Name: development of a larval zebrafish infection model for clostridioides difficile
Uploaded: 2020-02-14T13:30:00
Description: Watch this Scientific Journal Video about Development of a Larval Zebrafish Infection Model for Clostridioides difficile at JoVE.com

We are grateful to Timo Fritsch for excellent animal care. We thank the members of the K&#246;ster and Steinert labs for support and helpful discussions. We thank Dr. Dandan Han for critical reading the manuscript. We gratefully acknowledge funding by the Federal State of Lower Saxony, Nieders&#228;chsisches Vorab (VWZN2889).

All animal work described here was performed in accordance with legal regulations (EU-Directive 2010/63, license AZ 325.1.53/56.1-TUBS and license AZ 33.9-42502-04-14/1418).
1. Preparation of Low Melting Agarose, Gel Plate, and Microinjection/Microgavage Needles
<ol>
	<li>Dissolve 0.08 g of low melting agarose (Table of Materials, agarose A2576) in 10 mL of 30% Danieau&#39;s medium (0.12 mM MgSO4, 0.18 mM Ca [NO3]2), 0.21 mM KCl, 1.5 mM HEPES...

<ol>
	<li>Rupnik, M., Wilcox, M. H., Gerding, D. N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Clostridium+difficile+infection:+new+developments+in+epidemiology+and+pathogenesis.">Clostridium difficile infection: new developments in epidemiology and pathogenesis.</a> Nature Reviews Microbiology. 7, 526-536 (2009).</li><li>Yang, Z., 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=Mechanisms+of+protection+against+Clostridium+difficile+infection+by+the+monoclonal+antitoxin+antibodies+actoxumab+and+bezlotoxumab.">Mechanisms of protection against Clostridium difficile infection by the monoclonal antitoxin antibodies actoxumab and bezlotoxumab.</a> Infection and Immunity. 83, 822-831 (2015).</li><li>Kelly, C. P., Kyne, 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+host+immune+response+to+Clostridium+difficile.">The host immune response to Clostridium difficile.</a> Journal of Medical Microbiology. 60, 1070-1079 (2011).</li><li>Britton, R. A., Young, V. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Interaction+between+the+intestinal+microbiota+and+host+in+Clostridium+difficile+colonization+resistance.">Interaction between the intestinal microbiota and host in Clostridium difficile colonization resistance.</a> Trends in Microbiology. 20, 313-319 (2012).</li><li>Goorhuis, A., 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=Emergence+of+Clostridium+difficile+Infection+Due+to+a+New+Hypervirulent+Strain,+Polymerase+Chain+Reaction+Ribotype+078.">Emergence of Clostridium difficile Infection Due to a New Hypervirulent Strain, Polymerase Chain Reaction Ribotype 078.</a> Clinical Infectious Diseases. 47, 1162-1170 (2008).</li><li>P&#233;pin, J., 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=Emergence+of+fluoroquinolones+as+the+predominant+risk+factor+for+Clostridium+difficile-associated+diarrhea:+a+cohort+study+during+an+epidemic+in+Quebec.">Emergence of fluoroquinolones as the predominant risk factor for Clostridium difficile-associated diarrhea: a cohort study during an epidemic in Quebec.</a> Clinical Infectious Diseases. 41, 1254-1260 (2005).</li><li>Merrigan, M. M., Sambol, S. P., Johnson, S., Gerding, D. N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Prevention+of+Fatal+Clostridium+difficile+-Associated+Disease+during+Continuous+Administration+of+Clindamycin+in+Hamsters.">Prevention of Fatal Clostridium difficile -Associated Disease during Continuous Administration of Clindamycin in Hamsters.</a> The Journal of Infectious Diseases. 188, 1922-1927 (2003).</li><li>Chen, X., 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=A+Mouse+Model+of+Clostridium+difficile-Associated+Disease.">A Mouse Model of Clostridium difficile-Associated Disease.</a> Gastroenterology. 135, 1984-1992 (2008).</li><li>Page, D. M., 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=An+evolutionarily+conserved+program+of+B-cell+development+and+activation+in+zebrafish.">An evolutionarily conserved program of B-cell development and activation in zebrafish.</a> Blood. 122, 1-12 (2014).</li><li>Benard, E. L., 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=Infection+of+Zebrafish+Embryos+with+Intracellular+Bacterial+Pathogens.">Infection of Zebrafish Embryos with Intracellular Bacterial Pathogens.</a> Journal of Visualized Experiments. (61), e3781 (2012).</li><li>Theriot, C. M., Young, V. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Interactions+Between+the+Gastrointestinal+Microbiome+and+Clostridium+difficile.">Interactions Between the Gastrointestinal Microbiome and Clostridium difficile.</a> Annual Review of Microbiology. 69, 445-461 (2015).</li><li>Pham, L. N., Kanther, M., Semova, I., Rawls, J. F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Methods+for+generating+and+colonizing+gnotobiotic+zebrafish.">Methods for generating and colonizing gnotobiotic zebrafish.</a> Nature Protocols. 3, 1862-1875 (2008).</li><li>Ransom, E. M., Ellermeier, C. D., Weiss, D. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Use+of+mCherry+red+fluorescent+protein+for+studies+of+protein+localization+and+gene+expression+in+Clostridium+difficile.">Use of mCherry red fluorescent protein for studies of protein localization and gene expression in Clostridium difficile.</a> Applied and Environmental Microbiology. 81 (5), 1652-1660 (2015).</li><li>Cocchiaro, J. L., Rawls, J. F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Microgavage+of+Zebrafish+Larvae.">Microgavage of Zebrafish Larvae.</a> Journal of Visualized Experiments. (72), e4434 (2013).</li><li>Chen, X., 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=A+Mouse+Model+of+Clostridium+difficile-Associated+Disease.">A Mouse Model of Clostridium difficile-Associated Disease.</a> Gastroenterology. 135 (6), 1984-1992 (2008).</li><li>Hutton, M. L., Mackin, K. E., Chakravorty, A., Lyras, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Small+animal+models+for+the+study+of+Clostridium+difficile+disease+pathogenesis.">Small animal models for the study of Clostridium difficile disease pathogenesis.</a> FEMS Microbiology Letters. 352, 140-149 (2014).</li><li>Brugman, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+zebrafish+as+a+model+to+study+intestinal+inflammation.">The zebrafish as a model to study intestinal inflammation.</a> Developmental &amp; Comparative Immunology. 64, 82-92 (2016).</li><li>Goulding, D., 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=Distinctive+profiles+of+infection+and+pathology+in+hamsters+infected+with+Clostridium+difficile+strains+630+and+B1.">Distinctive profiles of infection and pathology in hamsters infected with Clostridium difficile strains 630 and B1.</a> Infection and Immunity. 77, 5478-5485 (2009).</li><li>Toh, M. C., 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=Colonizing+the+Embryonic+Zebrafish+Gut+with+Anaerobic+Bacteria+Derived+from+the+Human+Gastrointestinal+Tract.">Colonizing the Embryonic Zebrafish Gut with Anaerobic Bacteria Derived from the Human Gastrointestinal Tract.</a> Zebrafish. 10, 194-198 (2013).</li><li>Bloemberg, G. V., 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=Comparison+of+static+immersion+and+intravenous+injection+systems+for+exposure+of+zebrafish+embryos+to+the+natural+pathogen+Edwardsiella+tarda.">Comparison of static immersion and intravenous injection systems for exposure of zebrafish embryos to the natural pathogen Edwardsiella tarda.</a> BMC Immunology. 12, 58 (2011).</li><li>D&#237;az-Pascual, F., Ort&#237;z-Sever&#237;n, J., Varas, M. A., Allende, M. L., Ch&#225;vez, F. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=In+vivo+host-pathogen+interaction+as+revealed+by+global+proteomic+profiling+of+zebrafish+larvae.">In vivo host-pathogen interaction as revealed by global proteomic profiling of zebrafish larvae.</a> Frontiers in Cellular and Infection Microbiology. 7, 1-11 (2017).</li><li>Valenzuela, M. J., 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=Evaluating+the+capacity+of+human+gut+microorganisms+to+colonize+the+zebrafish+larvae+(Danio+rerio).">Evaluating the capacity of human gut microorganisms to colonize the zebrafish larvae (Danio rerio).</a> Frontiers in Microbiology. 9, (2018).</li></ol>

The presented methods modify and extend an existing approach to infect zebrafish larvae by performing both injection and microgavage10,14. It also demonstrates an approach to study anaerobic pathogens with zebrafish larvae22. In addition, the protocol facilitates the analysis of innate immune cell responses in vivo upon CDI and upon colonization of C. difficile in zebrafish. The method is reproducible and easy to conduct in a rout...

C. difficile is a gram-positive, spore-forming, anaerobic, and toxin-producing bacillus that is the leading cause of severe infections in the gastrointestinal tract1. Typical symptoms of CDI include diarrhea, abdominal pain, and fatal pseudomembranous colitis, and it can sometimes lead to death1,2. Evidence has shown that host immune responses play a critical role in both the progression and outcome of this disease3. In addition to the immune response, the indigenous gut microbiota is crucial for the onset and pathogenesis of CDI4. In the past decade, both the number of cases and the mortality rate of CDI have increased significantly due to the emergence of a hypervirulent strain of C. difficile (BI/NAP1/027)5,6. A better understanding of underlying immune mechanisms and the role of microbiota during CDI will help lead to new therapeutic developments and advances, enabling better control of this epidemic.
Several animal models, such as the hamster and mouse, have been developed to provide insight into the immune defense against C. difficile7,8. However, the role of innate immune cells is still poorly understood, particularly since innate immune cell behavior is mainly derived from histological analysis or cultured cells in vitro. Therefore, establishing a transparent zebrafish model to reveal the innate immune response to C. difficile inside of a living vertebrate organism will facilitate such studies. Zebrafish larvae have a functional innate immune system, but they lack the adaptive immune system until 4&#8211;6 weeks after fertilization9. This unique feature makes zebrafish larvae an excellent model to study the isolated response and function of innate immune cells in CDI.
This report describes new methods using zebrafish larvae to study the interactions between C. difficile and innate immune cells, such as macrophages and neutrophils. First, a localized microinjection protocol that includes C. difficile inoculum and staining is presented. Using in vivo confocal time-lapse imaging, the response of neutrophils and macrophages towards the infection site is recorded, and the phagocytosis of bacteria by neutrophils and macrophages is observed. However, it has been reported that the injection itself causes tissue damage and leads to the recruitment of leukocytes independent of the bacteria10. Therefore, a noninvasive microgavage protocol to deliver C. difficile into the intestine of zebrafish larvae is subsequently described. Previous studies have demonstrated that indigenous gastrointestinal microbiota protect a host against the colonization of C. difficile11. Therefore, gnotobiotic zebrafish larvae are also used to predispose the zebrafish that are infected 12. Afterwards, intestinal dissection is performed to recover viable C. difficile and validate the duration of their presence in zebrafish intestinal tracts.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>Agarose</td>
			<td>Sigma-Aldrich</td>
			<td>A2576</td>
			<td>Ultra-low gelling agarose</td>
		</tr>
		<tr>
			<td>Agarose low-melting (LM)</td>
			<td>Pronadisa</td>
			<td>8050</td>
			<td>It is used in agarose plates</td>
		</tr>
		<tr>
			<td>BacLight Red Bacterial Stain</td>
			<td>Thermo Fisher Scientific</td>
			<td>B35001</td>
			<td>Fluorescent dye</td>
		</tr>
		<tr>
			<td>Brain-Heart-Infusion Broth</td>
			<td>Carl Roth GmbH</td>
			<td>X916.1</td>
			<td></td>
		</tr>
		<tr>
			<td>Brass (wild-type)</td>
			<td></td>
			<td></td>
			<td>deficient in melanin synthesis, used to generate stable transgenic lines</td>
		</tr>
		<tr>
			<td>Calcium nitrate (Ca(NO3)2)</td>
			<td>Sigma-Aldrich</td>
			<td>C1396</td>
			<td></td>
		</tr>
		<tr>
			<td>Capillary Glass</td>
			<td>Harvard Apparatus</td>
			<td>30-0019</td>
			<td>Injection needles</td>
		</tr>
		<tr>
			<td>Clostridioides difficile</td>
			<td></td>
			<td></td>
			<td>R20291,, a ribotype 027 strain, TcdA+/TcdB+/CDT+ production</td>
		</tr>
		<tr>
			<td>DMSO</td>
			<td>Carl Roth GmbH</td>
			<td>A994</td>
			<td></td>
		</tr>
		<tr>
			<td>FIJI</td>
			<td>open-source platform</td>
			<td></td>
			<td>Image processing</td>
		</tr>
		<tr>
			<td>HEPES</td>
			<td>Carl Roth GmbH</td>
			<td>6763</td>
			<td></td>
		</tr>
		<tr>
			<td>Horizontal needle puller</td>
			<td>Sutter instrument Inc</td>
			<td>P-87</td>
			<td></td>
		</tr>
		<tr>
			<td>L-cysteine</td>
			<td>Sigma-Aldrich</td>
			<td>168149</td>
			<td></td>
		</tr>
		<tr>
			<td>Leica Application Suite X (LAS X)</td>
			<td>Leica</td>
			<td></td>
			<td>Image processing</td>
		</tr>
		<tr>
			<td>Magnesium sulfate (MgSO4)</td>
			<td>Carl Roth GmbH</td>
			<td>P026</td>
			<td></td>
		</tr>
		<tr>
			<td>Micro injector</td>
			<td>eppendorf</td>
			<td>5253000017</td>
			<td></td>
		</tr>
		<tr>
			<td>Microinjection molds</td>
			<td>Adaptive Science Tools</td>
			<td>TU1</td>
			<td></td>
		</tr>
		<tr>
			<td>Leica SP8 confocal microscope</td>
			<td>Leica</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Phenol Red</td>
			<td>Sigma-Aldrich</td>
			<td>P0290</td>
			<td></td>
		</tr>
		<tr>
			<td>Potassium chloride (KCl)</td>
			<td>Carl Roth GmbH</td>
			<td>5346</td>
			<td></td>
		</tr>
		<tr>
			<td>Sodium chloride (NaCl)</td>
			<td>Carl Roth GmbH</td>
			<td>9265</td>
			<td></td>
		</tr>
		<tr>
			<td>Taurocholate</td>
			<td>Carl Roth GmbH</td>
			<td>8149</td>
			<td></td>
		</tr>
		<tr>
			<td>Tg(lyZ: KalTA4)bz17/Tg(4xUAS-E1b:EGFP)hzm3</td>
			<td></td>
			<td></td>
			<td>stable transgenic line in which in which the lyZ promoters drive the expression of EGFP fluorescent protein in neutrophils</td>
		</tr>
		<tr>
			<td>Tg(mpeg1.1: KalTA4)bz16/Tg(4xUAS-E1b:EGFP)hzm3</td>
			<td></td>
			<td></td>
			<td>stable transgenic line in which in which the mpeg1.1 drive the expression of EGFP fluorescent protein in macrophages</td>
		</tr>
		<tr>
			<td>Tricaine</td>
			<td>Sigma-Aldrich</td>
			<td>E10521</td>
			<td></td>
		</tr>
		<tr>
			<td>Yeast extract</td>
			<td>BD Bacto</td>
			<td>212750</td>
			<td></td>
		</tr>
	</tbody>
</table>

development of a larval zebrafish infection model for clostridioides difficile

Clostridioides difficile infection (CDI) is considered to be one of the most common healthcare-associated gastrointestinal infections in the United States. The innate immune response against C. difficile has been described, but the exact roles of neutrophils and macrophages in CDI are less understood. In the current study, Danio rerio (zebrafish) larvae are used to establish a C. difficile infection model for imaging the behavior and cooperation of these innate immune cells in vivo. To monitor C. difficile, a labeling protocol using a fluorescent dye has been established. A localized infection is achieved by microinjecting labeled C. difficile, which actively grows in the zebrafish intestinal tract and mimics the intestinal epithelial damage in CDI. However, this direct infection protocol is invasive and causes microscopic wounds, which can affect experimental results. Hence, a more noninvasive microgavage protocol is described here. The method involves delivery of C. difficile cells directly into the intestine of zebrafish larvae by intubation through the open mouth. This infection method closely mimics the natural infection route of C. difficile.

C. difficile is strictly anaerobic, but the chromophore of fluorescent proteins usually requires oxygen to mature. To overcome this problem, a fluorescent dye was used to stain live C. difficile cells that were actively growing (R20291, a ribotype 027 strain; Figure 1A). Using the Gal4/UAS system, stable transgenic zebrafish lines were generated for live imaging, in which the mpeg1.1 or lyZ promoters drove the expression of EGFP fluorescen...

Watch this Scientific Journal Video about Development of a Larval Zebrafish Infection Model for Clostridioides difficile at JoVE.com

Development of a Larval Zebrafish Infection Model for Clostridioides difficile

Presented here is a safe and effective method to infect zebrafish larvae with fluorescently labeled anaerobic C. difficile by microinjection and noninvasive microgavage.

Development of a Larval Zebrafish Infection Model for Clostridioides difficile

Clostridioides difficile infection (CDI) is considered to be one of the most common healthcare-associated gastrointestinal infections in the United ...

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