We describe the use of a porcine cornea to test the antiviral efficacy of experimental drugs.
Viruses and bacteria can cause a variety of ocular surface defects and degeneration such as wounds and ulcers through corneal infection. With a seroprevalence that ranges from 60-90% worldwide, the Herpes Simplex Virus type-1 (HSV-1) commonly causes mucocutaneous lesions of the orofacial region which also manifest as lesions and infection-associated blindness. While current antiviral drugs are effective, emergence of resistance and persistence of toxic side-effects necessitates development of novel antivirals against this ubiquitous pathogen. Although in vitro assessment provides some functional data regarding an emerging antiviral, they do not demonstrate the complexity of ocular tissue in vivo. However, in vivo studies are expensive and require trained personnel, especially when working with viral agents. Hence ex vivo models are efficient yet inexpensive steps for antiviral testing. Here we discuss a protocol to study infection by HSV-1 using porcine corneas ex vivo and a method to treat them topically using existing and novel antiviral drugs. We also demonstrate the method to perform a plaque assay using HSV-1. The methods detailed may be used to conduct similar experiments to study infections that resemble the HSV-1 pathogen.
People suffering from ocular infections often incur vision loss1. With a high seroprevalence worldwide, HSV infected individuals suffer from recurring eye infections which lead to corneal scarring, stromal keratitis and neovascularization2,3,4,5. HSV infections have also shown to cause less frequently, a range of serious conditions among immunocompromised, untreated patients like encephalitis and systemic morbidity6,7,8. Drugs like Acyclovir (ACV) and its nucleoside analogs have shown consistent success in curbing HSV-1 infection and even control reactivation yet the prolonged use of these drugs is associated with renal failure, fetal abnormalities and failure to restrict the emergence of drug-resistance to evolving viral strains9,10,11,12,13. Complexities associated with HSV-1 ocular infections, have been previously studied in vitro using monolayers and 3D cultures of human corneal cells and in vivo using murine or rabbit ocular infections. While these in vitro models provide significant data on the cellular biological components of HSV-1 infections, they, however, fail to mimic the intricate complexity of corneal tissue and do little to illuminate the dendritic spread of the virus14. In contrast, although in vivo systems are more insightful in showing infection spread in corneas and immune activation responses during HSV-1 infection, they do come with the caveat that they require trained investigators and large facilities for animal care to overlook the experiments.
Here we use porcine corneas as an ex vivo model to examine the HSV-1 infection induced wound system. Both the potential pharmacology of certain drugs as well as the cell and molecular biology of the wound system caused by the infection can be studied through tissue explant cultures. This model may also be amended for the use for other viral and bacterial infections as well. In this study, porcine corneas were used to test the antiviral efficacy of a preclinical small molecule, BX795. The use of porcine corneas was preferred due to ease of access and cost effectiveness. Additionally, porcine corneal models are good models of human eyes with the corneas being easy to isolate, adequately sized for infection and visualization and robust to handle15. Porcine corneas are also comparable to the complexity of human corneal models in both trans corneal permeability and systemic absorption15. By using this model for the study, we were able to elucidate how BX795 is worthy of further investigation as a competent inhibitor of HSV-1 virus infection and adds to the literature of classifying it as a potential small-molecule antiviral compound16.
All the porcine tissue used in this study was provided by a third-party private organization and none of the animal handling was performed by University of Illinois at Chicago personnel.
1. Materials
2. Procedure
To understand the efficacy of the experimental antivirals, they need to be tested extensively before they are sent for in vivo human clinical trials. In this regard, positive control, negative control and test groups have to be identified. Trifluorothymidine (TFT) has long been used as the preferred treatment to treat herpes keratitis topically16. Used as a positive control, the TFT treated corneal groups show lower infection spread. As a negative control, we used DMSO or vehicle control dissolved in PBS. BX795, the experimental preclinical drug was the test group. A total of 4 corneas were assigned to each group and the drugs were added 3-times every day to the porcine corneas. Our results using stereoscopic fluorescence imaging show that the antiviral efficacy of BX795 is similar to TFT in controlling viral spread. Viral spread in our studies can be visualized by imaging the green fluorescence channel in the stereoscope. We observed that vehicle only treated negative control group corneas showed spread of the virus from the central infection zone to its periphery by 6 days post initial viral inoculation, while both drugs (BX795 and TFT) clear the infection in day 4 – 6 images (Figure 9A). Similarly, the ocular swabs taken on days 2 and 4 post infection show a complete inhibition of virus in the positive control and BX795 treated samples while a sharp increase in infectious virus titer is observed in the negative control group (Figure 9B).
Figure 1: Porcine eyes kept on ice until tissue is processed. Please click here to view a larger version of this figure.
Figure 2: Work bench setup. Please click here to view a larger version of this figure.
Figure 3: Porcine eyes placed on gauze. Please click here to view a larger version of this figure.
Figure 4: Porcine eye with 30G needle pictured. Please click here to view a larger version of this figure.
Figure 5: 30 G needle used; hole made at center of epithelial surface. Please click here to view a larger version of this figure.
Figure 6: Rotating action used to cut around corneal edge using sharp sterilized blade (A,B). Please click here to view a larger version of this figure.
Figure 7: Cornea images. (A,B) The cornea finally cut using sharp scissors (C) Isolated cornea is held by tweezers (D) Completely isolated cornea, ready for use Please click here to view a larger version of this figure.
Figure 8: Corneas placed in 12-well plate and incubated for 72 h. Please click here to view a larger version of this figure.
Figure 9: Progression of viral spread taken during course of infection. Freshly excised porcine corneas were infected with HSV-1 17-GFP and (A) imaged using microscope on days 2, 4 and 6 post infection. Topical treatment with DMSO, TFT or BX795 was started on day 2 post infection. (B) Plaque assays were performed using swabs taken from the porcine corneas on Vero Cells. Two-way ANOVA test was performed to understand significant differences between the treatment groups. n=4, ****p=0.0001. Please click here to view a larger version of this figure.
Prior research has shown BX795 to have a promising role as an antiviral agent against HSV-1 infection; by inhibiting the TANK-binding kinase 1 (TBK1)16. Both TBK1 and autophagy have played a role in helping inhibit HSV-1 infection as demonstrated on human corneal epithelial cells. BX795 was shown to be maximally effective with antiviral activity at a concentration of 10µM and using both western blot analysis and viral plaque analysis of key viral proteins, BX795 was shown to inhibit HSV-1 infection comparable to the activity of TFT16. The study on porcine corneas followed the same analysis and obtained similar results as demonstrated above; BX795 is shown to be just as effective as TFT in inhibiting infection – images taken of porcine corneas at day 4 and 6 of infection show comparable results in both TFT and BX795. Plaque assays performed to quantify secreted virions also reinforce these findings16. BX795 has also shown to have antiviral effects in vitro and its use topically in mouse models in vivo has also shown suppression of corneal HSV-1 infection16.
The study contributes to establishing BX795 as an effective and leading compound for broad-spectrum antiviral application against HSV-1 infection. By showing its efficacy in porcine models as comparable to TFT, BX795 stands to be successful in multiple infection models16. Additionally, BX795 is important as it has been shown to be effective in multiple virus strains, even HSV-1 (KOS)tk12 which is resistant to another widely used drug Acyclovir (ACV)16. BX975 treated cells show very little expression of HSV-1 viral protein gB which certify its inhibition efficacy of HSV-1 virus. BX795 is also demonstrates better anti-viral efficacy at lower doses compared to other treatments and anti-herpesvirus therapies. Furthermore, therapeutic concentrations of BX795 (even proposed concentration of 10 µM) show no adverse cytotoxicity towards cells – no apoptosis inducement and cell death, which is again comparable to the TFT control16.
Critical steps within the protocol section include isolation of porcine cornea from the whole eye. This involves the debridement of the cornea at the center of the eye using a needle and requires very little force to ensure no stromal involvement followed by excising the cornea from the ocular surface gently without disturbing the iris. Another set of critical steps include parts involving pre-wetting cotton tips and swabbing the corneal surface. The motion should be gentle to ensure corneal epithelium is not being dislodged from the ocular surface.
Modification can be done to the epithelial debridement step. Instead of using a 30 G needle to make a single poke at the center of the cornea, the experimenter can use a sterile blade or 30 G needle to gently make grid shaped scratches to the corneal epithelium. This ensures robust infection to the epithelium.
Porcine corneas should be used on the same day of procurement and should not be held for longer than 24 h. Porcine corneas kept in ice for longer than 4 h will result in the iris sticking to cornea. This makes it harder to separate the cornea from the rest of the eye during excision. Not all porcine corneas will get infected alike. The experimenter should infect a minimum of 5 eyes per group and then pick equally infected corneas on day 2 post infection to proceed with the experiment.
The significance of the current technique involves the cost effectiveness of using porcine over human corneas. The technique is also significant because of the relative freshness of the corneas being used when compared to human corneas.
Future applications of the current technique include but not limited to its use in testing drug permeability studies, ex vivo pharmacokinetic and pharmacodynamic studies. Porcine corneas can also be used to test antibacterial and antifungal drugs in addition to antiviral drugs. The corneas can also be used for ex vivo wound healing assays to study diabetic wounds.
The authors have nothing to disclose.
This study was supported by NIH grants (R01 EY024710, RO1 AI139768, and RO1 EY029426) to D.S. A.A. was supported by an F30EY025981 grant from the National Eye Institute, NIH.Study was conducted using the porcine corneas obtained from Park Packing company, 4107 Ashland Avenue, New City, Chicago, IL-60609
30 G hypodermic needles. | BD | 305128 | |
500 mL glass bottle. | Thomas Scientific | 844027 | |
Antimycotic and Antibiotic (AA) | GIBCO | 15240096 | Aliquot into 5 mL tubes and keep frozen until use |
Benchtop vortexer. | BioDot | BDVM-3200 | |
Biosafety cabinet with a Bio-Safety Level-2 (BSL-2) certification. | Thermofisher Scientific | Herasafe 2030i | |
Calgiswab 6" Sterile Calcium Alginate Standard Swabs. | Puritan | 22029501 | |
Cell scraper – 25 cm | Biologix BE | 70-1180 70-1250 | |
Crystal violet | Sigma Aldrich | C6158 | Store the powder in a dark place |
Dulbecco’s modified Eagle’s medium – DMEM | GIBCO | 41966029 | Store at 4 °C until use |
Ethanol | Sigma Aldrich | E7023 | |
Fetal bovine serum -FBS | Sigma Aldrich | F2442 | Aliquot into 50 mL tubes and keep frozen until use |
Flat edged tweezers – 2. | Harward Instruments | 72-8595 | |
Freezers –80 °C. – | Thermofisher Scientific | 13 100 790 | |
Fresh box of blades. | Thomas Scientific | TE05091 | |
Guaze | Johnson & Johnson | 108 square inch folder 12 ply | |
HSV-1 17GFP | grown in house | – | Original strain from Dr. Patricia Spears, Northwestern University. GFP expressing HSV-1 strain 17 |
Insulin, Transferrin, Selenium – ITS | GIBCO | 41400045 | Aliquot into 5 mL tubes and keep frozen until use |
Magnetic stirrer. | Thomas Scientific | H3710-HS | |
Metallic Scissors. | Harward Instruments | 72-8400 | |
Micropipettes 1 to 1000 µL. | Thomas Scientific | 1159M37 | |
Minimum Essential Medium – MEM | GIBCO | 11095080 | Store at 4 °C until use |
OptiMEM | GIBCO | 31985047 | Store at 4 °C until use |
Penicillin/streptomycin. | GIBCO | 15140148 | Aliquot into 5 mL tubes and keep frozen until use |
Phosphate Buffer Saline -PBS | GIBCO | 10010072 | Store at room temperature |
Porcine Corneas | Park Packaging Co., Chicago, IL | 0 | Special order by request |
Procedure bench covers – as needed. | Thermofisher Scientific | S42400 | |
Serological Pipettes | Thomas Scientific | P7132, P7127, P7128, P7129, P7137 | |
Serological Pipetting equipment. | Thomas Scientific | Ezpette Pro | |
Stereoscope | Carl Zeiss | SteREO Discovery V20 | |
Stirring magnet. | Thomas Scientific | F37120 | |
Tissue culture flasks, T175 cm2. | Thomas Scientific | T1275 | |
Tissue culture incubators which can maintain 5% CO2 and 37 °C temperature. | Thermofisher Scientific | Forma 50145523 | |
Tissue culture treated plates (6-well). | Thomas Scientific | T1006 | |
Trypsin-EDTA (0.05%), phenol red | GIBCO | 25-300-062 | Aliquot into 10 mL tubes and keep frozen until use |
Vero cells | American Type Culture Collection ATCC | CRL-1586 |