Human Cytomegalovirus Infects and Remodels 3D-biofabricated Skin Equivalents

Viral infection, including for the prototypical betaherpesvirus human cytomegalovirus (HCMV) is typically studied in two-dimensional monocultures, which provide experimentally tractable systems for measuring viral replication but do not reproduce the biologically accurate multicellular organization or interactions, nor the three-dimensional (3D) architecture of stratified epithelial tissues. Here, we evaluated a biofabricated 3D skin model containing fibroblasts and keratinocytes as a system to study HCMV infection. The model is generated using a fibrin-based matrix and spatially organization deposition of keratinocytes in combination with fibroblasts, followed by cellular differentiation controlled by calcium conditions. Cultures were infected with a GFP-expressing clinical strain of HCMV (TB40/E-GFP) and compared to traditional monolayer cultures or single cell type 3D cultures. HCMV infection was detectable by GFP expression in an MOI-dependent and longitudinal manner. Infectious virus was recovered from both the cellular associated and released into the extracellular space of the model, demonstrating that the model supports productive viral infection. Transit of infectious virus is reduced in both multicellular and single type 3D cultures, suggesting that the matrix composition influences viral kinetics. Treatment with the antiviral Ganciclovir suppressed virus production in both fibroblast monolayer cultures and 3D skin cultures. These findings establish a tractable, longitudinal observable, multicellular 3D system that supports productive HCMV infection and provides a reliable platform for investigating viral replication in a spatially organized tissue context.