The Role of Cellular Signaling and Immune Regulation in the Bone Marrow Microenvironment in Infectious Bone Diseases: Mechanism Insights and Treatment

Infectious bone diseases represent a significant clinical challenge, characterized by the invasion of pathogenic microorganisms into the skeletal system. These disorders often result in bone destruction, necrosis, and inflammation, leading to complications such as osteomyelitis, suppurative arthritis, and other specific infections. The progression can culminate in pathological fractures, sepsis, and growth disturbances. Current therapeutic strategies, including empirical antibiotic administration, surgical debridement, drainage, negative pressure aspiration, and hyperbaric oxygen therapy, have demonstrated limited long-term efficacy. The effectiveness of antimicrobial agents is often hindered by off-target effects, short duration of action, and potential for chronic infection recurrence upon cessation of therapy. The multidisciplinary nature required for accurate diagnosis and treatment—encompassing infectious diseases, orthopedics, and radiology—highlights the complexity of these conditions. With advances in the use of antibiotic-loaded bone cement, locally controlled drug-releasing nanomaterials, and immune-targeted therapies, there is a growing emphasis on early, precise intervention and the identification of novel therapeutic targets to improve patient outcomes.

This Research Topic focuses on advancing the comprehensive understanding of the molecular mechanisms underlying infectious bone diseases, including osteomyelitis, infectious osteoarthritis, periprosthetic infection, and spinal infection. The aim is to critically assess emerging evidence related to the pathophysiology, drug efficacy, anti-infective materials, and preclinical studies within this domain. By synthesizing recent research progress, the collection seeks to highlight new insights into drug performance, material development, and the regulation of the bone marrow microenvironment, particularly regarding immune and cellular signaling pathways, for the prevention and treatment of infectious bone diseases.

We welcome contributions that address, but are not limited to, the following topics:
1. Molecular and cellular mechanisms underlying the pathogenesis of infectious bone diseases, including immune regulation within the bone marrow microenvironment.
2. Advancements in drug delivery systems, such as antibiotic- or drug-loaded nanocomposites and bioactive materials, for targeting infectious bone diseases.
3. Physical and chemical stimulation therapies (e.g., temperature, pressure, bioactive peptides/proteins) and their effects on disease progression or resolution.
4. Strategies for diagnosis, prevention, and management of periprosthetic and tumor-related infectious bone diseases.
5. Preclinical and clinical studies on novel antimicrobials, materials, or surgical approaches for infectious bone diseases.
6. Safety, efficacy, and adverse effects associated with current and emerging therapies used in infectious bone disease management.

Article types and fees

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Clinical Trial
• Editorial
• FAIR² Data
• General Commentary
• Hypothesis and Theory
• Methods
• Mini Review
• Opinion
• ... View all formats

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Article types

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Clinical Trial
• Editorial
• FAIR² Data
• General Commentary
• Hypothesis and Theory
• Methods
• Mini Review
• Opinion
• Original Research
• Perspective
• Review
• Systematic Review

Keywords: Bone infectious diseases, Osteoblast, Osteoclast, Antibacterial treatment

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.