This protocol describes the infection of the skin of the commonly used inbred mouse strain C57BL/6 by Malassezia spp. Adapting this protocol to other mouse strains with a different genetic background (e.g., Balb/c) or to genetically modified mouse strains may need adjustment of the infection dose, the time point(s) of analysis, etc. To ensure reproducibility, groups of mice should always be of the same age and sex. The source of mice should be kept stable, as even slight changes in the genetic background and differences in the microbiota, which exist between vendors and may exist even between different units of a single breeding facility, can have an unpredictable impact on the course of infection. When setting up the Malassezia infection model described in this protocol, it is advised to perform a pilot study to carefully monitor the course of infection, including the extent of colonization, the kinetics of fungal clearance and the degree of inflammation and pathology that might be induced (e.g., if the ear skin is barrier-disrupted prior to infection) to determine the optimal assay conditions.
To ensure reproducibility and to reliably detect differences between experimental groups, the number of animals used per group must be calculated based on the statistical analysis. The sample size is calculated based on effect size, error rate and power, which consider biological and experimental variations (e.g., due to variation in the immune system). For ethical reasons avoid using unnecessarily high numbers of animals. Regarding Malassezia skin infection, treating only one ear with the fungus and using the other ear as a control within the same mouse, is not advised because mice may spread the fungus to both ears when grooming. However, using ½ ear for different methodological read outs such as determination of fungal burden, isolation of immune cells or histological analysis is often enough and results in a significant reduction in animal numbers used for experiments.
18 different species of Malassezia have been described up to date. Inter- and intraspecies variations within the genus Malassezia can affect the interaction with the host, as we have also learned from studies on other human pathogenic fungi13. Different Malassezia species and strains differ in their origin (e.g., M. pachydermatis is the most frequent species isolated from animals, while M. restricta, M. globosa and M. sympodialis are the most prominent members of the fungal skin microbiome in humans with variable distribution of these species between different skin areas). Some species have been associated with commensalism, while others are thought to be more pathogenic, although detailed evidence remains relatively weak. Importantly, some species and strains are inherently more difficult to grow than others. Thus, the decision of which species/strain to use for the infection must be based on the research question.
Experimental infection of the murine skin with some microbial organisms such as Candida albicans or Staphylococcus aureus require the disruption of the epidermal barrier prior to infection, e.g., with sand paper14,15,16. In contrast, the model of Malassezia infection described here is equally efficient with and without barrier disruption7. The degree of inflammation induced by the fungus is massively enhanced if the skin is tape stripped prior to infection7. Therefore, whether the skin should be manipulated before the application of Malassezia depends on the research question. Various models of chronic and acute skin inflammation (e.g., models for delayed type hypersensitivity (DTH) and contact hypersensitivity (CHS)) and models of barrier deficiency exist that may be of interest for investigating the contribution of commensal yeast to skin pathologies.
Inbred mice maintained under specific pathogen free (SPF) conditions are (to our knowledge) not naturally colonized with Malassezia. Therefore, the experimental application of Malassezia to the mouse ear skin represents a primary exposure to the fungus that induces an acute response in the host, which in turn leads to fungal clearance within 1 - 2 weeks7. While the model described in this protocol therefore only partially reflects the situation in immunocompetent humans or other host organisms that are permanently colonized with Malassezia, the experimental infection allows an ample window of opportunity to study antifungal immunity and the cellular and molecular mechanisms that underlie this response. It also allows investigating variations in the response to different Malassezia species and strains under different experimental conditions (e.g., with and without barrier disruption of the skin).
The study of Malassezia - host interactions have been limited in the past to in vitro experiments with isolated cell types in cultures (e.g., keratinocyte cell lines, PBMCs). Although these studies have shed some light on fungal and host determinants that shape the interplay between Malassezia and the host17, they do not allow to gain a comprehensive understanding of the fungus - host interaction in the complex environment of the skin, which involves multiple cell types that are in constant communication, such as keratinocytes, fibroblasts and tissue-resident immune cells, but also leukocyte populations that infiltrate the tissue only upon microbial encounter of the skin. This multicellular network cannot be fully reproduced in the in vitro models, even with most advanced organoid systems. Thus, the experimental infection of mice still represents the gold standard in immunology and infectious disease research, and the availability of the model described here represents a breakthrough in the field of Malassezia research. Importantly, this model relies on the epicutaneous application of Malassezia on the otherwise unperturbed mouse ear skin, and it does not implicate inoculation of the fungus by injection into the tissue, e.g., subcutaneously or intraperitoneally, as previous studies reported18, both of which are more distant from the situation in naturally colonized hosts.
The possibility to combine the model of Malassezia infection described in this protocol with other available mouse models greatly increases the scope and flexibility of the application. The latter include various models of specific skin disorders, such as the model of barrier deficiency that mimics important features of atopic dermatitis, a disease associated with Malassezia in both humans and dogs. Moreover, epicutaneous infection of the skin with Malassezia can easily be applied to mice with genetic defects in host genes of interest, or mice in which a cell type of interest are genetically deleted or can be pharmacologically depleted (e.g., by means of diphtheria toxin administration in diphtheria toxin receptor-expressing mice). Such models represent an inevitable tool for dissecting the host response to commensal and pathogenic microbes, including Malassezia, and to assess the role of these genes and cell type in the fungus-host interaction. The analyses of the Malassezia-host skin interaction can be expanded far beyond of what is described in this protocol. These include analyses by histology (e.g., to determine the degree of skin pathology or the epidermal thickening induced by the fungus), by immunohistochemistry or immunofluorescent staining of tissue sections using antibodies directed against cell type specific markers or other molecules of interest. It may also involve the isolation of cells (e.g., tissue resident or tissue-infiltrating leukocyte subsets) from the infected skin tissue to study the polarization, regulation, and dynamics of the immune response to Malassezia in great depth.