In situ DNA fragmentation assay for detection of apoptosis in paraffin-embedded tissue sections. Technical considerations.

Detection, by light microscopy, of cells in situ undergoing apoptosis has been improved by use of an in situ apoptosis (DNA fragmentation) assay on formalin-fixed and paraffin-embedded tissue sections. We studied conditions of tissue preparation and fixation that may affect the test results. In this study, we intended to determine whether archival tissues prepared under unknown conditions can be used for the in situ apoptosis assay. All tissue sections were pretreated with Proteinase K, followed by incubation with biotinylated 11-deoxyuridine triphosphate in terminal deoxynucleotidyl transferase and then avidin-biotin-peroxidase complex. The following formalin-fixed and paraffin-embedded histologic sections were tested: (1) normal tissues from surgically resected specimens fixed immediately or stored at 4 degrees C and then fixed after 1, 2, 4, 6, or 24 hours; (2) archival autopsy material from histologically normal tissues; and (3) freshly prepared normal tissues from C57 mice. We observed that fixation- and prefixation-elapsed times do not adversely affect the results of the assay. Similar, if not identical results were seen in archival human tissues stored for up to 25 years, the normal tissues freshly prepared from surgical specimens, and the tissues from C57 mice. We conclude that the in situ assay of DNA fragmentation is rapid, sensitive, and reproducible. The use of formalin-fixed and paraffin-embedded archival material as old as 25 years opens the way for a variety of studies of apoptosis in diverse pathologic states.