Tissue
Normal breast tissue was obtained from women undergoing reduction mammoplasty for cosmetic reasons. Information about donors is restricted to the donor´s age at the time of surgery. The tissue was donated with written consent by donors who received information before surgery at a clinic in the Greater Copenhagen area, Denmark. The Regional Scientific Ethical Committees (Region Hovedstaden, H-2-2011-052) and the Danish Data Protection Agency (2011-41-6722) reviewed and approved the use and storage of human material. Some of the donated tissue has been included in other studies. Procedures for orthotopic injection of human cells into the mouse mammary fat pad or under the skin was reviewed and approved by the Danish National Animal Experiment Inspectorate (2017-15-0201-01315 and 2017-15-0201-01210).
Cell isolation and cell culture
An established protocol for preparation and isolation of stromal cells and epithelial organoids was applied and can be found elsewhere [15]. We used four sets of primary CD105high/CD26low lobular- and CD105low/CD26high interlobular human breast fibroblastic cells (HBFCs) from four different biopsies obtained from donors at 19, 20, 23 and 29 years of age, which had been isolated previously [10]. These cell strains as well as the two hTERT immortalized fibroblast cell lines (iHBFCs, iHBFCCD105 and iHBFCCD26, respectively), derived from a donor of the age of 20 years were maintained in DMEM/F-12 (DMEM:Ham’s F12 Nutrient Mixture (F12), 1:1 v/v, Life Technologies) supplemented with 5% fetal bovine serum (FBS, Sigma), 2 mM glutamine and penicillin-streptomycin antibiotics (DMEM/F12-5%). The cultures were plated at a density of 5,600 cells/cm2 in collagen coated flasks (Nunc, 8 μg collagen/cm2, PureColl, Cell Systems).
An hTERT immortalized MSC line, hMSC-TERT4 [16] referred to here as hMSC-TERT was cultured on plastic (Nunc) in Minimum Essential Medium (MEM, containing Earle´s salts and L-Glutamine, Gibco) supplemented with 10% FBS (South American Origin, Gibco) and 1 % penicillin-streptomycin (Gibco) (MEM-10%) and split 1:4 at ~80% confluence. All cell cultures were maintained at 37 °C in a humidified atmosphere with 5 % CO2 with medium change three times a week.
Population doubling level (PDL) was calculated as: PDL = 3.32 (log I – log Y) +X, where I is the cell number of the inoculum, Y is the cell yield and X is the population doubling of the inoculum. The hTERT immortalized breast fibroblasts have currently been propagated for more than 80 passages (available through Ximbio, UK, IAHF, cat. no. 153783 and IEHF, cat. no. 153784).
Viral transduction
Viral constructs used included human telomerase (pBabe-neo-hTERT, Addgene #1774, a gift from Robert Weinberg [17]), empty vector (pBabe-neo, addgene # 1767, a gift from Hartmut Land & Jay Morgenstern & Robert Weinberg [18]), and viral packaging construct pCL-Ampho (a gift from Dr. Hung Nguyen, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, USA, [19]).
Retroviral particles +/- the hTERT construct were generated by transient co-transfection of pBabe-neo-hTERT or pBabe-neo (5 μg) and pCL-Ampho (2.5 μg) constructs into HEK293T cells grown in collagen coated flasks using the calcium-phosphate method. The following day, the DMEM/F12-5% medium was replaced. Medium containing viral particles was collected 96 hours post transfection, passed through a 0.45 μm filter. Subconfluent fibroblast cultures in passage eight were transduced with the viral supernatant supplemented with 8 μg/mL polybrene at serial dilution over-night upon when the medium was replaced. At 90% confluency, the transduced cells underwent antibiotic selection with medium containing 300 μg/mL G418 (Life Technologies) for nine days until non-transduced control cells showed no signs of cell survival. The concentration of antibiotic used was determined prior to transduction by testing different concentrations of G418 and choosing the dose of 300 μg/mL G418, which eliminated all cells within one week. The transduction efficiency was not more than 15%, in which the majority of cells were transduced by one copy of retroviral particle [20].
RNA extraction, RT-qPCR, and Next generation sequencing
To measure hTERT expression, total RNA was extracted from hTERT-transduced HBFCs, iHBFCs, and empty vector- transduced HBFCs, evHBFCs, in passage 11 according to the manufacturer’s instructions (Sigma, GenElute, RTN70) and the RNA was reverse transcribed to cDNA using the High Capacity RNA-to-cDNA Kit (Applied Biosystems). Real-time quantitative polymerase chain reaction (RT-qPCR) was performed as described [11] using TaqMan Gene Expression Assays (Applied Biosystems) and the TaqMan primers: human telomerase reverse transcriptase (hTERT, Hs00972656_m1), Glyceraldehyde-3-phosphate-dehydrogenase (GAPDH, Hs02758991_g1), hypoxanthine phosphoribosyltransferase 1 (HPRT1, Hs99999909_m1) and phosphoglycerate kinase 1 (PGK1, Hs00943178_g1). Gene expression was determined using the formula 1/(2ΔCT), in which ΔCT represents the difference between the target and the geometric mean of reference genes. GAPDH, HPRT1 and PGK1 served as reference genes for normalization.
For next generation sequencing, total RNA was extracted using Trizol (Thermo Fischer) and a spin column method according to the manufacturer’s instructions (Zymo Research) from subconfluent duplicate cultures of HBFCCD105 and HBFCCD26 in passage 9, and from duplicate cultures of passage 24 iHBFCCD105 and passage 25 iHBFCCD26. RNA sequencing and bioinformatics analysis was performed by the Beijing Genomics Institute (BGI), Hong Kong as previously described [11]. In brief, sequencing was performed using BGISeq 500 and 13.7 M clean reads were generated for each sample. Mapped clean reads to reference using Bowtie 2 tool [21] were then used to calculate gene expression with the RSEM package [22]. To identify differentially expressed genes (DEGs) between groups, the DESeq2 method was used [23]. A Venn diagram (https://bioinfogp.cnb.csic.es/tools/venny/index.html) was used to depict the overlap of DEGs with a 2 fold difference between fibroblast populations.
For analysis of cluster of differentiation (CD) molecular signature, a comprehensive list of 453 unique CD molecules and their gene names was retrieved from the Uniprot database (https://www.uniprot.org/docs/cdlist) and applied to filter DEGs with a 2 fold difference and FPKM larger than 5. The R software (v3.2.2) was used to plot gene expression values in a heatmap.
Adipocyte and osteoblast differentiation
To assess adipogenic differentiation, in seven independent tests, iHBFCs in passages 27, 28, 40, 49 and 50, were plated at 40,000 cells/cm2 in DMEM/F12-5%. 1-2 days after plating, the medium was changed to adipogenic inducing medium (MEM-10% with 2.5% horse serum (Sigma Aldrich), 100 nM dexamethasone (Sigma-Aldrich), 500 mM 1-methyl-3-isobutylxanthine (IBMX, Sigma-Aldrich), 1 mM Rosiglitazone (BRL49653, Cayman Chemical) and 5 mg/mL insulin (Sigma-Aldrich)) [24]. Controls received MEM-10 % medium. The medium was replaced three times per week over 13-25 days on which the cultures were evaluated by Oil Red O staining [25]. Nuclei were counterstained by hematoxylin and photographs were acquired on Leica DM5500B. For osteogenic differentiation, in 5 independent tests, HBFCs in passage 22, 28, 35, 49, and 50 were plated over-night at 20,000 cells/cm2, and were then exposed to osteogenic inducing medium (MEM-10% supplemented with 10 mM β-glycerophosphate (Calbiochem), 50 µg/mL L-ascorbic acid (Sigma), 10 nM Dexamethasone (Sigma), and 10 nM 1,25-dihydroxy vitamin D3 (LEO Pharma) [26] for 28-32 days with medium change three times a week. Controls received MEM-10% medium. Mineralization was assessed by alizarin red staining [24] and photographs were acquired with Leica Z6 AP0.
Fluorescence activated cell sorting and co-cultures
Primary MUC1high luminal epithelial cells (CD271low/MUC1high) and CD271high myoepithelial cells (CD271high/MUC1low or CD271high/EpCAMlow) were isolated from breast tissue biopsies as described [10, 11]. Freshly isolated myoepithelial cells were plated (2,500 – 5,000 cells/cm2) onto confluent fibroblasts feeder layers of iHBFCCD105 and iHBFCCD26, respectively. Myoepithelial/fibroblast co-cultures were maintained in a specialized culture medium, Myo medium [11], supplemented with 5% FBS (Myo 5%). In one experiment, cultures were maintained in DMEM/F12-5%, which gave a similar result. Primary myoepithelial cells were also plated on collagen coated plastic in Myo medium and expanded to passage 2 before use in co-cultures with fibroblasts in passage 3 using Myo 5% medium.
To isolate myoepithelial cells from co-cultures, the cell cultures were trypsinized (0.25% trypsin/1 mM EDTA), counted using a Burker-Türk chamber and stained for CD271-APC at 4°C for 30 minutes followed by two washes in HEPES/BSA/EDTA buffer. Fixable Viability Stain 780 (1:1000, BD Biosciences) live-dead discriminator was added prior to analysis and sorting on FACS ARIA-II or FACS Fusion (BD Biosciences). FACS data analysis was performed with FACS DIVA and FlowJo software.
In a cross-over test, myoepithelial cells in primary culture were isolated from co-cultures with iHBFCCD105 and iHBFCCD26, respectively, and from each, 1,600 myoepithelial cells/cm2 were re-plated onto confluent fibroblast feeders of both iHBFCCD105 and iHBFCCD26. To account for variance in absolute CD271 levels and for normalization purposes, myoepithelial CD271 levels were divided by the mean background CD271 fluorescence of the co-cultured fibroblasts.
For assessment of epithelial morphogenesis, FACS sorted primary MUC1high luminal cells (6,000 cells/ cm2) were seeded in Myo medium onto confluent feeder layers of iHBFCs and observed for up to three weeks using a phase contrast microscope and imaged (Leica DM IL).
In 15 tests using TGF-β signaling inhibition by SB431542 (Axon 1661, Axon Medchem), HBFCs representing four biopsies were allowed to grow to confluence over 7 days and were then treated with 10 μM SB431542 for 3 days before plating of MUC1high luminal cells at day 10 from five biopsies.
In two tests, MUC1high luminal cells from two biopsies were plated onto confluent HBFCs from two biopsies in Myo medium. From day 2-9 the co-cultures were exposed to 10 μM SB431542 or vehicle (DMSO).
Luminal differentiation
To assess the ability of fibroblasts to direct luminal differentiation capacity of myoepithelial progenitors, fourteen myoepithelial/fibroblast co-cultures (7 pairs of iHBFCCD105 and iHBFCCD26) representing six different biopsies were used. Specifically, from a pair of co-cultures in DMEM/F12-5% (passage 1) and three co-culture pairs in Myo 5% medium (passages 1, 2 and 3), representing three different biopsies, CD271high myoepithelial cells were isolated by FACS and plated at 1,600 cells/cm2 for analysis of luminal differentiation. In three other experiments, representing three additional biopsies, primary co-cultures from Myo 5% medium were trypsinized and cells plated without prior FACS sorting into luminal differentiation conditions. For luminal differentiation, conditions were used as described [11], or in some experiments, with similar results, the culture medium was replaced with DMEM/F12 supplemented with 2 mM glutamine, 50 μg/mL gentamycin (Biological Industries), 0.5 μg/mL hydrocortisone (Sigma, H0888), 5 μg/mL insulin (Sigma, I6634), 30 ng/ml epidermal growth factor (recombinant human) (Peprotech), 0.4% (approx. 50 μg/mL) bovine pituitary extract (Gibco, 13-028-014), 20 ng/mL basic fibroblast growth factor (Peprotech), 25 μM Repsox (Sigma, R0158), 4 μg/mL heparin (Sigma) and 20 μL/mL B27 ( Life Technologies).
Immunohistochemistry and immunocytochemistry
Cryostat sections of normal breast tissue biopsies, xenografts as well as cultured cells and cell smears were stained essentially as previously described after fixation in either methanol (M in Table 1) or formaldehyde (F1 in Table 1) or formaldehyde followed by methanol:acetone (F2 in Table 1) and included controls without primary antibody [12, 27, 28]. Blocking was performed for 5 minutes in 10% goat serum in PBS or Ultra V Block (Lab Vision Corporation TA125-UB). Cells were incubated with primary and secondary antibodies for 60 and 30 minutes respectively (Table 1). For immunoperoxidase staining, the secondary antibody was UltraVision ONE HRP Polymer (Thermo Fisher, TL-125-PHJ) and for fluorescence, isotype-specific goat anti-mouse IgG AlexaFluor (AF, Life Technologies) secondary antibodies were used. Nuclei of immunoperoxidase- or fluorescence stained sections and cells were counterstained with hematoxylin or ProLong Gold Antifade reagent with 4, 6-diamino-2-phenylindole (DAPI, Life Technologies), respectively.
Table 1. List of antibodies and protocols.
Antibody
|
Clone/isotype
|
Company/Catalogue no
|
Peroxidase
|
Fluorescence
|
FACS
|
Fixation
|
α-SMA
|
1A4
|
Sigma/A2547
|
|
1:5000
|
|
F1
|
CD105
|
SN6
|
Abcam/Ab11414
|
1:200
|
|
|
F2/M
|
CD26
|
202-36
|
Abcam/Ab3154
|
1:50
|
|
|
F2/M
|
CD140b
|
PR7212
|
R&D Systems/MAB1263
|
1:1000-1:2000
|
|
|
F1
|
CD248
|
EPR17081
|
Abcam/ab204914
|
1:1000-1:2500
|
|
|
F1
|
K17
|
E3
|
DAKO/M7046
|
|
1:50
|
|
F1/F2/M
|
K14
|
LL002
|
Monosan/MONX10687
|
|
1:25-1:50
|
|
F1/F2/M
|
K19
|
Ba16
|
GenWay/GWB22664E
|
1:200
|
|
|
F2/M
|
K19
|
Ba16
|
Abcam/ab20210
|
1:200
|
1:50
|
|
F2/M
|
K19
|
A53-B/A2
|
Abcam/ab7754
|
|
1:100
|
|
F/M
|
CD271
|
ME20.4
|
BioLegend/345102
|
|
1:25
|
|
F1
|
CD271-APC
|
ME20.4
|
Cedarlane/CL10013APC
|
|
|
1:50
|
|
CD326-488
|
9C4
|
BioLegend/324210
|
|
|
1:50
|
|
CD326
|
9C4
|
BioLegend/324202
|
|
1:25
|
|
F1
|
MUC1
|
115D8
|
Biogenesis/1510-5025
|
|
1:10-1:20
|
1:50
|
F2
|
Vimentin
|
SP20
|
Thermo Fisher Scientific/RM-9120
|
1:200
|
|
|
F1
|
AF488
|
IgG1
|
Life Technologies/A21121
|
|
1:500
|
|
|
AF488
|
IgG2b
|
Life Technologies/A21141
|
|
1:500
|
1:500
|
|
AF488
|
IgG3
|
Life Technologies/A21151
|
|
1:500
|
|
|
AF568
|
IgG1
|
Life Technologies/A21124
|
|
1:500
|
|
|
AF568
|
IgG2b
|
Life Technologies/A21144
|
|
1:500
|
|
|
AF647
|
IgG2a
|
Life Technologies/A21241
|
|
1:500
|
|
|
11 pairs of iHBFCCD105 and iHBFCCD26 spanning passages 11-50 were stained by immunoperoxidase for CD105 (Abcam, SN6) and CD26 (Abcam, 202-36). Photographs were acquired with Leica DM5500B.
6-8 mm cryostat sections of three different biopsies were triple-stained by fluorescence for CD271 (BioLegend, ME20.4), α-SMA (Sigma, 1A4), and EpCAM (BioLegend, 9C4) followed by AF488 (IgG1), AF568 (IgG2b) and AF647 (IgG2a). The triple-stainings were evaluated and imaged using confocal microscopy (Zeiss LSM 700).
6-8 mm cryostat sections of 10 different biopsies were immunoperoxidase-stained for CD140b (PDGFRb; R&D Systems, PR7212) and CD248 (Abcam, EPR17081), evaluated and imaged (DM5500B).
Xenografts were sectioned (6-8 μm) and co-stained by fluorescence for K19 (Abcam, A53-B/A2) and K14 (Monosan, LL002), followed by incubation with AF568 (IgG2a) and AF488 (IgG3).
MUC1high-luminal/fibroblast co-cultures were immunoperoxidase-stained on day 9-12 for Keratin 19 (GenWay or abcam, BA16) and images acquired on Leica Z6 AP0 at 1.25 magnification. The images were analyzed with ImageJ software (v1.52a) in batch mode using a macro previously established [10] counting the number of epithelial structures larger than 0.0026 mm2.
For observation of epithelial polarization, 10 pairs of iHBFCCD105 and iHBFCCD26 in co-culture with luminal epithelial cells from five different biopsies were co-stained on day 9-23 by fluorescence for K19 (Abcam, BA16) and MUC1 (Biogenesis, 115D8) followed by AF488 (IgG2b) and AF568 (IgG1). The co-stainings were evaluated by epi-fluorescence microscopy (Leica DM5500B) and imaged using confocal microscopy (Zeiss LSM 700).
Myoepithelial/fibroblast co-cultures were co-stained for K14 (Monosan, LL002), K17 (Dako, E3) and K19 (Abcam, BA16), followed by AF488 (IgG3), AF568 (IgG2b) and AF568 (IgG1). Images of three co-cultures representing three different biopsies were acquired with Leica DM5500B and K17 intensity measured with image analysis software, ImageJ (1.52a). For this, segmentation was first performed on K14 using the ImageJ functions Multiply, Median and Make Binary providing the outline of the myoepithelial cells. This segmentation was then applied to corresponding images of K17 in which fluorescence intensity was measured.
Cultures subjected to luminal differentiation conditions were stained for K19 (Abcam, BA16) by immunoperoxidase on day 8-12, evaluated and imaged using Leica DM5500B.
For a quantitative assessment of CD271 as a marker for ductal myoepithelium, cellular smears were prepared from FACS-isolated CD271high versus CD271low myoepithelial cells from four different biopsies. The smeared cells were fixed at room temperature for 10 minutes in 3.7% paraformaldehyde, washed three times in PBS and permeabilized in 0.01% Triton X-100 for 10 min followed by three washes in PBS. The fixed smears were blocked by 5 minutes incubation in Ultra V Block followed by 5 minutes in 10% goat serum before staining with K17 (Dako, E3) antibody, followed by AF488 (IgG2b) and DAPI. Images of stained smears were acquired with Leica DM5500B and a minimum 100 cells per cell preparation was counted using ImageJ (v1.52a) Cell Counter plugin.
Xenografts were sectioned (6-8 μm) and co-stained by fluorescence for K19 (Abcam, A53-B/A2) and K14 (Monosan, LL002), followed by incubation with AF568 (IgG2a) and AF488 (IgG3) prior to confocal imaging (Zeiss LSM 700).
In vivo bone formation assay
One million hMSC-TERT (2 implants, 1 mouse), iHBFCCD105 (4 implants, 3 mice) were mixed with 40 mg hydroxyapatite/tricalcium phosphate (HA/TCP) ceramic powder (Zimmer Scandinavia, Albertslund, Denmark), incubated at 37 °C at 5 % CO2 atmosphere over-night and then implanted subcutaneously in the dorsal side of NOD.CB17-PrkdcScid/J mice (Charles River, France) [29]. Implants were removed after eight weeks, transferred to 4% neutral buffered formalin for 24 hours followed by incubation in formic acid for three days. The processed implants were paraffin-embedded, sectioned and stained as described [30] with human-specific vimentin (Thermo Fisher Scientific, clone SP20) antibody or by hematoxylin-eosin [31].
In vivo morphogenesis
From primary co-culture with iHBFCCD105 or iHBFCCD26, approximately 500,000 myoepithelial cells, with or without removal of co-cultured CD271low fibroblasts by FACS, representing two biopsies, were admixed with 125,000 or 500,000 irradiated (~20Gy) iHBFCCD105 or iHBFCCD26 cells and suspended in cold 1:1 collagen gel: growth factor reduced Matrigel (BD Biosciences) for transplantation. Cells were orthotopically injected into the 4th left and right mammary fat pad of 7-10 week old female NOD.Cg-PrkdcSCID Il2rgtm1sug mice (NOG mice, Taconic) (iHBFCCD105: 10 transplants, 5 mice; iHBFCCD26: 8 transplants, 4 mice). Mice were supplemented with 0.67 μg/mL 17β-estradiol (Sigma-Aldrich) in the drinking water throughout the experimental period. After eight weeks the mice were sacrificed and the mammary glands excised and snap frozen in -80°C n-Hexane (Sigma) before mounting for cryostat sectioning.
Statistics
Statistical analyses and data visualization were performed with a statistical programing language R (version 3.6.3) and its integrated development environment, R studio (version 1.2.5033) and GraphPad Prism (version 8). Estimated p values were based on Shapiro-Wilk test for normality, one-way analysis of variance (ANOVA) with Tukey’s test, Kruskal-Wallis rank-sum test, Wilcoxon signed-rank test or nested t-test, as indicated.