ORIGINAL RESEARCH article
Front. Pharmacol.
Sec. Experimental Pharmacology and Drug Discovery
This article is part of the Research TopicInnovations in Immunometabolic Treatment and Controlled Release Systems for Bone and Joint DisordersView all 18 articles
Shikonin Inhibits MRSA Biofilm Formation to Alleviate Periprosthetic Joint Infection
Provisionally accepted
Shangyi Liu1,2*
Haoran Zhang2Xi Zheng2Xiaoqin Mou2
Zhongbao Wu2Lili Zou2*Kangquan Shou1,2*
Xiaowen Liu1,2*- 1Yichang Central People's Hospital, Yichang, China
- 2Three Gorges University Basic Medical College, Yichang, China
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To alleviate methicillin-resistant Staphylococcus aureus (MRSA)-induced periprosthetic joint infection (PJI), this study explored shikonin (SKN)’s effect on MRSA biofilm formation in vitro and in vivo. Key methods included rat PJI models, MIC/MBC assays, crystal violet staining, transcriptomic/amino acid metabolomic analyses, and evaluations on clinical MRSA strains. Results showed high-dose SKN significantly reduced MRSA biofilm formation in rats, improved local inflammation and tissue repair, and inhibited implant surface biofilm (SEM-confirmed). SKN had an MIC of 70 µM against MRSA (bacteriostatic, not bactericidal) and suppressed/eradicated MRSA biofilm at sublethal concentrations. Omics and functional validation suggested its mechanism might involve regulating MRSA cysteine metabolism. SKN also inhibited clinical MRSA strains and their biofilms. Conclusion: SKN alleviates MRSA-induced PJI by suppressing biofilm formation, potentially via regulating MRSA cysteine metabolism.
Keywords: Biofilm formation, cysteine metabolism, Methicillin-resistant Staphylococcus aureus (MRSA), periprosthetic joint infection (PJI), Shikonin (SKN)
Received: 05 Nov 2025; Accepted: 02 Feb 2026.
Copyright: © 2026 Liu, Zhang, Zheng, Mou, Wu, Zou, Shou and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Shangyi Liu
Lili Zou
Kangquan Shou
Xiaowen Liu
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