Name: deep dermal injection as a model of candida albicans skin infection for histological analyses
Uploaded: 2018-06-13T13:00:00
Description: Watch this Scientific Journal Video about Deep Dermal Injection As a Model of Candida albicans Skin Infection for Histological Analyses at JoVE.com

FG is supported by Associazione Italiana per la Ricerca sul Cancro (IG 2016Id.18842), Cariplo Foundation (Grant 2014-0655), and Fondazione Regionale per la Ricerca Biomedica (FRRB). 
IZ is supported by NIH grant 1R01AI121066-01A1, 1R01DK115217, HDDC P30 DK034854 grant, Harvard Medical School Milton Found, CCFA Senior Research Awards (412708), the Eleanor and Miles Shore 50th Anniversary Fellowship Program, and the Cariplo Foundation (2014-0859).

All the procedures were approved under the Institutional Animal Care and Use Committee (IACUC) and operated under the supervision of the department of Animal Resources at Children&#39;s Hospital (ARCH) at Boston Children&#39;s Hospital or were approved by the Italian Ministry of Health and performed under the Institutional Animal Care Committee at the University of Milano-Bicocca.
1. C. albicans Preparation
<ol>
	<li>Culture C. albicans, strain CAF3-113</s...

<ol>
	<li>Belkaid, Y., Segre, J. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Dialogue+between+skin+microbiota+and+immunity.">Dialogue between skin microbiota and immunity.</a> Science. 346 (6212), 954-959 (2014).</li><li>Kashem, S. W., Kaplan, D. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Skin+Immunity+to+Candida+albicans.">Skin Immunity to Candida albicans.</a> Trends Immunol. 37 (7), 440-450 (2016).</li><li>Havlickova, B., Czaika, V. A., Friedrich, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Epidemiological+trends+in+skin+mycoses+worldwide.">Epidemiological trends in skin mycoses worldwide.</a> Mycoses. 51, 2-15 (2008).</li><li>Wisplinghoff, H., Bischoff, T., Tallent, S. M., Seifert, H., Wenzel, R. P., Edmond, M. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Nosocomial+Bloodstream+Infections+in+US+Hospitals:+Analysis+of+24,179+Cases+from+a+Prospective+Nationwide+Surveillance+Study.">Nosocomial Bloodstream Infections in US Hospitals: Analysis of 24,179 Cases from a Prospective Nationwide Surveillance Study.</a> Clin Infect Dis. 39 (3), 309-317 (2004).</li><li>Romani, L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Immunity+to+fungal+infections.">Immunity to fungal infections.</a> Nat Rev Immunol. 4 (1), 11-24 (2004).</li><li>Odds, F. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Pathogenesis+of+Candida+infections.">Pathogenesis of Candida infections.</a> J Am Acad Dermatol. 31 (3), S2-S5 (1994).</li><li>MacCallum, D. M., Odds, F. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Temporal+events+in+the+intravenous+challenge+model+for+experimental+Candida+albicans+infections+in+female+mice.">Temporal events in the intravenous challenge model for experimental Candida albicans infections in female mice.</a> Mycoses. 48 (3), 151-161 (2005).</li><li>Dai, T., Kharkwal, G. B., Tanaka, M., Huang, Y. -. Y., Bil de Arce, V. J., Hamblin, M. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Animal+models+of+external+traumatic+wound+infections.">Animal models of external traumatic wound infections.</a> Virulence. 2 (4), 296-315 (2018).</li><li>Gaspari, A. A., Burns, R., Nasir, A., Ramirez, D., Barth, R. K., Haidaris, C. G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=CD86+(B7-2),+but+not+CD80+(B7-1),+expression+in+the+epidermis+of+transgenic+mice+enhances+the+immunogenicity+of+primary+cutaneous+Candida+albicans+infections.">CD86 (B7-2), but not CD80 (B7-1), expression in the epidermis of transgenic mice enhances the immunogenicity of primary cutaneous Candida albicans infections.</a> Infect Immun. 66 (9), 4440-4449 (1998).</li><li>Koh, A. Y. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Murine+models+of+Candida+gastrointestinal+colonization+and+dissemination.">Murine models of Candida gastrointestinal colonization and dissemination.</a> Eukaryot Cell. 12 (11), 1416-1422 (2013).</li><li>Mear, J. B., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Candida+albicans+Airway+Exposure+Primes+the+Lung+Innate+Immune+Response+against+Pseudomonas+aeruginosa+Infection+through+Innate+Lymphoid+Cell+Recruitment+and+Interleukin-22-Associated+Mucosal+Response.">Candida albicans Airway Exposure Primes the Lung Innate Immune Response against Pseudomonas aeruginosa Infection through Innate Lymphoid Cell Recruitment and Interleukin-22-Associated Mucosal Response.</a> Infect Immun. 82 (1), 306-315 (2014).</li><li>Leoni, G., Neumann, P. -. A., Sumagin, R., Denning, T. L., Nusrat, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Wound+repair:+role+of+immune-epithelial+interactions.">Wound repair: role of immune-epithelial interactions.</a> Mucosal Immunol. 8 (5), 959-968 (2015).</li><li>Fonzi, W. A., Irwin, M. Y. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Isogenic+strain+construction+and+gene+mapping+in+Candida+albicans.">Isogenic strain construction and gene mapping in Candida albicans.</a> Genetics. 134 (3), 717-728 (1993).</li><li>Santus, W., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Skin+infections+are+eliminated+by+cooperation+of+the+fibrinolytic+and+innate+immune+systems.">Skin infections are eliminated by cooperation of the fibrinolytic and innate immune systems.</a> Sci Immunol. 2 (15), (2017).</li><li>Florescu, D. F., Brostrom, S. E., Dumitru, I., Kalil, A. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Candida+albicans+Skin+Abscess+in+a+Heart+Transplant+Recipient.">Candida albicans Skin Abscess in a Heart Transplant Recipient.</a> Infect Dis Clin Pract. 18 (4), 243-246 (2010).</li><li>Pradeu, T., Cooper, E. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+danger+theory:+20+years+later.">The danger theory: 20 years later.</a> Front Immunol. 3, 287 (2012).</li><li>Cheng, A. G., DeDent, A. C., Schneewind, O., Missiakas, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+play+in+four+acts:+Staphylococcus+aureus+abscess+formation.">A play in four acts: Staphylococcus aureus abscess formation.</a> Trends Microbiol. 19 (5), 225-232 (2011).</li></ol>

Here we described a method of C. albicans infection to study the inflammatory process that is initiated upon fungal entrance in the deep derma.
Even though skin abscess formation is a relatively rare event upon C. albicans infection15, injection of the fungus directly in the deep derma allows not only the study of fungal-driven abscess formation, but also the analysis of specific immune cells that participate to contain fungal spread. With the method d...

The human body is covered with an extremely high number of microorganisms. The skin surface is the habitat of almost one million bacteria per square centimeter1. This number, however, does not reflect the full variety of microorganisms that colonizes the skin. In addition to bacteria, the human body is colonized by many fungal species, including C. albicans, which is able to survive both at the mucosal and the skin level2.
In recent years, the percentage of people diagnosed with fungal infections has enormously increased. This is mainly due to the higher number of immunocompromised persons, i.e., HIV-positive patients and patients that have gone through either chemotherapy or immunosuppressive drugs after transplantation3. In a surveillance study performed in the United States, Wisplinghoff et al. showed that 9.5% of the nosocomial bloodstream infections were caused by Candida species4. Due to the increased occurrence of fungal infections, and especially because of the elevated percentage of Candida species found during bloodstream infections, understanding how this pathogen escapes the control of the immune system is extremely important.
C. albicans is a dimorphic fungus that grows in different morphological forms such as yeast, blastospores, pseudohyphae, and hyphae depending on the environmental conditions5. In its hyphal form, C. albicans shows its highest invasiveness capacity and has the ability to penetrate the epithelium6.
C. albicans infections have been studied using several experimental approaches. The most common model of infection is the intravenous injection of C. albicans yeast7. However, this model does not take into consideration all the processes that happen before the fungus manages to spread into the bloodstream. Another model takes advantage of the ability of C. albicans to invade the epithelium. This method, also known as the sand paper model8, was developed by Gaspari et al. in 19989, and consists of using sand paper to abrade the skin, thus eliminating the stratum corneum before applying C. albicans. This procedure allows the fungus to penetrate the epithelium, thus enabling the analysis of the invasive abilities of this pathogen. Finally, other models of infections for the gastrointestinal10 and respiratory tracts11 have been used in different studies.
The formation of a wound (as in the sand paper model) causes the activation of several pathways, including immune cell recruitment and activation, in order to promote the healing process12. This can either alter or mask the immune response specifically elicited against the pathogen, thus leading to confounding results.
Here we describe a method of skin infection that avoids initial wound formation and the induction of a basal inflammatory environment. To maintain the intact epithelial structure, we directly inject C. albicans in its hyphal form in the deep derma. Even though a single injection can elicit mild inflammation, the amount of inflammation is limited and restricted compared to the formation of an open wound as in the sand paper model. The approach that we describe here allows the study of the immune response to fungal infection and spread while avoiding the excessive and pre-existing inflammatory environment caused by mechanical damage.

<table>
	<tbody>
		<tr>
			<td>Reagents</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>PBS</td>
			<td>Euroclone</td>
			<td>ECB4053L</td>
			<td>warm in 37 &#176;C bath before use</td>
		</tr>
		<tr>
			<td>H-OCT compound</td>
			<td>histo-line laboratories</td>
			<td>R0030</td>
			<td></td>
		</tr>
		<tr>
			<td>Gill&#39;s Hematoxilyn</td>
			<td>histo-line laboratories</td>
			<td>09-178-2</td>
			<td></td>
		</tr>
		<tr>
			<td>Eosin Y solution, alcoholic</td>
			<td>histo-line laboratories</td>
			<td>09-209-05</td>
			<td></td>
		</tr>
		<tr>
			<td>Ethanol absolute</td>
			<td>scharlau</td>
			<td>ET00232500</td>
			<td></td>
		</tr>
		<tr>
			<td>Citro-HISTOCLEAR</td>
			<td>histo-line laboratories</td>
			<td>R0050</td>
			<td></td>
		</tr>
		<tr>
			<td>Eukitt, mounting medium</td>
			<td>bio-optica</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Acetone</td>
			<td>sigma-aldrich</td>
			<td>179124</td>
			<td></td>
		</tr>
		<tr>
			<td>PAS staining system</td>
			<td>sigma-aldrich</td>
			<td>395B-1KT</td>
			<td></td>
		</tr>
		<tr>
			<td>Bacto Peptone</td>
			<td>BD</td>
			<td>211677</td>
			<td></td>
		</tr>
		<tr>
			<td>Bacto Yeast Extract</td>
			<td>BD</td>
			<td>212750</td>
			<td></td>
		</tr>
		<tr>
			<td>D(+)-Glucose anhydrous for molecular biology</td>
			<td>Applichem PanReac</td>
			<td>50-99-7</td>
			<td></td>
		</tr>
		<tr>
			<td>Uridine</td>
			<td>Merck Millipore</td>
			<td>8451</td>
			<td></td>
		</tr>
		<tr>
			<td>HEPES</td>
			<td>Applichem PanReac</td>
			<td>A1070,0500</td>
			<td></td>
		</tr>
		<tr>
			<td>Safe-Lock tubes 2 mL</td>
			<td>eppendorf</td>
			<td>30121597</td>
			<td></td>
		</tr>
		<tr>
			<td>TRIzol Reagent</td>
			<td>Life Technologies</td>
			<td>15596018</td>
			<td>Toxic, corrosive and mutagen. Use all precaution needed</td>
		</tr>
		<tr>
			<td>Rneasy Mini Kit</td>
			<td>QIAGEN</td>
			<td>74104</td>
			<td></td>
		</tr>
		<tr>
			<td>liquid nitrogen</td>
			<td></td>
			<td></td>
			<td>Wear eye protection</td>
		</tr>
		<tr>
			<td>Instrument</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Coulter Counter-Particle Count</td>
			<td>Beckman Coulter</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Centrifuge 5415 R</td>
			<td>eppendorf</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>MC 3000 Microtome Cryostat</td>
			<td>histo-line laboratories</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>TissueLiser</td>
			<td>QIAGEN</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Materials</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>0.3 ml Insulin Syringe with a 30G x 8mm needle&#160;</td>
			<td>BD</td>
			<td>324826</td>
			<td></td>
		</tr>
		<tr>
			<td>Surgical forceps</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Surgical scissors</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Base mould disposable</td>
			<td>histo-line laboratories</td>
			<td>2781</td>
			<td></td>
		</tr>
		<tr>
			<td>Positively charged bio microscope slides</td>
			<td>bio-optica</td>
			<td>09-2000</td>
			<td></td>
		</tr>
		<tr>
			<td>Cover slips 24 x 50 mm</td>
			<td>thermo scientific</td>
			<td>11911998</td>
			<td></td>
		</tr>
	</tbody>
</table>

deep dermal injection as a model of candida albicans skin infection for histological analyses

The skin is an extremely extended organ of the body and, due to this large surface, it is continuously exposed to microorganisms. Skin damage can easily lead to infections in the dermis which can, in turn, result in the dissemination of pathogens into the bloodstream. Understanding how the immune system fights infections at the very early stage and how the host can eliminate the pathogens is an important step to set the base for future therapeutic interventions. Here we describe a model of Candida albicans infection that can visualize the processes that occur early during an infection, including when the pathogen has passed the epithelial barrier, as well as the immune response elicited by the C. albicans invasion. We used this infection model to perform histological analyses that show the immune cells that infiltrate the skin as well as the presence and localization of the pathogen. Samples collected after the infection can be processed for RNA extraction.

Through the injection of the pathogen directly in the deep derma, the structural morphology of the tissue remains intact (Figure 1A).
The maintenance of skin structural integrity allows the detection of immune cells and their localization at the site of infection. The higher magnification shown in Figure 1B reveals that the abscess is mainly composed of polymorphonuclea...

Watch this Scientific Journal Video about Deep Dermal Injection As a Model of Candida albicans Skin Infection for Histological Analyses at JoVE.com

Deep Dermal Injection As a Model of Candida albicans Skin Infection for Histological Analyses

Here we describe a protocol that allows histological and molecular analysis of skin samples after Candida albicans intradermal injection. This protocol maintains the structural integrity of the skin and allows for the localization of tissue-resident or newly recruited immune cells as well as the pathogen distribution.

Deep Dermal Injection As a Model of Candida albicans Skin Infection for Histological Analyses

The skin is an extremely extended organ of the body and, due to this large surface, it is continuously exposed to microorganisms. Skin damage can easily ...

Research

JoVE Journal

Immunology and Infection

A 96 Well Microtiter Plate-based Method for Monitoring Formation and Antifungal Susceptibility Testing of Candida albicans Biofilms

A 96 Well Microtiter Plate-based Method for Monitoring Formation and Antifungal Susceptibility Testing of Candida albicans Biofilms

Candida albicans remains the most frequent cause of fungal infections in an expanding population of compromised patients and candidiasis is now the third ...

Introducing Shear Stress in the Study of Bacterial Adhesion

During bacterial infections a sequence of interactions occur between the pathogen and its host. Bacterial adhesion to the host cell surface is often the ...

Use of Galleria mellonella as a Model Organism to Study Legionella pneumophila Infection

Use of Galleria mellonella as a Model Organism to Study Legionella pneumophila Infection

Legionella pneumophila, the causative agent of a severe pneumonia named Legionnaires&#39; disease, is an important human pathogen that infects and ...

Studying Microbial Communities In Vivo: A Model of Host-mediated Interaction Between Candida Albicans and Pseudomonas Aeruginosa in the Airways

Studying Microbial Communities In Vivo: A Model of Host-mediated Interaction Between Candida Albicans and Pseudomonas Aeruginosa in the Airways

Studying host-pathogen interaction enables us to understand the underlying mechanisms of the pathogenicity during microbial infection. The prognosis of ...

Visualization of Biofilm Formation in Candida albicans Using an Automated Microfluidic Device

Visualization of Biofilm Formation in Candida albicans Using an Automated Microfluidic Device

Candida albicans is the most common fungal pathogen of humans, causing about 15% of hospital-acquired sepsis cases. A major virulence attribute of C. ...

Using Robotic Systems to Process and Embed Colonic Murine Samples for Histological Analyses

The understanding of human diseases has been greatly expanded thanks to the study of animal models. Nonetheless, histopathological evaluation of ...

Daily Phototherapy with Red Light to Regulate Candida albicans Biofilm Growth

Daily Phototherapy with Red Light to Regulate Candida albicans Biofilm Growth

Here, we present a protocol to assess the outcomes of per diem red light treatment on the growth of Candida albicans biofilm. To increase the planktonic ...

Clarifying and Imaging Candida albicans Biofilms

Clarifying and Imaging Candida albicans Biofilms

The microbial fungus Candida albicans can undergo a change from commensal colonization to virulence that is strongly correlated with its ability to switch ...

Rose Bengal-Mediated Photodynamic Therapy to Inhibit Candida albicans

Rose Bengal-Mediated Photodynamic Therapy to Inhibit Candida albicans

Invasive Candida albicans infection is a significant opportunistic fungal infection in humans because it is one of the most common colonizers of the gut, ...

Use of In Vivo Imaging to Screen for Morphogenesis Phenotypes in Candida albicans Mutant Strains During Active Infection in a Mammalian Host

Use of In Vivo Imaging to Screen for Morphogenesis Phenotypes in Candida albicans Mutant Strains During Active Infection in a Mammalian Host

Candida albicans is an important human pathogen. Its ability to switch between morphologic forms is central to&#160;its pathogenesis; these morphologic ...