All reagents and media were warmed to 37°C prior to use. The amniotic membrane was processed as described previously [6 , 12 (link), 14 (link)] Briefly, the amnion membrane was manually peeled from normal, term, not in labor caesarean section placentas, rinsed in saline and transferred to a petri dish containing Hanks Balanced Salt Solution (HBSS; Mediatech Inc., Manassas, VA). After cutting the amnion into 2 cm x 2 cm pieces, they were digested twice in 0.25% trypsin and 0.125% Collagenase A (Sigma–Aldrich, St. Louis, MO) in HBSS for 35 minutes at 37°C. After each digestion, the tissue was filtered through a 70 μm cell strainer (Thermo Fisher Scientific, Waltham, MA) and trypsin was inactivated using complete Dulbecco's Modified Eagle Medium: Nutrient Mixture F-12 media (DMEM/F12; Mediatech Inc.) supplemented with 15% fetal bovine serum (FBS; Sigma-Aldrich), 10% Penicillin/Streptomycin (Mediatech Inc.) and 100 μg/mL epidermal growth factor (EGF; Sigma-Aldrich). The collected filtrate was centrifuged for 10 minutes at 3000 RPM and the pellet was resuspended in 3.0 mL complete DMEM/F12. Once cells were counted, approximately 3–5 million cells per flask were cultured in T75 flasks containing complete DMEM/F12 media at 37°C, 5% CO2, and 95% air humidity to 70–80% confluence.
To ensure the purity of our primary AEC cultures, immunofluorescent staining was performed. Cells were seeded on glass coverslips at a density of 30,000 cells per slip and incubated overnight. Cells were fixed with 4% paraformaldehyde (PFA), permeablized with 0.5% Triton X and blocked with 3% BSA in PBS prior to incubation with Cytokeratin 18 (Abcam, Cambridge, United Kingdom) primary antibody diluted 1:300 in 3% BSA overnight at 4°C. After washing with PBS, slides were incubated Alexa Fluor conjugated secondary antibodies (Life Technologies, Carlsbad, CA) diluted 1:400 in PBS for 1 hour in the dark. Slides were washed with PBS then treated with NucBlue® Live ReadyProbes® Reagent (Life Technologies) then mounted using Mowiol 4–88 mounting medium (Sigma-Aldrich). Images were captured using LSM 510 Meta UV confocal microscope (63x) (Zeiss, Germany).
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