AO Research Institute Davos, Davos, Switzerland; Department of Medical Microbiology, Amsterdam UMC, University of Amsterdam, Amsterdam Infection and Immunity Institute, Amsterdam, the Netherlands.
Center for Musculoskeletal Research and Department of Orthopaedics, University of Rochester Medical Center, Rochester, New York.
Am J Pathol. 2020 Jun;190(6):1151-1163. doi: 10.1016/j.ajpath.2020.02.007. Epub 2020 Mar 16.
Osteomyelitis is an inflammation of the bone and bone marrow that is most commonly caused by a Staphylococcus aureus infection. Much of our understanding of the underlying pathophysiology of osteomyelitis, from the perspective of both host and pathogen, has been revised in recent years, with notable discoveries including the role played by osteocytes in the recruitment of immune cells, the invasion and persistence of S. aureus in submicron channels of cortical bone, and the diagnostic role of polymorphonuclear cells in implant-associated osteomyelitis. Advanced in vitro cell culture models, such as ex vivo culture models or organoids, have also been developed over the past decade, and have become widespread in many fields, including infectious diseases. These models better mimic the in vivo environment, allow the use of human cells, and can reduce our reliance on animals in osteomyelitis research. In this review, we provide an overview of the main pathologic concepts in osteomyelitis, with a focus on the new discoveries in recent years. Furthermore, we outline the value of modern in vitro cell culture techniques, with a focus on their current application to infectious diseases and osteomyelitis in particular.
骨髓炎是一种骨和骨髓的炎症，最常见的病因是金黄色葡萄球菌感染。近年来，我们对骨髓炎的潜在病理生理学有了更多的了解，包括从宿主和病原体两个角度来看，其中一些显著的发现包括骨细胞在招募免疫细胞中的作用、金黄色葡萄球菌在皮质骨亚微米通道中的入侵和持续存在，以及多形核细胞在植入物相关骨髓炎中的诊断作用。在过去十年中，还开发了高级的体外细胞培养模型，如体外培养模型或类器官，并且已经在许多领域得到广泛应用，包括传染病。这些模型更好地模拟了体内环境，允许使用人类细胞，并减少了我们在骨髓炎研究中对动物的依赖。在这篇综述中，我们概述了骨髓炎的主要病理概念，重点介绍了近年来的新发现。此外，我们概述了现代体外细胞培养技术的价值，重点介绍了它们在传染病，特别是骨髓炎中的当前应用。
