Bacterial membrane nanovesicles encapsulating prodrug assemblies combine chemical and immunological therapies for chronic bacterial infection management

Addressing the challenges of drug delivery to infection sites and modulating the immunosuppressive microenvironment are critical hurdles in treating chronic bacterial infections, characterized by intracellular bacteria and resilient biofilms. To overcome these barriers, we report a multifunctional nanomedicine (CpE@BMV). The prodrug conjugate (CpE), composed of two phenylboronic acid-modified ciprofloxacin (Cip-pba) molecules and ellagic acid (Ea), self-assembles due to its amphiphilic nature. Bacterial membrane vesicles (BMVs) derived from Escherichia coli aid in CpE assembly and structural stabilization. Upon administration, pathogen-associated molecular patterns on CpE@BMV engage toll-like receptors on macrophages, activating these cells and enhancing their phagocytic response. Once internalized, CpE responds to elevated intracellular H₂O₂ levels, releasing Cip to eliminate intracellular bacteria. Additionally, Ea scavenges excess reactive oxygen species in inflamed macrophages and modulates the expression of inflammatory factors, preventing an exaggerated inflammatory response. The CpE@BMV formulation also penetrates biofilms, eliminating bacteria and releasing antigens. These antigens are transported to draining lymph nodes, where they induce dendritic cell maturation and trigger a robust T and B cell-mediated immune response, helping restore immune balance and combat pathogens effectively. Therefore, our CpE@BMV provide an efficient strategy combining chemical and immunological therapies for chronic bacterial infection management.