Immune escape of mediated by osteocyte lacuna-canalicular network leads to persistent and uncured bone infection.

Bone infections, specifically chronic osteomyelitis, are characterized by recurrent episodes. They are considered intractable clinical diseases as they require protracted and difficult-to-cure courses. () is the most common pathogen responsible for bone infections and has high destruction rates. Previous literature has indicated that during osteomyelitis, immune evasion mainly involves three mechanisms: biofilm formation, intracellular infection, and abscess formation. However, recently, it was observed that can enter and persist for a long time in the Osteocyte lacuno-canalicular network (OLCN), a bone microstructure. Furthermore, it has been found to successfully evade the host's immune system natural physical barriers, chemical properties, and bone microstructure's immune escape mechanisms. Therefore, bone infections are more difficult to cure than soft-tissue infections. Currently, there are only a few studies on OLCN invasion by , and the clinical evidence is not sufficient. Therefore, this review aimed to combine relevant published literature on the OLCN-mediated immune escape of to elaborate on the pathological mechanisms associated with protracted and difficult-to-cure bone infections. The findings will provide a scientific basis and theoretical foundation for future comprehensive analysis of how invades OLCN and novel treatment strategies for bone infections.