eHealth Program, DeGroote School of Business, McMaster University, Hamilton, ON, Canada.
Health Policy, Management and Informatics, Allied Health, Credit Valley Hospital, Mississauga, ON, Canada.
Arch Microbiol. 2024 Jun 5;206(7):288. doi: 10.1007/s00203-024-04015-2.
Bone infections caused by Staphylococcus aureus may lead to an inflammatory condition called osteomyelitis, which results in progressive bone loss. Biofilm formation, intracellular survival, and the ability of S. aureus to evade the immune response result in recurrent and persistent infections that present significant challenges in treating osteomyelitis. Moreover, people with diabetes are prone to osteomyelitis due to their compromised immune system, and in life-threatening cases, this may lead to amputation of the affected limbs. In most cases, bone infections are localized; thus, early detection and targeted therapy may prove fruitful in treating S. aureus-related bone infections and preventing the spread of the infection. Specific S. aureus components or overexpressed tissue biomarkers in bone infections could be targeted to deliver active therapeutics, thereby reducing drug dosage and systemic toxicity. Compounds like peptides and antibodies can specifically bind to S. aureus or overexpressed disease markers and combining these with therapeutics or imaging agents can facilitate targeted delivery to the site of infection. The effectiveness of photodynamic therapy and hyperthermia therapy can be increased by the addition of targeting molecules to these therapies enabling site-specific therapy delivery. Strategies like host-directed therapy focus on modulating the host immune mechanisms or signaling pathways utilized by S. aureus for therapeutic efficacy. Targeted therapeutic strategies in conjunction with standard surgical care could be potential treatment strategies for S. aureus-associated osteomyelitis to overcome antibiotic resistance and disease recurrence. This review paper presents information about the targeting strategies and agents for the therapy and diagnostic imaging of S. aureus bone infections.
金黄色葡萄球菌引起的骨骼感染可能导致一种称为骨髓炎的炎症状态,导致进行性骨质流失。生物膜形成、细胞内存活以及金黄色葡萄球菌逃避免疫反应的能力导致反复和持续的感染,这给骨髓炎的治疗带来了重大挑战。此外,由于免疫系统受损,糖尿病患者容易发生骨髓炎,在危及生命的情况下,这可能导致受影响肢体的截肢。在大多数情况下,骨骼感染是局部的;因此,早期发现和靶向治疗可能有助于治疗金黄色葡萄球菌相关的骨骼感染并防止感染的传播。骨骼感染中特定的金黄色葡萄球菌成分或过度表达的组织生物标志物可以作为靶点来输送有效的治疗药物,从而减少药物剂量和全身毒性。肽和抗体等化合物可以特异性地与金黄色葡萄球菌或过度表达的疾病标志物结合,并将这些与治疗药物或成像剂结合,可以促进靶向递送到感染部位。通过向这些治疗方法中添加靶向分子,可以提高光动力疗法和热疗的有效性,从而实现特定部位的治疗。例如,宿主导向治疗策略侧重于调节金黄色葡萄球菌用于治疗效果的宿主免疫机制或信号通路。靶向治疗策略与标准手术护理相结合可能是治疗金黄色葡萄球菌相关骨髓炎的潜在治疗策略,以克服抗生素耐药性和疾病复发。本文综述了金黄色葡萄球菌骨骼感染的靶向治疗和诊断成像策略及相关试剂。