Engineered macrophage-derived exosomes via click chemistry for the treatment of osteomyelitis

, after the intravenous administration of RAB-EXO, it can target the bone tissue and release antimicrobial peptides in the high ROS environment of osteomyelitis. The released antimicrobial peptides markedly inhibit bacterial growth at the infection sites. Moreover, M2 differentiation of the bone tissue macrophages are facilitated by EXO, thereby decreasing the inflammatory factors and achieving the anti-inflammatory effect. Finally, the complete healing of osteomyelitis without adverse effects associated with traditional treatments is achieved within 28 days in rat models. Our findings confirm that RAB-EXO, as a targeted treatment for osteomyelitis, offers promising directions for addressing other bacterial infection diseases, such as periodontitis and rheumatoid arthritis, through similar mechanisms.