, we have demonstrated the underlying effect OCT has on sample integrity (Fig. 3b-e and 4d). We therefore decided to discontinue the use of OCT in our experimental workflow and opted to directly freeze samples without OCT embedment.
Moreover, the Swiss Cheese effect was observed in rat whole muscle samples cryopreserved in LN2, suggesting nonuniform and slow cooling of tissue (6, 24). When LN2 encounters the warmer surface of the tissue, it forms an insulating layer of vapours encapsulating the specimen, preventing direct contact with LN2 and hence, slower and uneven freezing - the Leidenfrost effect (39). To overcome this, the use of isopentane pre-cooled in LN2 has been advocated (40). Isopentane has a melting point of -160°C, which means that when cooled by LN2, it moves from a liquid state to a solid state, eliminating the possibility of vapour formation and subsequent impeded cooling (7).
To mimic the conditions of human needle biopsies more closely, we opted to dissect the rat muscle into smaller fragments before subjecting them to various freezing methods. This approach allowed for a direct comparison of cryopreservation methods on biopsy-sized fragments, and their impact on tissue morphology and staining quality. Our histological staining results showed that varying degrees of ice crystal formation were observed in all samples, except for cryopreservation with pre-cooled isopentane with the sample placed in a histocassette (Fig. 5). Fluorescence microscopy demonstrated the same, with disruption of myofibrillar arrangement, saturation of fluorescence signal, and empty gaps dominating the tissue periphery of all samples except for isopentane/histocassette combination (Fig. 6). Previous literature demonstrates that isopentane offers enhanced tissue penetration with homogenous tissue freezing, resulting in consistent histological sections with minimal to no artefacts (5, 7), but scrutiny of our tissues revealed the presence of ice crystals in the peripheral regions. The use of histocassettes for containment during freezing, however, provided additional advantages in tissue handling. The use of containers with fenestra has been employed in some studies (6, 8). A multi-hole cryovial employed by Huang et al. (2017) to freeze skeletal muscle samples demonstrated that fenestra around tissue promote flow of cryopreservative medium, and this limits the Leidenfrost effect seen with LN2 (6). Due to the lack of commercial availability of such vials, histocassettes were employed by Lee et al. (2020) when freezing rat muscle samples and human needle biopsies in LN2 (8). We decided to employ histocassettes for freezing in both LN2 and pre-cooled isopentane. In contrast to the results shown by Lee et al., samples in histocassettes immersed in LN2 exhibited ice crystals at the periphery of the specimen, with complete myofibrillar disruption observed using fluorescence microscopy. However, the use of histocassettes with pre-cooled isopentane resulted in no crystal artefacts on histological staining, and absolute preservation of myofibrillar arrangement on fluorescence microscopy. A further advantage of using histocassettes is the ability to label specimens for identification, and they are easily available in the laboratory settings.
We utilised the OCT dip technique when freezing specimens with either LN2 or pre-cooled isopentane, aiming to take advantage of its cryoprotective properties while preserving tissue morphology. We also wished to assess any effects OCT may have on smaller tissue samples. Unfortunately, ice crystals were observed in muscle samples frozen in this way. This reaffirmed our previous findings with whole muscle samples (Fig. 3) and emphasised the drawbacks associated with OCT in the context of skeletal muscle cryopreservation.
Our experimental freezing setup for the smaller rat skeletal muscle samples consisted of simple and readily accessible equipment. With LN2 in a dewar, and isopentane in a beaker mounted on a ladle, we provided a cost-effective and practical experimental setup that can easily be established by researchers in various laboratory settings and can be performed independently with ease.
We have also demonstrated PSR to be a useful tool in conjunction with H&E staining to provide robust evaluation of cryopreservation outcomes, and aid in selecting the most ideal methods (Fig. 5). If cryopreservation methods are optimised and result in tissue samples that exhibit preserved structural integrity, outcomes of subsequent experiments, such as fluorescence microscopy, can be considered reliable as tissues are free of crystal artefacts.
Having identified the isopentane/histocassette method as the most effective and reliable cryopreservation technique, we then focused on optimising the analysis of frozen skeletal muscle tissues. To this end, we developed and refined a workflow for mitochondrial analysis, aiming to overcome existing challenges and improving the clarity of mitochondrial imaging in skeletal muscle studies. We realised the lacunae that exist in the literature regarding mitochondrial analysis of confocal microscopy images of skeletal muscle tissues, with most platforms focusing specifically on cells. Here, we created and optimised a workflow adopting existing Fiji plugins, to allow for tissue quantification of mitochondria, while trying to limit the effect of the high background observed with mitochondrial dyes.
We employed existing workflows, functions, and plugins in Fiji for mitochondrial network quantification. Mitochondrial analyser and MiNA plugins provide a broad range of parameters for this purpose (11, 12). However, the high signal-to-noise ratio observed in skeletal muscle tissues stained with MitoView Green limits the extent to which the entire mitochondrial network can be thresholded in these plugins (Fig. 11). The use of threshold optimisation in Mitochondrial Analyser, and any of the available preprocessing options presented in MiNA, are both unable to demarcate the dimmer mitochondrial branches in type I myofibres, and the entire network in the weakly stained type II myofibres. Deconvolution algorithms have been employed in literature to enhance signal contrast and improve image resolution. However, deconvolution does not reduce the background and hence, does not allow for accurate distinction between signal and noise (12). The use of Trainable Weka Segmentation plugin allows users to define the range of pixel intensities representing mitochondria and their branches, and to differentiate the network from the high tissue background. This will then allow for accurate mapping of mitochondria and thresholding of the image, which can be utilised for subsequent analysis. The Trainable Weka Segmentation plugin can accurately distinguish between signal (of all intensities) and noise, and can provide a map most closely aligned to the actual mitochondrial network. The overlaying option keeps the user in check to ensure additional features have not been falsely added to the image, nor been removed. The training data can be saved and reused for subsequent imaging analysis and can also be altered in case the new image shows variable signal-to-noise ratio, or presents different pixel intensities of the actual signal. The workflows employed in previous literature perform preprocessing that is unsuitable for type II myofibres, which stain very weakly with MitoView Green and present a significantly low signal-to-noise ratio. The Trainable Weka Segmentation plugin can be adequately trained to identify the dim signal in type II myofibres.
The modification of our workflow to generate a mitochondrial map presents an avenue to allow for localisation of our targets of interest with respect to spatial relationships within the mitochondrial network. We believe creating a ‘How To’ guide for the use of this plugin will be a helpful addition to support other researchers with their analysis needs. This can specifically aid in assessing fibre-specific changes in various conditions, and for proteins that have an association with mitochondrial networks.
The limitation of our mitochondrial analysis workflow is that it is time-consuming. However, this could be effectively streamlined if combined with more sophisticated coding and programming methods (41, 42). Analysis requires thorough self-reflection to ensure no feature has been missed or falsely added, with effective blinding techniques in place to prevent bias at the analysis stage (43). The variation in the intensity of signal across cells within the tissue section prevents the use of the same training data being applied to all sample sets.
One issue revealed in our study was the lack of penetration of VDAC antibodies in the tissue (Fig. 15). Fixation was not used as a method of preservation of tissues prior to cryosectioning, so epitope masking should potentially not arise. However, we will aim to perform antigen retrieval methods to assess whether the 10-minute fixation step during immunofluorescence is causing the penetration issue. Moreover, we will aim to use different skeletal muscle proteins to explore whether this is an antibody-specific effect, arising from the sensitivity of the antibody to fixation steps.
In conclusion, our findings underscore the importance of selecting appropriate cryopreservation techniques to ensure the structural preservation of skeletal muscle biopsies, which is crucial for accurate histological and immunohistochemical analyses. The optimised workflow for mitochondrial analysis further enhances the utility of preserved tissue samples, providing a robust tool for future studies in muscle biology. A summary of the optimised cryopreservation techniques and workflow for mitochondrial analysis is shown in Fig. 16.