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Published on: September 11, 2015
Prospects and challenges for the application of tissue engineering technologies in the treatment of bone infections
Leilei Qin1,2, Shuhao Yang1,2, Chen Zhao1,2
1Department of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
Abstract:
Osteomyelitis is a devastating disease caused by microbial infection in deep bone tissue. Its high recurrence rate and impaired restoration of bone deficiencies are major challenges in treatment. Microbes have evolved numerous mechanisms to effectively evade host intrinsic and adaptive immune attacks to persistently localize in the host, such as drug-resistant bacteria, biofilms, persister cells, intracellular bacteria, and small colony variants (SCVs). Moreover, microbial-mediated dysregulation of the bone immune microenvironment impedes the bone regeneration process, leading to impaired bone defect repair. Despite advances in surgical strategies and drug applications for the treatment of bone infections within the last decade, challenges remain in clinical management. The development and application of tissue engineering materials have provided new strategies for the treatment of bone infections, but a comprehensive review of their research progress is lacking. This review discusses the critical pathogenic mechanisms of microbes in the skeletal system and their immunomodulatory effects on bone regeneration, and highlights the prospects and challenges for the application of tissue engineering technologies in the treatment of bone infections. It will inform the development and translation of antimicrobial and bone repair tissue engineering materials for the management of bone infections.
Insights
Osteomyelitis treatment faces challenges due to microbial evasion and impaired bone repair. Tissue engineering offers new strategies for bone infection management and regeneration.
Area of Science:
- Orthopedics
- Infectious Diseases
- Biomaterials Science
Background:
- Osteomyelitis is a severe bone infection with high recurrence rates.
- Microbes employ sophisticated mechanisms to evade immune responses and persist in bone.
- Impaired bone regeneration is a significant clinical challenge in treating osteomyelitis.
Purpose of the Study:
- To review microbial pathogenic mechanisms in skeletal infections.
- To analyze immunomodulatory effects of microbes on bone regeneration.
- To highlight tissue engineering applications for bone infection treatment.
Main Methods:
- Comprehensive literature review of microbial pathogenesis in osteomyelitis.
- Analysis of immune evasion strategies employed by bone pathogens.
- Evaluation of tissue engineering approaches for antimicrobial and bone repair applications.
Main Results:
- Microbial virulence factors and immune evasion strategies contribute to treatment resistance.
- Dysregulation of the bone immune microenvironment by microbes hinders bone regeneration.
- Tissue engineering materials present promising avenues for combined antimicrobial and regenerative therapies.
Conclusions:
- Understanding microbial mechanisms is crucial for overcoming osteomyelitis.
- Tissue engineering holds significant potential for developing novel treatments for bone infections.
- Further research is needed to translate tissue engineering innovations into clinical practice for bone infection management.
