Our research team recently found that CCL20 is a small protein belonging to the large family of proteins known as chemokines. This newly discovered protein could be key in our fight against debilitating bone infections from Staphylococcus aureus. This discovery has the potential to inspire new anti-infection therapies. It would improve diagnostic approaches for diseases such as osteomyelitis, affecting millions of patients annually and increasing access to timely diagnosis and treatment.
CCL20 is released when the body mounts an immune response against S. aureus infections. This important molecule helps recruit immune system cells to where an infection or injury has occurred. The CCL20-CCR6 signaling pathway is essential for regulating disease severity. This important mechanism is further modulated in the course of development of bone infections. Importantly, CCL20 levels were shown to be increased in patients that went on to develop infections after orthopedic surgeries. In healthy people that underwent uncomplicated hip or knee replacement, CCL20 was normal. In contrast, those who suffered the infections had a fivefold increase in CCL20. In contrast, patients who died from sepsis showed a 100-fold increase.
Staphylococcus aureus is everywhere—all of which increase the likelihood of human Staph infections. It is often an urgent cause of osteomyelitis, endocarditis, and other skin and soft tissue infections. The United States undertakes close to 2 million total joint replacements annually. By 2030, experts estimate that these procedures will cause up to 200,000 prosthetic joint infections per year. The economic cost of these infections is enormous. By October 2023 health care costs due to bone infections are expected to surge to $3 billion a year.
Staphylococcus aureus infection continues to be an overwhelming clinical burden, effective therapies are lacking. As Himanshu Meghwani, the first author of the study, stated:
“There is no satisfactory treatment or diagnostic test for bone infection, and there has been no improvement in surgical outcomes in more than 20 years. It would be a huge advantage for surgeons if we could use a simple blood draw to measure CCL20 and predict the patient outcome based on its levels and further help surgeons to add appropriate interventions.”
Meghwani explains, “CCL20 might be harnessed as an anti-infection therapy. Because it draws immune cells to an infection site, it can undertake the body’s infection-fighting efforts. He warned that researchers have much left to understand about this protein’s role during infections. These patients with high CCL20 levels are still doing poorly and even worsening to sepsis.
Gowrishankar Muthukrishnan emphasized the urgency of prompt treatment for staph infections:
“Treating a staph infection quickly offers patients the best chance at recovery and can prevent the risk of sepsis, which can cause death in a matter of hours.”
Current research is deeply investigating the intricacies of CCL20 and its ability to fight against bone infections. Healthcare providers are eager for innovations that promise to change the way we practice medicine and improve care for patients.