Direct Cell Counting Assays for Immuno Therapy

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Direct Cell Counting Assays for Immuno Therapy Cytotoxicity assays play a central role in studying the function of immune effector cells such as cytolytic T lymphocytes (CTL) and natural killer (NK) cells. Traditionally, cytotoxicity assays have been performed using Chromium-51 ( 51 Cr) and Calcein release assays. The assays involve labeling tumor cells (target) with radioisotope or fluorescent dyes, when the target cells are subjected to CTLs or NK cells (effector) mediated killing, they release the entrapped labels into the media. The amount of released label in the media is measured to determine the level of cytotoxicity the effectors have induced. A novel cytotoxicity assay using the Celigo imaging cytometer to directly count live, fluorescently labeled target cells has recently been introduced. Celigo Imaging Cytometry for Direct Cell Counting ADCC Assay 1. Celigo Imaging Cytometer is a plate-based cytometer that can scan the entire well of standard microplates and captures bright-field and fluorescent images. 2. The captured images are analyzed with the Celigo software to measure size, morphology, cell count, confluence, and fluorescent intensity. 3. The measured parameters are used to generate cell proliferation kinetic data, GFP/RFP expression, tumor spheroid size change, DNA cell cycle analysis, apoptosis, and ADCC cytotoxicity results. Direct Cell Counting Method using Calcein AM Uses Celigo to capture and analyze bright-field and green fluorescent images Target suspension and adherent cells are stained with Calcein AM and then mixed with the Effector cells The number of Target cells (Calcein+) are counted and monitored over time Reduction in Target cell number indicates cell-mediated or antibody- dependent cell-mediated cytotoxicity (ADCC)

4. Celigo image cytometer produces whole well images for 96-, 384-well plates. Cytolytic cells CIK cells NK cells Neutrophils CAR T cells Fluorescent stains Fluorescent proteins - GFP, RFP Calcein AM Cell tracer dyes CFSE CellTrace TM dyes Viability dyes - PI, DAPI 5. Cell images are used by the Celigo software to count live tumor cells for each well. Image tumor cells stained with Calcein AM Count Calcein+ live tumor cells

6. Direct cell counts for each well are reported in the plate map format 7. Each plate can be imaged multiple times during the killing process Time = min Time = 4 min Time = 16 min

8. Numerical data output into.csv file with plate level readout. Live Count 1 2 3 4 5 6 7 8 9 1 11 12 A B C D E F G H 27 69 92 3178 214 548 431 3442 883 145 1297 434 1454 2535 2272 456 294 3197 333 3855 2895 3342 3729 4119 1234 297 2173 969 24 3223 3418 1 9458 272 468 4764 9855 34 6457 6273 9836 4158 7123 7158 947 4856 6857 891 9418 9. Total cell count, live cell count, % live cell count and other parameters are generated for each well General Scan Area Location: C2 % LIve: 3.14% Live Count: 1954 PI(+): Mean Intensity vs. CF SE(+): Mean Intensity Dead CIK Cells Dead Tumor Cells Total Count: 6223 % Well Sampled: 1.% AVG Live Mean Intensity: 15.22 SD of Live Mean Intensity: 28.36 AVG Live Integrated Intensity: 15,178.3 PI(+): Mean Intensity SD of Live Integrated Intensity: 11,16.99 AVG Total Mean Intensity: 113.75 SD of Total Mean Intensity: 22.25 AVG Total Integrated Intensity: 3,897.3 Live Tumor Cells CF SE(+): Mean Intensity SD of Total Integrated Intensity: 3,812.26

Quantification of Natural Killer Cell-Mediated Cytotoxicity Over 4 Hours with Multiple Time Point Measurement Celigo Experimental Protocol Target cells are collected and stained with Calcein AM (1 µm) Plate the Target cells at 1, cells/well Collect Effector NK cells and add to 96-well plate at different E:T ratios Image and analyze Calcein AM stained live cells with Celigo at t=1, 2, 3, 4 h % Lysis Calculation for Cytotoxicity Measurement Count # of live Target cells (Calcein AM positive) in wells with Effector cells Count # of live Target cells (Calcein AM positive) in wells without Effector cells (control) % Lysis = ncam+_t ncam+_t ncam+_t ncam+_t ncam+_t treated ncam+_t control Experiment Design IMR32 (Adherent) and K562 (Suspension) target cells are used to demonstrate the NK Cell-mediated cytotoxicity detection method using Calcein AM staining for direct cell counting The Effector-to-Target (E:T) ratio will be 1:1, 5:1, 2.5:1, 1.3:1,.6:1, and.3:1 The Maximum Release uses Triton X1 to lyse all cells and release the Calcein AM fluorescent molecules Live Target cells are automatically counted at each E:T ratio from t = 1-4 hours Cell images at 4 hours for K562 cells Control E:T =.6:1 E:T = 5:1

E:T Ratio and Time Dependant Cytotoxicity of K562 The example Calcein+ fluorescent images are the K562 Target cells at t = 4 hours The resulting fluorescent images showed increase in Calcein AM positive Target cells as E:T ratio decreased % Lysis 1% 9% 8% 7% 6% 5% 4% 3% 2% 1% % K562 1 1.5 2 2.5 3 3.5 4 Incubation Time (Hour) 1:1 5:1 2.5:1 1.25:1.6:1.3:1 % Lysis 1% 9% 8% 7% 6% 5% 4% 3% 2% 1% % K562 1:1 5:1 2.5:1 1.3:1.6:1.3:1 E:T Ratio t=1 t=2 t=3 t=4 The live K562 suspension cells were directly measured using the Celigo The number of Calcein AM positive cells was counted at each hour and used to calculate the % lysis for each E:T Ratio By analyzing the time course data of K562, we can see that the % lysis difference between the E:T Ratios is much smaller in comparison to IMR32 % Lysis 1% 9% 8% 7% 6% 5% 4% 3% 2% 1% % IMR32 1 1.5 2 2.5 3 3.5 4 Incubation Time (Hour) 1:1 5:1 2.5:1 1.25:1.6:1.3:1 % Lysis 1% 9% 8% 7% 6% 5% 4% 3% 2% 1% % IMR32 1:1 5:1 2.5:1 1.3:1.6:1.3:1 E:T Ratio t=1 t=2 t=3 t=4 The live IMR32 adherent cells were directly measured using the Celigo without trypsinization The number of Calcein AM positive cells was counted at each hour and used to calculate the % lysis for each E:T Ratio By analyzing the time course data of IMR32, we can see that there is a large % lysis difference between the E:T Ratio

Antibody-Dependent CIK-Mediated Cytotoxicity Using CFSE and PI Fluorescent and Bright-Field Cell Images and Overlay for CFSE and PI CFSE PI PI(+): Mean Intensity vs. CF SE(+): Mean Intensity Dead CIK Cells Dead Tumor Cells CFSE + PI CFSE + PI + BF Dead tumor cell Live CIK cell PI(+): Mean Intensity Dead CIK cell Live tumor cell Live Tumor Cells CF SE(+): Mean Intensity Live tumor cells (CFSE+PI-) Dead tumor cells (CFSE+PI+) Live Effector cells (CFSE-PI-) Dead Effector cells (CFSE-PI+) The fluorescent intensities of CFSE and PI are plotted directly in the Celigo Software Quadrant LR indicates the live tumor cells Quadrant UR indicates the dead tumor cells Quadrant UL indicates the dead CIK effector cells Antibody Concentration Dependent Cytotoxicity = Live Tumor Cells = Dead Tumor Cells = Dead CIK Cells High Antibody Concentration Low

Cytotoxicity Assay Using Bright-field Morphological Confluence Assay Direct Cell Killing Effect with Drug Concentration Curve 1% Bright field based cell confluence cytotoxicity assay 1% Cell confluence 8% 6% 4% 2% % 1 2 3 4 5 6 7 8 9 1 Drug dilutions The captured images show an increase of cell confluence with increased drug dilution. Celigo software produces cell growth curves for each drug treated sample. (not shown here) Confluence Measurements for a Multi-drug Cytotoxicity Assay Control Treatment 1 2 3 4 5 6 Drug treatment, concentration dependent cytotoxicity is represented by well level confluence measurement in a 384-well plate. Green color indicates the level of confluence per well.

Traditional Methods vs. Natural Killer - Cell-Mediated Cytotoxicity Detection Methods Traditional Cell-Mediated Cytotoxicity Detection Methods Detection Method Description Existing Issues Radioactivity Release Fluorescence Release LDH Release Measure release or radiolabels, 51Cr, 11In in the supernatant Measure release of Calcein AM fluorescent molecules in the supernatant Measure release of cytosolic enzyme in the supernatant Handling hazardous material and indirect measurement of cell death Indirect measurement of cell death, endpoint assay only Indirect measurement of cell death, endpoint assay only Luciferase Reporter Assay Measure luciferase as the cells die Indirect measurement of cell death Flow Cytometery Measure number of viable cells and viability in the sample Cannot perform in plates, must trypsinize for adherebt cells Celigo Benefits for Direct Cell Counting ADCC Time-course tracking of % lysis can eliminate the need of multiple controls, and the effect of non-uniform cell seeding in the final cytotoxicity calculation. Adherent cells can be measured and analyzed directly in the plate without trypsinization. The number of cells used is significantly reduced compared to other release assays and Flow Cytometry, from 1, to 1, target cells. The visual observation of Cell-Mediated, ADCC, or CDC effect on tumor cells provides additional information on the functionality of antibodies or complements. Celigo Assays for Immuno-Oncology Direct cell counting and confluence measurement using bright-field Antibody-mediated cell killing (cell proliferation) Direct cell counting method using Calcein AM (or GFP, RFP) NK cell-mediated cytotoxicity NK ADCC Neutrophil ADCC CDC Direct cell counting method using tracer dye, fluorescent protein, viability dye CIK ADCC CAR T cell-mediated cytotoxicity Simply Counted Image Cytometer Nexcelom products are for RESEARCH USE ONLY and are not approved for diagnostic or therapeutic use. Copyright 215 Nexcelom Bioscience LLC. All Rights Reserved. For more information, visit www.nexcelom.com Contact us at: Nexcelom Bioscience 36 Merrimack Street, Building 9 Lawrence, MA 1843, USA Email: info@nexcelom.com Phone: 978.327.534 Fax: 978.327.5341 1131 RevB 5/15