This protocol describes the use of a customizable automated microfluidic device to visualize biofilm formation in Candida albicans under host physiological conditions.
Candida albicans is the most common fungal pathogen of humans, causing about 15% of hospital-acquired sepsis cases. A major virulence attribute of C. albicans is its ability to form biofilms, structured communities of cells attached to biotic and abiotic surfaces. C. albicans biofilms can form on host tissues, such as mucosal layers, and on medical devices, such as catheters, pacemakers, dentures, and joint prostheses. Biofilms pose significant clinical challenges because they are highly resistant to physical and chemical perturbations, and can act as reservoirs to seed disseminated infections. Various in vitro assays have been utilized to study C. albicans biofilm formation, such as microtiter plate assays, dry weight measurements, cell viability assays, and confocal scanning laser microscopy. All of these assays are single end-point assays, where biofilm formation is assessed at a specific time point. Here, we describe a protocol to study biofilm formation in real-time using an automated microfluidic device under laminar flow conditions. This method allows for the observation of biofilm formation as the biofilm develops over time, using customizable conditions that mimic those of the host, such as those encountered in vascular catheters. This protocol can be used to assess the biofilm defects of genetic mutants as well as the inhibitory effects of antimicrobial agents on biofilm development in real-time.
Candida albicans is a commensal member of the human microbiota, however it is also an opportunistic pathogen, capable of causing superficial and severe fungal infections1,2. A major virulence trait of C. albicans is its ability to form resilient and drug resistant biofilms, communities of cells adhered to a surface and enclosed in an extracellular matrix material1,3. C. albicans biofilms are highly structured, containing several layers of multiple cell types (round budding yeast-form cells, oval pseudohyphal cells, and tubular hyphal cells)4. C. albicans biofilm development begins with the adherence of round yeast-form cells to a surface (seeding the biofilm), followed by the proliferation of these cells on the surface, and then the maturation of the immature biofilm structure into a fully-formed biofilm that is surrounded by extracellular matrix material4. The mature biofilm is predominantly composed of elongated hyphal cells that form dense and interconnecting networks, providing the architectural stability to the biofilm4. Throughout the biofilm life cycle, round budding yeast cells disperse from the mature biofilm, and may travel to other regions of the body to cause disseminated infections or seed new biofilms at other sites4,5. C. albicans can form biofilms on biotic surfaces, such as mucosal surfaces and throughout host tissue, and on abiotic surfaces, such as catheters, pacemakers, dentures, and prosthetic joints. Due to the recalcitrant properties of biofilms, they are extremely difficult to eradicate, and in many cases the only effective treatment strategy is removal of the infected device4. It is thus crucial to investigate biofilm formation under conditions similar to those observed in clinical settings.
There are several critical in vivo animal models used to study C. albicans biofilm formation6,7,8; however, these studies can be costly, time consuming, and are limited by the number of strains and antimicrobial agents that can be tested at a given time. In vitro biofilm assays, on the other hand, allow for the rapid, high-throughput assessment of antifungal compounds and mutant strains, and are much more cost-effective and ethical than biofilm assays carried out in animal models9,10,11,12,13,14. Here we describe an in vitro assay that we developed and optimized to observe biofilm formation temporally under laminar flow using a customizable microfluidic device14,15. The assay allows for the visualization of each stage of biofilm formation, including the initial adherence step, cell proliferation, biofilm maturation, and cell dispersion. The assay is also useful to visualize cell morphology changes throughout the development of a biofilm.
Microtiter plates, which are typically utilized for in vitro biofilm assays, while high throughput, do not allow for controlled flow conditions. Traditional laminar flow cell systems allow for the continuous assessment of biofilm formation in controlled flow conditions, but these are often time consuming to set up and tend to have limited dynamic range control and throughput. The microfluidic device utilized here overcomes these limitations by combining high throughput plates (containing 48 wells) with a built-in laminar flow chamber and is highly reproducible, versatile, and customizable.
Here, we describe a protocol for the use of a commercially available automated microfluidic device to assess biofilm formation of a wild-type C. albicans strain, the effects of a known antifungal agent on the development of a biofilm, and biofilm formation in two mutant strains (bcr1Δ/Δ and efg1 Δ/Δ) that were previously reported to have biofilm defects in vitro and in vivo16,17,18. The described protocol can be used to test the efficacy of antimicrobial agents in inhibiting biofilm formation throughout the development of a biofilm, and to identify genes required for normal biofilm development by screening mutant libraries.
1. Fungal Cell Culture Preparation
NOTE: Conduct cell culture work (i.e. opening cryogenic stock tubes, cell culture tubes, and flasks) within a biosafety cabinet. Turn on the cabinet's ultraviolet (UV) germicidal lamp at least 1 h prior to work, and turn off the UV lamp while actively working in the cabinet. Wear gloves, safety glasses, and appropriate personal protective equipment, and decontaminate the surface of the bench and pipettes with 70% ethanol prior to the start of the experiment. Use of sterile filter tips and familiarity with basic aseptic microbiological techniques are recommended.
2. Preparation of Microfluidic Channels of the Microfluidic Plate
NOTE: Refer to user manual of microfluidic system (see table of materials) for information on plates and instrument setup.
3. Candida albicans Biofilm Formation in the Microfluidic System
4. Setting Up the Stage Positions for the Microfluidic Experiment
NOTE: The stage positions and plate calibration should be set just before starting the experiment. This setup allows the computer to store the positions of each viewing channel for capturing the images during the experiment. The microfluidic plate should not be disturbed after setting up the stage positions. If the plate is moved, the stage positions will have to be reset before the start of the experiment.
5. Setting Up Acquisitions for Image Capture During the Microfluidic Experiment
6. Running the Microfluidic Experiment
7. Analyzing the Results
We performed the microfluidic biofilm assay described here using a wild-type C. albicans strain under two media conditions (RPMI-1640 and Spider media), the wild-type strain in the presence of the known antifungal drug amphotericin B (16 µg/mL) in RPMI, and two mutant strains previously reported to have defects in biofilm formation (bcr1Δ/Δ and efg1 Δ/Δ) in Spider media.
Video 1 shows the development of a wild-type biofilm in RPMI-1640 medium and the effects of the antifungal drug, amphotericin B, on biofilm formation. Under wild-type conditions, several cells strongly adhere to the channel, the cells form hyphae as time progresses, and a thick biofilm can be observed with intercalating hyphae and yeast cells. Towards the end of the microfluidic experiment, the wild-type biofilm completely fills the viewing channel. The presence of amphotericin B, however, has a pronounced effect on reducing the biofilm. Specifically, the adherence of cells is diminished, and, unlike untreated conditions, in the presence of amphotericin B, several cells can be seen flowing away with the shear flow of the media. As time progresses, the cells fail to form hyphae and a biofilm is not formed. These differences are also shown in Figure 3, which depicts 4 time-points from the assay at 0 h, 2 h, 6 h, and 12 h.
Video 2 shows the development of a wild-type biofilm and two previously reported biofilm-defective mutants (bcr1 Δ/Δ and efg1 Δ/Δ) in Spider media. Both bcr1 Δ/Δ and efg1 Δ/Δ strains show severely reduced biofilm formation compared to the isogenic wild-type strain. For the efg1 Δ/Δ strain, we observed that the adhered cells do not form hyphae and the resulting biofilm is severely defective. For the bcr1 Δ/Δ strain, we observed that not only is the bcr1 Δ/Δ strain defective in biofilm formation, but it also displays a clear adherence defect, where cells can be seen drifting in the direction of the shear flow as they fail to adhere to the viewing channel. These differences are also shown in Figure 4, which depicts 4 time points from the assay at 0 h, 2 h, 6 h, and 12 h.
Figure 1: Microfluidic instrument used in this experiment. Panel A shows the microfluidic instrument used, panel B shows the interface plate, panel C shows a schematic outline of a single viewing channel (stage) and three sub-stages captured by the camera during the experiment, and panel D shows a schematic outline of the 48-well microfluidic plate used with a schematic of the outlet and inlet wells and viewing window. Please click here to view a larger version of this figure.
Figure 2: Select screenshots of imaging modulesoftware and microfluidic plate control system. Panel A shows the Control Module, that contains the controls for the microfluidic plate, and panel B shows the imaging module window, the 'Move Stage to Absolute Position' (MAP) module, the 'Multi-dimensional Acquisition' (MDA) module, and the 'Sample Reload Adjustment' (SRA) module. Please click here to view a larger version of this figure.
Figure 3: Exposure to amphotericin B results in biofilm formation defects. Time dependent visualization of biofilm formation in RPMI-1640 media (Column 1), and RPMI-1640 media supplemented with 16 µg/mL amphotericin B (Column 2) under dynamic flow (0.5 dyne/cm2) at 37 °C for 12 h post-adherence in the microfluidic system. Representative 0 h (post-adherence and initial wash), 2 h, 6 h, and 12 h images (top to bottom) are shown for the isogenic wild-type strain SN250 (Columns 1 and 2). Scale bars are 20 µm in each panel. Corresponding time lapse videos of biofilm formation are provided in Video 1. Please click here to view a larger version of this figure.
Figure 4: Deletion of BCR1 or EFG1 results in biofilm formation defects. Time dependent visualization of biofilm formation in Spider media (Columns 1-3) under dynamic flow (0.5 dyne/cm2) at 37 °C for 12 h post-adherence in the microfluidic system. Representative 0 h (post-adherence and initial wash), 2 h, 6 h, and 12 h images (top to bottom) are shown for the isogenic wild-type strain SN250 (Column 1), bcr1Δ/Δ strain (Column 2), and efg1 Δ/Δ strain (Column 3). Scale bars are 20 µm in each panel. Corresponding time lapse videos of biofilm formation are provided in Video 2. Please click here to view a larger version of this figure.
The customizable microfluidic biofilm assay described here allows for the visualization of biofilm formation in real-time at a single cell level when exposed to a fixed rate laminar flow and constant temperature. It provides a powerful means to study the development of biofilms in wild-type and mutant strains, and the effects of antimicrobial agent treatments on biofilms under conditions that mimic physiological conditions observed in clinical settings. Unlike most in vitro biofilm assays, this method allows for the examination of a developing biofilm in real-time as it forms.
This method can be used in a high-throughput manner, where up to 24 samples can be run simultaneously to assess biofilm formation. The method can also be used to conduct genetic screens of mutant libraries to identify genes required for normal biofilm development and can be used to assess the effectivity against biofilms of antimicrobial compounds of interest in compound library screens. We anticipate that future applications of this microfluidic device will include such screens. We note, however, that certain drug treatment testing will be limited by the thickness of the biofilm formed using this microfluidic device as biofilms grown for >16 h tend to clog the viewing channel. Thus, drug testing experiments will need to be performed for <16 h.
Overall, this device is highly customizable and versatile, and can be adjusted to assess different microbial species across kingdoms, flow rates, temperatures, incubation times, and media. The method described provides information about a number of different aspects of biofilm formation, including initial cell adherence, biofilm maturation, and cell dispersal. Although we only report results for single-species biofilm formation here, this protocol could also be adapted to study dual- and mixed-species biofilm formation.
Two steps are critical to successfully perform this protocol. First, air bubbles in the system must be avoided by preheating the media at the experimental temperature. One common misstep is the dilution of cells in media that was not preheated. Cells should be diluted in the same media that is being used for the inlet wells. Second, the flow of cells from outlet to inlet wells must be carefully monitored; if the cells flow too far, the inlet media will become contaminated and the experiment will not yield interpretable results. On the other hand, if the cells are not allowed to move all the way into the viewing channel, then no cells will be visible in the channel during the experiment, leading to blank images. Additional key points to keep in mind are that the volume and movement between wells in the microfluidic plate are linked together for each column, and it is important to maintain as much media consistency as possible (with similar viscosity, cell density, and composition) and similarly sized cells (if possible), as different media and different cell sizes will have different flow rates in the column. During the experiment, the backflow of the cells is monitored using a microscope; however, only two channels can be viewed at one time (using a 10X objective). Thus, it is highly recommended to perform a mock experiment to measure the time required to flow from outlet to inlet wells using the cells and media planned to be used in the actual experiment.
In general, we highly recommend use of this microfluidic biofilm assay as an in vitro assay to be utilized before in vivo animal testing. The assay, however, is still an in vitro assay, and results will need to be validated in relevant animal models. In our experiences, the results of this microfluidic biofilm assay have had the best predictive value for in vivo biofilm assays compared with other in vitro assays we have assessed14.
The authors have nothing to disclose.
We thank all members of the Nobile lab for helpful discussions on biofilm assays. This study was supported by National Institutes of Health (NIH) grant R21 AI125801 (to C.J.N.). D.L.R. was supported by a doctoral fellowship from The University of California Institute for Mexico and the United States (UC-MEXUS) and Consejo Nacional de Ciencia y Technologia (CONACYT).
BioFlux 1000z | Fluxion | Automated microfluidic device for live cell analysis | |
48-well plate 0-20 dyne | Fluxion | 910-0047 | Microfluidic plate |
Montage Software | Fluxion | Version 7.8.4.0 | Visualization analysis software |
ImageJ Software | NIH | https://imagej.nih.gov/ij/ | |
Yeast Extract | Criterion | C7341 | |
Bacto Peptone | BD Biosciences | 211677 | |
Dextrose (D-Glucose) | Fisher Scientific | D163 | |
Potassium Phosphate Monobasic | Fisher Scientific | P285-500 | |
RPMI-1640 | Sigma-Aldrich | R6504 | |
MOPS | Sigma-Aldrich | M3183 | |
Nutrient Broth | Criterion | C6471 | |
Difco D-Mannitol | BD Biosciences | 217020 | |
Agar | Criterion | C5001 | |
Amphotericin B | Corning | 30-003-CF | |
Sterile Inoculating Loops | VWR | 30002-094 | |
Petri Dishes with Clear Lid | Fisher Scientific | FB0875712 | |
Disposable Cuvettes | Fisher Scientific | 14-955-127 | |
Lens Paper | VWR | 52846-001 | |
Microplate and Cuvette Spectrophotometer | BioTek | EPOCH2TC | |
Shaking Incubator | Eppendorf | M12820004 |