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Abstract
Staphylococcus aureus, traditionally viewed as an extracellular pathogen, is increasingly recognized for its ability to persist intracellularly, particularly within macrophages. This intracellular lifestyle is central to osteomyelitis, a chronic bone infection characterized by persistent inflammation, bone destruction, and impaired repair. Within bone, S. aureus exploits macrophage plasticity by driving a shift from pro-inflammatory, bactericidal M1-like states to anti-inflammatory, tissue-reparative M2-like phenotypes. This polarization suppresses immune clearance and promotes an environment conducive to bacterial survival and dissemination. Additional strategies – including biofilm formation, small colony variants, and inhibition of phagolysosomal killing – further enhance persistence and immune evasion. While these mechanisms are well studied in extracellular infections, their role in intracellular survival is increasingly evident. This review synthesizes emerging insights into how S. aureus manipulates macrophage function to establish chronic bone infection and highlights therapeutic opportunities targeting macrophage polarization to improve immune-mediated clearance and bone repair in osteomyelitis.
Document Type
Article
Publication Date
2025
Digital Object Identifier (DOI)
https://doi.org/10.1080/21505594.2025.2553789
Funding Information
This work was supported by the National Institutes of Health Grant [R00-AI166116] (C.D.R.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Repository Citation
Lathram, William A. and Radka, Christopher D., "Intracellular survival of Staphylococcus aureus in macrophages during osteomyelitis" (2025). Microbiology, Immunology, and Molecular Genetics Faculty Publications. 206.
https://uknowledge.uky.edu/microbio_facpub/206
Notes/Citation Information
© 2025 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.