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Last updated date: May 14, 2024 Views: 148 Forks: 0
A Multi-color Immunofluorescence Assay to Distinguish Intracellular from External Leishmania Parasites
Arani Datta1, Umaru Barrie1,2 and Dawn M. Wetzel1,3, *
1Department of Pediatrics, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, Texas, 75390, United States; 2Medical Scientist Training Program, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, Texas, 75390, United States; 3Department of Biochemistry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, Texas, 75390, United States.
*For correspondence: Dawn M. Wetzel, M.D., Ph.D. Dawn.Wetzel@UTSouthwestern.edu
Abstract
Leishmaniasis, a neglected tropical disease, is caused by the intracellular protozoan parasite Leishmania. Upon its transmission through a sandfly bite, Leishmania binds and enters host phagocytic cells, ultimately resulting in a cutaneous or visceral form of disease. The limited therapeutics available for leishmaniasis, in combination with this parasite’s techniques to evade the host immune system, call for exploring various methods to target this infection. To this end, our laboratory has been characterizing how Leishmania is internalized by phagocytic cells though the activation of multiple host cell signaling pathways. This protocol, which we use routinely for our experiments, delineates how to infect mammalian macrophages with either promastigote or amastigote forms of the Leishmania parasite. Subsequently, the number of intracellular parasites, external parasites, and macrophages can be quantified using immunofluorescence microscopy and semi-automated analysis protocols. Studying the pathways that underlie Leishmania uptake by phagocytes will not only improve our understanding of these host-pathogen interactions but also may provide a foundation for discovering additional treatments for leishmaniasis.
Key Features
Graphical Overview

Keywords
Leishmania, amastigote, macrophage, confocal microscopy, fluorescent labeling, phagocytic index
Background
Leishmaniasis wreaks havoc in a population of approximately 2 million annually across 90 endemic countries, and it is caused by <20 different species of the parasite Leishmania (WHO., 2023). Depending on the infective species and host immune system function, the resulting pathology can include cutaneous, mucocutaneous, or visceral disease. A need for new, effective drugs is demonstrated by the inadequacies of existing treatments, since current drugs for leishmaniasis already suffer serious limitations such as poor efficacy, toxicity and resistance (Dorlo et al., 2014; Mohapatra, 2014).
In their sand-fly vector, Leishmania exist as free, motile promastigotes with an elongated cell shape as well as a long flagellum. After transmission into the mammalian host, they multiply, undergo transformation and subsequently survive as intracellular amastigotes in the phagolysosomal compartment of macrophages (Mf) and other phagocytes (Handman, 1999). Amastigotes exhibit significantly lower cell surface to volume ratio and the flagellum is reduced to a tiny distended tip (Sunter & Gull, 2017). Although both forms are capable of infecting mammalian cells, only amastigotes can spread and eventually sustain the infection in the host (Mandell et al., 2017; Serafim et al., 2018). Conversely, for many (although not all) Leishmania species, only promastigotes can be cultured without mammalian cells (axenically). As such, although the process of Leishmania uptake by human Mf has been studied using confocal microscopy, the relative intractability of amastigotes has resulted in a predominant focus on promastigotes, which in turn overlooks many of the intricacies involved in Leishmania’s interactions with host Mf (Paixão et al., 2021). Since the host cell response to promastigotes and amastigotes varies significantly, a more comprehensive understanding of the entire life cycle is required for effective pathogenesis studies and drug discovery strategies.
Here, we provide a multicolor immunofluorescence protocol for studying the uptake of Leishmania by Mf with microscopy. In combination with various culture techniques, our protocol encompassing both promastigotes and amastigotes in the experimental setup has further expanded approaches to studies characterizing host-pathogen interactions. Furthermore, our protocol provides many ways in which it can be adapted to the situation at hand, including characterization of higher-order subcellular structures during parasite internalization or high-throughput screening and analysis for drug discovery. Our expanded approach provides a foundation for a better understanding of the pathogenesis of leishmaniasis and the development of more efficacious and targeted therapeutic interventions.
Materials and Reagents
Biological Materials
Reagents
Solutions
Recipes
| Reagent | Final concentration | Quantity |
| DMEM | n/a | 440 mL |
| FBS | 10% | 50 mL |
| Penicillin-streptomycin solution | 1x | 5 mL |
| Hygromycin | 1x | 5 mL |
| Total | n/a | 500 mL |
| Reagent | Final concentration | Quantity |
| 10 M sodium hydroxide | 50 mM | 0.5 mL |
| Water | n/a | 99.5 mL |
| Total | n/a | 100 mL |
| Reagent | Final concentration | Quantity |
| Hemin | 2.5 mg/mL | 25 mg |
| 50 mM sodium hydroxide | n/a | 10 mL |
| Total | n/a | 10 mL |
| Reagent | Final concentration | Quantity |
| Schneider’s Drosophila medium | n/a | 835 mL |
| FBS | 15% | 150 mL |
| Penicillin-streptomycin solution | 10% | 10 mL |
| Hygromycin | 1x | 5 mL |
| Total | n/a | 1000 mL |
| Reagent | Final concentration | Quantity |
| Schneider’s Drosophila medium | n/a | 785 mL |
| FBS | 20% | 200 mL |
| Penicillin-streptomycin solution | 1x | 10 mL |
| Hemin | 0.5% | 5 mL |
| Total | n/a | 1000 mL |
Adjust final pH to 5.4
| Reagent | Final concentration | Quantity |
| Formaldehyde, 37 % in Water | 4% | 5 mL |
| 1x PBS | n/a | 45 mL |
| Total | n/a | 50 mL |
| Reagent | Final concentration | Quantity |
| Bovine Serum Albumin | 5% | 2.5 gm |
| 1x PBS | n/a | 50 mL |
| Total | n/a |
|
| Reagent | Final concentration | Quantity |
| Triton X-100 | 5% | 0.5 mL |
| Blocking solution | n/a | 9.5 mL |
| Total | n/a | 10 mL |
Laboratory Supplies
Equipment
Software and Datasets
Procedure
Caution: The incubator containing the culture should not contain any fungal cells or bacteria to avoid potential cross-contamination issues. Regular cleaning of the incubator (at least once in 2 weeks) is recommended. All species of Leishmania that can infect humans are Biosafety Level 2 organisms and appropriate precautions should be taken in this regard.
(Optional) Carefully transfer the microplate into a plate adapter before placing in the centrifuge and spin at 500g for 1 minute at room temperature to ensure the settling of the cells at the base of the wells.
Note: To ensure optimal cell density and parasite burden for immunofluorescence analysis, a strategic approach to dilutions is recommended. The parasite and cell concentration should be determined by systematic dilutions to find the most suitable concentration range for achieving robust unsaturated signal strength from sufficient cells and parasites. This optimization step addresses potential issues related to overcrowding or sparse distribution of parasites on the imaging surface, attains appropriate signal-to-noise ratios, reduces background fluorescence, and enhances the clarity of cellular structures. Similarly, incubation time should be systematically tested to allow adaptation to the experimental question being addressed. Finally, when initiating this protocol, it is helpful to include uninfected Mf as controls, as well as control samples with parasites and Mf that were incubated at 4C (so parasites should be bound by Mf, but not internalized).
Pause point: After fixing, one can add 50 µL of PBS in each well of the microplate and it can be stored in 4 ºC, ideally for a maximum of 48 hours, before proceeding with the next steps.
Caution:The cell membrane of RAW 264.7 cells acts as a natural barrier during the antibody labeling steps. Following the outlined sequence of first labeling the external parasites, permeabilization, and finally antibody labeling of internalized parasites is critical to avoid any anomalous labeling of parasites.
Note: The settings can be saved by user for future use. However, the values may need adjustment depending on laser conditions, microscope type and fluorescence signal intensity.
Table 1. Parameters set for confocal microscopy
Parameters | External Parasites (red) | Internalized Parasites (green) | Nuclei (blue) |
Contrast Method | Fluorescence | Fluorescence | Fluorescence |
Excitation Wavelength (ex.) | 561 nm. | 488 nm. | 405 nm. |
Emission Wavelength (em.) | 588 nm. | 521 nm. | 432 nm. |
Pinhole | 0.68 AU | 0.59 AU | 0.78 AU |
Scan Mode | Frame | Frame | Frame |
Scan Zoom | 1.0 | 1.0 | 1.0 |
Rotation | 0º | 0º | 0º |
Pixel Time | 2.05 µs | 2.05 µs | 2.05 µs |
Line Time | 30.00 µs | 30.00 µs | 30.00 µs |
Frame Time | 15.10 s | 15.10 s | 15.10 s |
Scan Direction | Unidirectional | Unidirectional | Unidirectional |
Averaging | 16 | 16 | 16 |
Note: Image may be optimized by adjusting the laser power, gain, and offset and saturated pixels (if any) can be eliminated by reducing laser power.
Table 2. Parameters set for imaging
Parameters | Values |
Image size | 1,024 × 1,024 pixels |
Speed | 8 |
Averaging | 4 lines |
Bit depth | 16 |
Pixel Size | 0.1 μm × 0.1 μm × 1 μm. |
Z-stack | 5 slice (4 μm) |
Scan to generate the representative image(s).

Figure 1. Representative image of immunofluorescence assay on amastigote uptake by RAW 264.7 cells. A. External parasites labelled red. In this image, 2 extracellular Leishmania amastigotes and one partly internalized amastigote can be seen. B. All parasites are labeled green. In this image, 4 total Leishmania amastigotes are visualized. Faint autofluorescence of RAW 264.7 cells can be seen in the green channel, but its intensity is well below that of the labeled parasites, and the mammalian cells are also a different size than the parasites. C. RAW 264.7 cell nuclei labeled blue with Hoechst 33342. In this image, one can see 6 Mf nuclei. D. Overlay of the 3 images. The fully internalized amastigote is green. The two external amastigotes are both green and red (orange in the merged image). The amastigote that is in the process of being taken up by the macrophage is orange (extracellular) on the right side and green (intracellular) on the left lower side. Scale bar represents 20 μm.
Total Parasites = internalized green + external red parasites
Phagocytic Index (%) = (internalized green parasites/blue RAW 264.7 cell nuclei) x 100
Adhesion Index (%) = (total parasites/blue RAW 264.7 cell nuclei) x 100
Further expansion of this protocol to incorporate different study items includes:
Caution: Despite its merits, the BioTek Cytation 5 also has its limitations. Factors such as the need for accurate configuration of excitation and emission wavelengths, magnification limits and potential variations in signal intensities may impact the precision of results. Additionally, the machine’s capabilities may be influenced by the quality and specificity of the antibodies used in the immunofluorescence assays. Users should compare the automated analyses with representative images at all relevant times.
Note: As a further alternative to ImageJ, Adobe Illustrator can be used for creating ROI for phagocytic cups and measuring fluorescence intensity.

Figure 2. Representative image of immunofluorescence assay to visualize phagocytic cup formations upon amastigote uptake by RAW 264.7 cells. A. External parasites labelled red. B. Intracellular parasites labelled green. C. Nuclei labelled blue with Hoechst 33342. D. Actin filaments labelled white. Phagocytic cups (n=8) are identified by ROIs (marked with purple circles), where we have delineated all parasites that are fully in focus and could be undergoing the process of entering cells, i.e., the parasite color is a combination of both red and green. E. Overlay of the 4 images. Scale bar represents 20 μm.
Validation of protocol
The concepts of amastigogenesis and Leishmania internalization by phagocytic cells has been studied and replicated for some time (Mandell et al., 2017; Mosser et al., 1985), but only limited studies have employed quantitative analyses through image-based approaches (Siqueira-Neto et al., 2012) or characterized the uptake of amastigotes. This protocol, along with its variations, have been thoroughly peer-reviewed and validated independently by multiple researchers before publication (Ullah et al., 2023; Wetzel et al., 2012; Wetzel et al., 2016). Similar techniques have been used by our group and others for other microbes (e.g., the parasites Toxoplasma and Cryptosporidium) (Wetzel et al., 2003; Wetzel et al., 2005) for a number of years.
General Notes and Troubleshooting
Phagocytic cells, i.e., Mfs in this case, can display a lack of uniformity and consistency in the number of phagocytosed parasites. A general benchmark of RAW 264.7 cells to amastigotes ratio of 1:15 is a good starting point for setting up infections in 96-well plates. As described above (part D), this ratio can be adjusted to improve parasite visualization in a single pane. However, assessing the total numbers of cells and parasites should always be performed during microscopy to ensure quality results. We have found that there can be some variation between biological replicates of this assay. Under these circumstances, normalization of experimental values against a specific control group can be performed, which still maintains the integrity of the results. If this technique is used, one must either adjust corresponding statistical analysis accordingly (e.g., use one-sample two tailed t-tests to analyze for deviations from an expected result) or perform analysis before normalization. We also note that our flexible protocol allows incorporation of various fluorophores simultaneously to suit the objectives of the experiment. Naturally, it is imperative that fluorophores’excitation and emission spectra are checked for potential overlap through spectrum viewers available on various product websites such as https://www.thermofisher.com/order/fluorescence-spectraviewer.
Acknowledgements
We appreciate Bio-protocol’s invitation to submit this manuscript and the ongoing interest of the cell biology and microbiology communities in our multicolor immunofluorescence internalization assay. In particular, Drs. I. George Miller and Anthony J. Koleske, both from Yale University, have previously advocated for our submitting this assay as a protocol-based manuscript. We must acknowledge the generations of parasitologists who have been conducting similar studies to ours for inspiring the experimental variations that we have described, but whom we could not cite due to space constraints. We thank additional members of the Wetzel lab who have characterized host-pathogen interactions, including Gina Aloisio, Francis TH Khuong, and Imran Ullah, for their dedication to this ongoing project. We appreciate the assistance of Hanspeter Niederstrasser and Bruce A. Posner at the UT Southwestern High Throughput Screening Core with our automated analysis. We also thank the Biochemistry Department for access to the departmental Cytation 5. Work conducted over the years as a result of the protocol described here has been supported by NIH F32 AI094905, NIH K08 AI103036, NIH R01 AI146349, a Pediatric Infectious Diseases Society of America Fellowship, a Yale Center for Molecular Discovery Pilot Project Grant, Children’s Clinical Research Advisory Committee (CCRAC) Junior Investigator and Early Investigator Awards, a Welch Grant for Chemistry (I-2086) and funds from the UT Southwestern Department of Pediatrics (all to Dr. Wetzel). U.B. was supported by a National Institutes of Health Supplement to Promote Diversity in Health-Related Research (R01 AI146349-S1) and Medical Scientist Training (MD/PhD) Grant NIH T32GM008014. The Zeiss LSM880 with Airyscan was purchased with a Shared Instrumentation grant from NIH (1S10OD021684-01 to Katherine Luby-Phelps). The funders did not play a role in the writing of this manuscript.
Competing interests
The authors declare no conflict of interest.
Ethical considerations
Use of Leishmania amazonensis, which is a Biosafety Level (BSL)-2 organism, was approved by the Biosafety Committee (Protocol# RDSR-2023-044) of The University of Texas Southwestern Medical Center, Dallas, TX.
References
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Mandell, M. A., & Beverley, S. M. (2017). Continual renewal and replication of persistent Leishmania major parasites in concomitantly immune hosts. Proceedings of the National Academy of Sciences, 114 (5), E801-E810. doi:10.1073/pnas.1619265114
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Paixão, A. R., Dias, B. R. S., Palma, L. C., Tavares, N. M., Brodskyn, C. I., de Menezes, J. P. B., & Veras, P. S. T. (2021). Investigating the phagocytosis of Leishmania using confocal microscopy. J Vis Exp (173). doi:10.3791/62459
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