Implant-associated infections (IAIs) caused by Staphylococcus aureus ( S. aureus ) are notoriously recalcitrant to treatment due to the self-reinforcing interplay between bacterial virulence and a suppressive biofilm immune microenvironment (BIME). Here, we present a dual-engineering metalloimmunotherapy nanoplatform that synchronously silences bacterial virulence and reprograms host immunity to eradicate IAIs. The nanoplatform, termed HMPF, integrates a fenoprofen-loaded, polydopamine-modified hollow MnO 2 core that is further cloaked with a macrophage-erythrocyte hybrid membrane, enabling bacteria-targeted delivery and hemolysin-responsive drug release. By inhibiting the SaeRS two-component system of S. aureus , HMPF suppresses virulence factor expression and disrupts biofilm structure, dismantling the physical barrier for immune cell infiltration. Simultaneously, Mn 2+ release and mild photothermal stimulation activate the cGAS-STING and pattern recognition receptor pathways, reprogramming host BIME to enhance both innate and adaptive immune responses. Crucially, HMPF establishes pathogen-specific immune memory, which prevents infection recurrence, outperforming vancomycin in murine IAIs models. This pathogen-host dual-engineering strategy remains effective against other clinical S. aureus strains without inducing drug resistance, bridging virulence disarmament and immunomodulation to offer a transformative antibiotic alternative for resistant IAIs. • S. aureus isolates and Sting ⁻/⁻ mice reveals the vital roles of bacterial virulence and host cGAS–STING pathway in IAIs. • HMPF nanoparticles silence virulence, disrupt biofilms, and reprogram immune microenvironments to restore host immunity. • Metalloimmunotherapy shows broad efficacy against MRSA and VISA, offering a resistance-free alternative to treat IAIs.
Jiang et al. (Sun,) studied this question.