FCM is a generally accepted tool to analyze apoptosis. Unfortunately, the cell preparation of all commercial kits available includes cell washing known to cause cell loss which is most likely to affect apoptotic cells in particular. To address this, we developed a seven-color single-platform no-wash analysis technique and compared the results with those from an analogous procedure including cell washing. A five-color mAb cocktail was employed to address target cells by surface labeling, Yo-PRO-1 1 and DAPI were used to discriminate apoptotic and necrotic from viable cells. Cells were quantified on the basis of internal-standard fluorescent beads. Jurkat cells ACC 282 treated with camptothecin were employed to establish the staining procedure, which was then applied to blood cells collected by extracorporeal apheresis and treated with UV irradiation. Data evaluation showed that although each method by itself was highly reproducible (R 2 5 0.973), the numbers of apoptotic cells detected with the no-wash procedure were significantly higher than those obtained after cell washing (P 5 6.6 E 25 , Wilcoxon Test). In addition, the observed differences increased with higher cell numbers (Bland and Altmann). We conclude that the described test is a feasible and reliable tool for apoptosis measurement and it provides results that are definitely closer to the truth than those obtained from kits that require cell washing. ' 2010 International Society for
Advancement of CytometryKey terms multicolor flow cytometry; apoptosis; Trucount TM ; single platform; Yo-PRO-1 1 APOPTOSIS plays a major role in various physiological and pathological processes.Cell demise has been investigated in different fields, also including extracorporeal photopheresis (ECP), a therapeutic intervention used in several auto immune disorders, diseases with pathogenic T cell involvement, and chronic graft-versus-host disease (GvHD) (1). Collected cells are reinfused after in vitro exposure to 8-methoxypsoralen and ultraviolet A (UVA) light. One known effect of ECP on PBMC is the induction of apoptosis (2,3), which can be analyzed by FCM, a generally accepted and reliable tool for detection of apoptosis on single-cell level (4,5). Several assays for FCM analysis of different stages of programmed cell death are commercially available but all of them include at least one centrifugation step. Hypothesizing that, after apoptosis-inducing treatment, part of the PBMC will be disrupted by centrifugation and thus will not be present for FCM analysis, our intention was to establish a single-platform, no-wash, and multicolor FCM methodology to quantify apoptotic T cells in ECP products.To discriminate viable from early and late apoptotic/necrotic cells, we tested several markers. We favored the YO-PRO-1 1 /DAPI combination which allows discrimination of apoptotic from necrotic cells. YO-PRO-1, a DNA-intercalating dye excited at 488 nm, is a reliable marker for FCM analysis of apoptosis (6,7). DAPI, a nuclear dye excited at 405 nm, which is commonly used in ...