Establishing a Porcine Ex Vivo Cornea Model for Studying Drug Treatments against Bacterial Keratitis

Summary

This article describes a step-by-step protocol to set up an ex vivo porcine model of bacterial keratitis. Pseudomonas aeruginosa is used as a prototypic organism. This innovative model mimics in vivo infection as bacterial proliferation is dependent on the ability of the bacterium to damage corneal tissue.

Abstract

When developing novel antimicrobials, the success of animal trials is dependent on accurate extrapolation of antimicrobial efficacy from in vitro tests to animal infections in vivo. The existing in vitro tests typically overestimate antimicrobial efficacy as the presence of host tissue as a diffusion barrier is not accounted for. To overcome this bottleneck, we have developed an ex vivo porcine corneal model of bacterial keratitis using Pseudomonas aeruginosa as a prototypic organism. This article describes the preparation of the porcine cornea and protocol for establishment of the infection. Bespoke glass molds enable straightforward setup of the cornea for infection studies. The model mimics in vivo infection as bacterial proliferation is dependent on the ability of the bacterium to damage corneal tissue. Establishment of infection is verified as an increase in the number of colony forming units assessed via viable plate counts. The results demonstrate that infection can be established in a highly reproducible fashion in the ex vivo corneas using the method described here. The model can be extended in the future to mimic keratitis caused by microorganisms other than P. aeruginosa. The ultimate aim of the model is to investigate the effect of antimicrobial chemotherapy on the progress of bacterial infection in a scenario more representative of in vivo infections. In so doing, the model described here will reduce the use of animals for testing, improve success rates in clinical trials and ultimately enable rapid translation of novel antimicrobials to the clinic.

Introduction

Corneal infections are important causes of blindness and occur in epidemic proportions in low- and mid-income countries. The etiology of the disease varies from region to region but bacteria account for a large majority of these cases. Pseudomonas aeruginosa is an important pathogen that causes a rapidly progressive disease. In many cases, patients are left with stromal scarring, irregular astigmatism, require transplant or in the worst case scenario, lose an eye^1,2.

Bacterial keratitis caused by P. aeruginosa is a difficult eye infection to treat particularly due ....

Protocol

Albino laboratory rabbits were sacrificed in the laboratory for other planned experimental work under home office approved protocols. The eyes were not required for experimental use in those studies so they were used for this protocol.

1. Sterilization

1. CRITICAL STEP: Disinfect all forceps and scissors by soaking for 1 h in 5% (v/v) solution of Distel in distilled water, clean with a brush, rinse with tap water and sterilize in an oven at 185 °C for a minimum of 2 h.
2. Sterilize all other glassware and reagents by autoclaving at 121 °C for 15 minutes or prepare reagents according to the manufacturer’s inst....

Results

The design of the glass molds are an innovative and original idea, the use of which allowed us to set up the model in a consistent fashion with minimal/no issues with contamination. The molds were prepared by a glass blower at the University of Sheffield based on a design (Figure 1A). The experimental setup maintains the convex shape of the cornea and holds bacteria on the top of the epithelium where infection takes place (Figure 1B).

Discussion

The main driver behind the development of this keratitis model using ex vivo porcine cornea is to provide researchers developing novel antimicrobials with a representative in vitro model to more accurately determine antimicrobial efficacy at the preclinical stages. This will provide researchers involved in developing new antimicrobials greater control over drug design and formulation at the pre-clinical stages, increase success at clinical trials, reduce use of animals by enabling targeted studies and result in faster tr.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
50 mL Falcon tube	SLS	352070
Amphotericin B	Sigma	A2942
Cellstar 12 well plate	Greiner Bio-One	665180
Dextran	Sigma	31425-100mg-F
Distel	Fisher Scientific	12899357
DMEM + glutamax	SLS	D0819
Dual Oven Incubator	SLS	OVe1020	Sterilising oven
Epidermal growth factor	SLS	E5036-200UG
F12 HAM	Sigma	N4888
Foetal calf serum	Labtech International	CA-115/500
Forceps	Fisher Scientific	15307805
Handheld homogeniser 220	Fisher Scientific	15575809	Homogeniser
Heracell VIOS 160i	Thermo Scientific	15373212	Tissue culture incubator
Heraeus Megafuge 16R	VWR	521-2242	Centrifuge
Insulin, recombinant Human	SLS	91077C-1G
LB agar	Sigma	L2897
Multitron	Infors	Not appplicable	Bacterial incubator
PBS	SLS	P4417
Penicillin-Streptomycin	SLS	P0781
Petri dish	Fisher Scientific	12664785
Petri dish 35x10mm CytoOne	Starlab	CC7672-3340
Povidone iodine	Weldricks pharmacy	2122828
Safe 2020	Fisher Scientific	1284804	Class II microbiology safety cabinet
Scalpel blade number 15	Fisher Scientific	O305
Scalpel Swann Morton	Fisher Scientific	11849002