Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, United States.
Department of Neurosurgery, University of Nebraska Medical Center, Omaha, NE, United States.
Front Immunol. 2021 Feb 23;12:625467. doi: 10.3389/fimmu.2021.625467. eCollection 2021.
Bacterial infections in the central nervous system (CNS) can be life threatening and often impair neurological function. Biofilm infection is a complication following craniotomy, a neurosurgical procedure that involves the removal and replacement of a skull fragment (bone flap) to access the brain for surgical intervention. The incidence of infection following craniotomy ranges from 1% to 3% with approximately half caused by (). These infections present a significant therapeutic challenge due to the antibiotic tolerance of biofilm and unique immune properties of the CNS. Previous studies have revealed a critical role for innate immune responses during craniotomy infection. Experiments using knockout mouse models have highlighted the importance of the pattern recognition receptor Toll-like receptor 2 (TLR2) and its adaptor protein MyD88 for preventing outgrowth during craniotomy biofilm infection. However, neither molecule affected bacterial burden in a mouse model of brain abscess highlighting the distinctions between immune regulation of biofilm vs. planktonic infection in the CNS. Furthermore, the immune responses elicited during craniotomy infection are distinct from biofilm infection in the periphery, emphasizing the critical role for niche-specific factors in dictating biofilm-leukocyte crosstalk. In this review, we discuss the current knowledge concerning innate immunity to craniotomy biofilm infection, compare this to biofilm infection in the periphery, and discuss the importance of anatomical location in dictating how biofilm influences inflammatory responses and its impact on bacterial clearance.
中枢神经系统（CNS）的细菌感染可能危及生命，并且经常损害神经功能。生物膜感染是开颅术后的一种并发症，开颅术是一种神经外科手术，涉及移除和替换颅骨碎片（骨瓣）以进入大脑进行手术干预。开颅术后感染的发生率为 1%至 3%，其中约一半由 （）引起。这些感染由于生物膜的抗生素耐药性和中枢神经系统的独特免疫特性而带来重大的治疗挑战。先前的研究表明，固有免疫反应在开颅术感染中起着关键作用。使用基因敲除小鼠模型的实验突出表明了模式识别受体 Toll 样受体 2 (TLR2)及其衔接蛋白 MyD88 在防止开颅术生物膜感染期间 生长的重要性。然而，这两种分子都没有影响 脑脓肿小鼠模型中的细菌负荷，这突出了 CNS 中生物膜与浮游感染的免疫调节之间的区别。此外，开颅术感染期间引发的免疫反应与周围的生物膜感染不同，强调了特定部位因素在决定 生物膜-白细胞串扰中的关键作用。在这篇综述中，我们讨论了有关开颅术生物膜感染的固有免疫的现有知识，将其与周围的生物膜感染进行了比较，并讨论了解剖位置在决定生物膜如何影响炎症反应及其对细菌清除的影响方面的重要性。
