Hi Jerry, 

I would never try to persuade anyone.  I'm no smarter than the next lab worker 
trying to make sense of this and science biology in general. But this is how I 
see TUNEL and FFPE and after all the years I'm happy with things. 



I have not noticed false positives at all when looking at TUNEL FFPE versus 
frozen or whole cells and even when adapting the animal model to other 
verifying procedures (annexinV in flow) or caspace-3 when applicable.  Formalin 
can cause strand breaks, that is true but these are not amplifiable breaks.  
For TdT to work, the break must be of particular kinds.  But that discussion is 
far beyond the realm of possibility in HistoNet.  Up at UW, if you haven't done 
so, there is a great Cell and Molecular Biology Grad level course that is 
required in grad school and I'd recommend it for anyone.  It is phenomenal to 
help in understanding molecular mechanisms. 

When I was down the hallway in grad school in Biological Structure, we had a 
PhD/MD student in adjacent lab who was working on apoptosis and macrophage 
scavenging in the developing limb buds (the web between "fingers") for a 
thesis.  Did TUNEL on FFPE and it was exquisite, beautiful and accepted as a 
(small part) of thesis.  Thousands of peer-reviewed articles in prestigous 
journals use TUNEL on FFPE.  Indeed, a review of specific articles where they 
are are trying to measure precisely strand breaks of DNA in UVA skin or 
germ-cell or other models, every one I see, the specimen is then placed into 
formalin or such for processing.  Why would they try to get a precise 
measurement of DNA strand breaks in their experimental model only to throw 
specimens into formalin if that is going to cause ubiquitous strand breaks and 
flood the assay?  All DNA strand breaks are not the same and the kind caused by 
formalin are simply not amplifiable by TdT. 



If they were, you could simply place a piece of normal, healthy mouse liver or 
some other tissue with non-apoptosing cells in formalin, process and every 
nuclei in liver, with broken strands from formalin would turn positive.  I've, 
never, ever seen such a thing in a well set up TUNEL assay.  And then if you do 
something to cause apoptosis, those nuclei are positive while others remain 
unaffected by formalin.  Since I worked in thymus a lot,I had a control block 
of 4 thymii, one no treatment and the other 3 with varying time treatments of 
hydrocortisone to induce steroidal T-cell apoptosis (widely accepted model).  
The differences where easily recognizable in apoptosis and when run with other 
tissues, non-apoptosing cells were still clean as anything. 



(1) strand breaks by formalin not amplifiable in TUNEL, otherwise every nuclei 
formalin fixed would be pos.  Just not so. 

(2) microtomy could not possibly cause strandbreaks that are amplifiable. 
Cutting is working on a micron scale.  Pieces of DNA are at nanometer or 
Angstrom scale.  If it did, again, every nuclei would be possitive that the 
blade "sliced through",  And then why would frozen TUNEL be ok if a blade is 
slicing through DNA in those sections.  So I disagree that "every one of them 
(nuclei in section) is detectable by TUNEL".  Again as before a common piece of 
healthy mouse liver cut at 4 microns would show nuclei all over positive.  That 
just doesn't happen. 



What I've seen and done, with very specifically controlled experiments, the 
vast amount  of peer-reviewed literature and thinking through the processes at 
a molecular level, I just can't come to the conclusion that TUNEL on FFPE is a 
failed assay that cannot work.  No assay is perfect.  PCR has primer-dimer and 
other problems to deal with.  IHC has false pos and false neg to worry about.  
Flow has Fc receptor problems to deal with.  ISH has stringency issues to 
create false pos and false neg.  I think there is beyond overwheming evidence 
that TUNEL on FFPE is an essential (if never perfect) tool in molecular science 
for apoptosis but as with every assay you have to be aware of limitations and 
problems.  I just don't believe at all that amplifiable formalin strand breaks 
and amplifiable microtome strand beaks are any problem at all and should not be 
a reason to turn from TUNEL on FFPE. 



But again, that is just my opinion that is no more valid than others who might 
differ. 



Ray 



Raymond Koelling 

PhenoPath Labs 

Seattle, WA  98155 











rocedure called microtomy. When a microtome bvlade passes through the nucleus 
of a cell it breaks a lot of DNA strands. And every one of them is detectable 
by TUNEL. 

I've heard of people getting rerasonable results with whole cells and frozen 
tissues, by for FFPE tissue, my current philosophy is: It is an assay that 
CANNOT work, even in principle. 

'Course, I've been wrong about other things, 

I'm open to persuasion. 



Jerry Ricks 
Research Scientist 
University of Washington 
Department of Pathology 

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