The human microbiome includes diverse organisms from multiple taxonomic kingdoms that share geographic regions in the body. Adherence to cell surfaces is an essential first step in biofilm formation, which is part of the microbiome colonization process. Included in the microbiome can be viruses that cause chronic and persistent infections. The chronic cell infection by these viruses can cause an alteration in putative receptor availability.1,2 In addition, cell entry by intracellular pathogens could also affect host membrane fluidity/hydrophobicity which in turn may alter attachment of other microbiome members, including bacteria and fungi. In order to understand the interactions that can occur between these multiple pathogens that co-localize in the same geographic regions of the human host, we must be able to study the interaction of pathogens that represent the spectrum of taxonomic kingdoms present at the mucosal surface.
The Herpesviridae are a family of microbes present in 100% of humans as permanent members of the microbiome3,4. In addition they can also be persistently shed both in the presence and absence of symptoms. Specifically, herpes simplex virus-1 and herpes simplex virus-2 (HSV-1 and HSV-2, respectively) are permanent members of the microbiome in the oronasopharynx and genital tract. In immune-competent individuals, both HSV-1 and HSV-2 cause gingivostomatitis, as well as genital herpes5-8. At these sites, HSV causes a latent infection characterized by chronic persistent asymptomatic viral shedding9. Entry of HSV into cells results in alterations in surface expression of nectins, heparan sulfate, lipid rafts and herpesvirus entry mediator/tumor necrosis factor receptor (HVEM/TNFr)10-25. These potentially represent shared receptors for some bacteria and fungi, e.g. S. aureus and C. albicans,which while opportunistic pathogens, can also reside as members of the mucosal microbiome of the oronasopharynx 26,27. Within the oronasopharynx S. aureus and C. albicans occupy two distinct sites of colonization. In hosts with natural teeth, the oral mucosa is shared by HSV-1 and C. albicans, while the anterior nasal nares are occupied by S. aureus28. However, despite in vitro findings that S. aureusadheres to mouth epithelial cells, 29,30 S. aureus is infrequently isolated from oral specimens when normal tissue is present29,30. Little is known concerning genital tract co-colonization niches beyond the clinical findings that S. aureus is associated with aerobic vaginitis, characterized by genital inflammation, discharge and dyspareunia, while C. albicans produces mucosal lesions similar to that observed in the oral cavity31-35. Thus, although these members of the oral and genital microbiome cross taxonomic kingdoms little is known concerning their interaction as it impacts their ability to initiate biofilm formation through adherence to the host cell surface5. This protocol has been effectively applied to determine the functional consequences of co-colonization/infection.