The protocol describes the cultivation of cross-kingdom biofilms consisting of Candida albicans and Streptococcus mutans and presents a confocal microscopy-based method for the monitoring of extracellular pH inside these biofilms.
Cross-kingdom biofilms consisting of both fungal and bacterial cells are involved in a variety of oral diseases, such as endodontic infections, periodontitis, mucosal infections and, most notably, early childhood caries. In all of these conditions, the pH in the biofilm matrix impacts microbe-host interactions and thus the disease progression. The present protocol describes a confocal microscopy-based method to monitor pH dynamics inside cross-kingdom biofilms comprising Candida albicans and Streptococcus mutans. The pH-dependent dual-emission spectrum and the staining properties of the ratiometric probe C-SNARF-4 are exploited to determine drops in pH in extracellular areas of the biofilms. Use of pH ratiometry with the probe requires a meticulous choice of imaging parameters, a thorough calibration of the dye, and careful, threshold-based post-processing of the image data. When used correctly, the technique allows for the rapid assessment of extracellular pH in different areas of a biofilm and thus the monitoring of both horizontal and vertical pH gradients over time. While the use of confocal microscopy limits Z-profiling to thin biofilms of 75 µm or less, the use of pH ratiometry is ideally suited for the noninvasive study of an important virulence factor in cross-kingdom biofilms.
Cross-kingdom biofilms comprising both fungal and bacterial species are involved in several pathologic conditions in the oral cavity. Candida spp. have frequently been isolated from endodontic infections1 and from periodontal lesions2,3. In mucosal infections, streptococcal species from the mitis group have been shown to enhance fungal biofilm formation, tissue invasion, and dissemination in both in vitro and murine models4,5,6,7. Most interestingly, oral carriage of Candida spp. has been proven to be associated with the prevalence of caries in children8. As shown in rodent models, a symbiotic relationship between Streptococcus mutans and Candidas albicans increases the production of extracellular polysaccharides and leads to the formation of thicker and more cariogenic biofilms9,10.
In all of the above-mentioned conditions, early childhood caries in particular, the biofilm pH is of importance for disease progression, and the eminent role of the biofilm matrix for the development of acidogenic microenvironments11 calls for methodologies that allow studying pH changes inside cross-kingdom biofilms. Simple and accurate confocal microscopy-based approaches to monitor pH inside bacterial12 and fungal13 biofilms have been developed. With the ratiometric dye C-SNARF-4 and threshold-based image post-processing, extracellular pH can be determined in real-time in all three dimensions of a biofilm14. Compared to other published techniques for microscopy-based pH-monitoring in biofilms, pH ratiometry with C-SNARF-4 is simple and cheap, because it does not require the synthesis of particles or compounds that include a reference dye15 or the use of two-photon excitation16. The use of just one dye prevents problems with probe compartmentalization, fluorescent bleed-through, and selective bleaching16,17,18 while still allowing for a reliable differentiation between intra- and extracellular pH. Finally, incubation with the dye is performed after biofilm growth, which allows studying both laboratory and in situ-grown biofilms.
The aim of the present work is to extend the use of pH ratiometry and provide a method to study pH changes in cross-kingdom biofilms. As proof of concept, the method is used to monitor pH in dual species biofilms consisting of S. mutans and C. albicans exposed to glucose.
The protocol for saliva collection was reviewed and approved by the Ethics Committee of Aarhus County (M-20100032).
1. Cultivation of Cross-kingdom Biofilms
2. Ratiometric pH Imaging
NOTE:Ratiometric pH imaging needs to be performed immediately after biofilm growth is complete.
3. Calibration of the Ratiometric Dye
NOTE: Calibration of the dye and the fitting of a calibration curve can be performed on a different day than ratiometric pH imaging.
4. Digital Image Analysis
NOTE:Digital image analysis can be performed at any time point after calibration of the dye and ratiometric pH imaging.
After 24 h and 48 h, robust cross-kingdom biofilms developed in the well plates. C. albicans showed varying degrees of filamentous growth, and S. mutans formed dense clusters of up to 35 µm in height. Single cells and chains of S. mutans grouped around fungal hyphae, and large intercellular spaces indicated the presence of a voluminous matrix (Figure S1).
Calibration of the ratiometric dye yields an asymmetrical sigmoidal curve13,14. The extracellular pH in the biofilms dropped quickly in the first 5 min after exposure to glucose at different rates in different microscopic fields of view. Thereafter, acidification slowed down, typically reaching values of 5.5–5.8 after 15 min (Figure 1). Replicate biofilms showed a similar behavior, with only slight variations in average pH (Figure S2).
The accuracy of the pH calculations is strongly dependent on a careful choice of image settings during acquisition. For the biofilms in question, an optical slice of 0.8 µm proved to be ideal to obtain the best possible contrast between extracellular areas and fungal cytoplasm (Figure S3). Moreover, a pixel size of 0.28 µm (Figure S4), a pixel dwell time of 102.4 µs (Figure S5), and a line average of 2 (Figure S6) provided a good contrast along with an acceptable image acquisition time of ~1 min. During image post-processing, all bacterial and fungal cells were removed from the images, while most of the surrounding extracellular areas were included in the subsequent pH analysis. Depending on the brightness of the images, different upper and lower thresholds had to be chosen (Figure 2).
The pH data shown in Figure 1 and Figure S2 were recorded 5 µm from the biofilm-substratum interface. With increasing distance from the substrate, and depending on the cell density in the biofilms, the fluorescence intensity decreases, resulting in a lower contrast between cells and matrix. However, in the thin biofilms (~35 µm) grown in the present study, contrast at the top of the biofilm allowed reliable image analysis (Figure S7A).
Figure 1: Use of pH ratiometry in cross-kingdom biofilms exposed to glucose. (A) A field of view in a stained biofilm was imaged with confocal microscopy and the area covered by bacterial and fungal cells was removed prior to ratiometric analysis. (B) The pH in the extracellular space was calculated and visualized using a lookup table (16 colors). Scale bars = 20 µm. (C) The pH in the 24 h cross-kingdom biofilms dropped rapidly upon exposure to glucose at slightly different rates in different fields of view. Error bars = standard deviation (SD). Please click here to view a larger version of this figure.
Figure 2: Threshold-based image segmentation of stained biofilms. Due to the local pH changes, fluorescence intensity in the biofilms changes over time. (A) and (B) show the same microscopic field of view after 1 min and 15 min of exposure to glucose, respectively. During image segmentation, high and low thresholds need to be chosen adequately to eliminate all areas covered by bacterial and fungal cells. (C) Blue areas were eliminated by the low threshold (40), red areas by the high threshold (115). (D) Only extracellular areas were recognized as objects (surrounded by orange lines). (E) After elimination of the area covered by microbial cells, the pH calculation could be performed in the biofilm matrix. Scale bars = 20 µm. Please click here to view a larger version of this figure.
Figure S1: Typical 24 h cross-kingdom biofilm stained with the ratiometric dye. Many C. albicans cells displayed filamentous growth, while S. mutans (yellow) cells formed dense clusters or localized around fungal hyphae as single cells or chains. Large intercellular spaces indicated the presence of a voluminous biofilm matrix. Scale bars = 20 µm. Please click here to view a larger version of this figure.
Figure S2: The pH development in 24 h cross-kingdom biofilms exposed to glucose. (A), (B), and (C) The pH was determined ratiometrically in three replicate biofilms for 15 min after exposure to glucose. After a rapid pH drop in the first 5 min, acidification slowed down, and levels of 5.5−5.8 were reached after 15 min. Slightly different rates were observed in different microscopic fields of view (each represented by a line). Calibration of the ratiometric probe was only performed once. Error bars = SD. Please click here to view a larger version of this figure.
Figure S3: Impact of optical slice thickness on image contrast. Images of stained biofilms were acquired with (A) a pinhole size of 2 Airy Units and an optical slice thickness of 1.6 µm, and (B) 1 Airy Unit and an optical slice of 0.8 µm. At 1 Airy Unit, a higher laser power/gain was needed for image acquisition, but the contrast between fungal cytoplasm and extracellular areas improved. Scale bars = 20 µm. Please click here to view a larger version of this figure.
Figure S4: Impact of resolution on image contrast. Images of stained biofilms were acquired with pixel sizes of (A) 1.12 µm, (B) 0.56 µm, (C) 0.28 µm, (D) 0.14 µm, and (E) 0.11 µm. Reduction of the pixel size below 0.28 µm did not improve the contrast between extracellular areas and fungal cytoplasm. Scale bars = 20 µm. Please click here to view a larger version of this figure.
Figure S5: Impact of scan speed on image contrast. Images of stained biofilms were acquired with pixel dwell times of (A) 12.8 µs, (B) 25.6 µs, (C) 51.2 µs, (D) 102 µs, and (E) 164 µs. Increasing the pixel dwell time beyond 102 µs did not improve the contrast between extracellular and intracellular areas. Scale bars = 20 µm. Please click here to view a larger version of this figure.
Figure S6: Impact of averaging on image contrast. Images of stained biofilms were acquired with line averages (mean) of (A) 1, (B) 2, and (C) 4. A line average of 2 provided the best compromise between contrast and acquisition time. Scale bars = 20 µm. Please click here to view a larger version of this figure.
Figure S7: Image contrast in purely fungal biofilms and cross-kingdom biofilms. (A) The top of a stained cross-kingdom biofilm was imaged 30 µm from the interface. The contrast between extracellular and intracellular areas was lower than at the biofilm base but still sufficient for ratiometric pH analysis. (B) A C. albicans monospecies biofilm was imaged for pH ratiometry. Laser power/gain could be increased to optimize the contrast between fungal cell walls and cytoplasm. (C) In cross-kingdom biofilms, the brightly fluorescent bacteria precluded further increase of laser power/gain. Hence, the contrast between fungal cell walls and cytoplasm is less pronounced than in purely fungal biofilms. Scale bars = 20 µm. Please click here to view a larger version of this figure.
Different protocols for the cultivation of cross-kingdom biofilms involving C. albicans and Streptococcus spp. have been described previously9,22,23,24,25. However, the present setup focuses on simple growth conditions, a time schedule compatible with regular working days, a balanced species composition, and the development of a voluminous biofilm matrix. Moreover, 96-well plates were coated with salivary solution to mimic oral conditions of adhesion to some extent.
The use of pH ratiometry with C-SNARF-4 is an inexpensive method for rapid measurements of biofilm pH, the advantages and disadvantages of which have been discussed in detail elsewhere12,26. In brief, the technique allows for the assessment of pH in different locations inside biofilms and thus the monitoring of horizontal pH gradients and pH developments over time27. Vertical pH profiles can be recorded, too, but the penetration depth is limited by the use of confocal microscopy. Hence, pH ratiometry represents a faster, more versatile, and less invasive alternative to pH microelectrodes, which are currently the method of choice for Z-profiling of thick biofilms28. Compared to other microscopy-based methods for pH recordings in biofilms, pH ratiometry with C-SNARF-4 has the advantage of only employing one stain. Therefore, several problems that may arise from the differential fluorescent behavior and the interaction between different dyes are circumvented26.
In cross-kingdom biofilms, threshold-based differentiation between microbial biomass and extracellular areas poses some problems when compared to biofilms that only comprise bacterial or fungal cells. Bacterial cells internalize the ratiometric dye and display a bright fluorescent signal compared to the biofilm matrix, but also compared to fungal cell walls. Fungal cell walls appear somewhat brighter than the biofilm matrix, which in turn shows higher fluorescence than the fungal cytoplasm. In biofilms that only consist of fungal cells, images can be acquired with a high laser power/gain, which results in sufficient contrast between the biofilm matrix and the fungal cytoplasm (Figure S7B). When bacteria are present, laser power/gain must be reduced to avoid overexposure of bacterial cells (Figure S7C). Hence, the contrast between fungal cytoplasm and extracellular areas is not as pronounced, and image settings such as pinhole size, pixel size, and pixel-dwell time must be chosen with great care for ratiometric analysis.
As for all microscopy-based techniques, image quality and acquisition time are inversely correlated. In the present cross-kingdom biofilms, an imaging time of ~30 s, ideally 1 min, was necessary to obtain an appropriate quality for subsequent pH analysis. In comparison, biofilms that only harbor bacteria can be imaged with sufficient quality in 10 s or less29. For microscopy analyses of biofilm growth, structure, or composition, acquisition times of 1 min do not pose a problem, and in many instances, this may also apply to pH recordings. However, extreme pH changes, such as the rapid acidification observed immediately after exposure to glucose (ΔpH > 1 unit/min), are difficult to monitor in cross-kingdom biofilms.
The present work demonstrates that ratiometric pH recordings with C-SNARF-4 are feasible in cross-kingdom biofilms composed of S. mutans and C. albicans. Future studies may employ the method to analyze pH changes in cross-kingdom biofilms with greater species diversity, especially in biofilms grown in situ (i.e. in children with early childhood caries)30. In this study, the pH in the biofilms was monitored under static conditions and for a limited observation time of 15 min, right after a glucose pulse. Further advancements may include the application of a fluid flow to mimic in situ conditions more closely14,31,32. Moreover, pH ratiometry may be used to study the impact of various nutritional conditions on long-term pH changes in cross-kingdom biofilms and contribute to elucidate the effect of biofilm pH on the underlying host tissues. Again, the demineralization of dental enamel in early childhood caries may serve as a prominent example.
The authors have nothing to disclose.
Anette Aakjær Thomsen and Javier E. Garcia are acknowledged for excellent technical support. The authors thank Rubens Spin-Neto for fruitful discussions on image analysis.
Blood agar plates | Statens Serum Institut | 677 | |
Brain heart infusion | Oxoid | CM1135 | |
Brain heart infusion + 5 % sucrose | BDH laboratory supplies | 10274 | |
Candida albicans | National Collection of Pathogenic Fungi | NCPF 3179 | |
D-(+)-Glucose | Sigma-Aldrich | G8270 | |
daime: digital image analysis in microbial ecology | Universität Wien | N/A | Freeware; V2.1; https://dome.csb.univie.ac.at/daime |
Dimethyl sulfoxide | Life Technologies | D12345 | |
Fetal bovine serum | Gibco Life technologies | 10270 | |
GS-6R refrigerated centrifuge | Beckman | N/A | |
ImageJ | National Institutes of Health (NIH) | N/A | Freeware; V1.46r; https://imagej.nih.gov/ij |
Java | Oracle | N/A | Freeware necessary to run ImageJ; V8.0; https://java.com/en/download |
µ-Plate 96 Well Black | Ibidi | 89626 | |
MyCurveFit | MyAssays Ltd. | N/A | |
2-(N-Morpholino)ethanesulfonic acid (MES) buffer | Bioworld | 700728 | |
PHM210 pH-meter | Radiometer Analytical | ||
Plan-Apochromat 63x oil immersion objective | Zeiss | N/A | NA=1.4 |
SNARF®-4F 5-(and-6)-Carboxylic Acid | Life Technologies | S23920 | |
Sterile physiological saline | VWR | 6404 | |
Streptococcus mutans | Deutsche Sammlung von Mikroorganismen und Zellkulturen | DSM 20523 | |
Vis-spectrophotometer V-3000PC | VWR | N/A | |
XL Incubator | PeCON | N/A | |
Zeiss LSM 510 META | Zeiss | N/A |