Implant-related infections, characterized by recalcitrant biofilm formation, antibiotic resistance, and immune evasion, pose a severe clinical burden in orthopedics due to the limited therapeutic efficacy of conventional approaches. Addressing this challenge requires innovative strategies capable of simultaneously disrupting biofilms and overcoming bacterial defense mechanisms. To address this, we developed flower-like copper phosphate (CuP) nanozymes with dual enzymatic activities (peroxidase- and glutathione peroxidase-like) that synergistically eradicate biofilms for implant-related infections through cuproptosis-like death and two-component system (TCS) inhibition. In vitro antimicrobial experiments demonstrated that CuP nanozymes significantly inhibited and disrupted bacterial biofilms. These CuP nanozymes generate reactive oxygen species (ROS) while depleting glutathione (GSH), disrupting bacterial membranes, and disrupting metabolic processes such as the TCA cycle and glycolysis. Transcriptomic analysis revealed suppressed expression of oxidative phosphorylation genes and quorum-sensing regulators, confirming dual targeting of bacterial viability and communication. In vivo , CuP nanozymes effectively eliminated biofilm infections on implants, reduced inflammatory responses, and demonstrated excellent biocompatibility. By integrating enzymatic ROS amplification, metabolic interference, and TCS inhibition, this strategy offers a transformative approach to combat resistant implant infections, surpassing conventional therapies in both efficacy and safety. • Dual enzyme activities enhances the antibacterial performance of nanozymes: Through the synergistic function of POD-like and GSH-Px-like, it significantly removed GSH and generated a large amount of ROS at the same time, which provides an antibacterial effect. • Induction of cuproptosis-like death synergizes with nanozyme activities to enhance antibacterial efficacy: Through the induction of bacterial cuproptosis-like death, deep strengthening of antibacterial, to achieve the effect of saturation attack on bacteria. • Inhibition of bacterial two-component system specific synergistic removal of biofilm: Specifically blocking the pathway of bacterial biofilm formation, On the basis of the above sterilization effect, additional specific enhancement of the inhibition and removal of biofilm effect.
Liu et al. (Wed,) studied this question.