Pathogenic mechanisms and therapeutic advances of small colony variants

Small colony variants (SCVs) are unique phenotypic variants produced by bacteria such as Staphylococcus aureus under environmental selective pressure, with specific biological characteristics, including slow growth, reduced pigment synthesis, auxotrophy, enhanced drug resistance, and easier intracel...

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Main Authors: LIANG Xiaoning, SHI Tingwang, CHEN Yunfeng
Format: Article
Language:zho
Published: Editorial Office of Journal of Shanghai Jiao Tong University (Medical Science) 2025-06-01
Series:Shanghai Jiaotong Daxue xuebao. Yixue ban
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Online Access:https://xuebao.shsmu.edu.cn/article/2025/1674-8115/1674-8115-2025-45-6-784.shtml
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author LIANG Xiaoning
SHI Tingwang
CHEN Yunfeng
author_facet LIANG Xiaoning
SHI Tingwang
CHEN Yunfeng
author_sort LIANG Xiaoning
collection DOAJ
description Small colony variants (SCVs) are unique phenotypic variants produced by bacteria such as Staphylococcus aureus under environmental selective pressure, with specific biological characteristics, including slow growth, reduced pigment synthesis, auxotrophy, enhanced drug resistance, and easier intracellular colonization and biofilm formation. In recent years, it has been increasingly recognized that SCVs play a crucial role in the chronic progression of infections and poor prognosis. SCVs exhibit significant heterogeneity with complex and diverse molecular profiles. Compared with wild-type strains, SCVs have low virulence and significantly enhanced adherence, and they can effectively evade immune system recognition and clearance. SCVs invade host cells, including macrophages, and form dormant intracellular forms, causing antimicrobial resistance. These variants can revert to wild-type bacteria when environmental conditions improve, causing persistent and refractory infections such as osteomyelitis, cystic fibrosis, and implant-associated infections. However, current treatments for SCV-related infections are limited to long-term antibiotic therapy combined with debridement of infected tissue, and understanding of SCVs, their pathogenic mechanisms, and treatments remains limited. Traditional therapies, such as rifampicin combined with vancomycin, have limited efficacy against intracellular SCVs. Novel strategies, such as targeting ATP synthase inhibitors (eg. lycopene), using nanocarrier-delivered antibiotics to enhance intracellular penetration, alkalinizing of the microenvironment, or disrupting biofilms by physical therapies, are important breakthroughs in the fight against SCV-associated infections. This paper summarizes the biological characteristics, pathogenic mechanisms, and therapeutic progress of SCVs, providing reference for research and treatment of SCV-related infections.
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spelling doaj-art-5618bcbc7e2f43339a87cbcccfcb00df2025-08-20T02:44:52ZzhoEditorial Office of Journal of Shanghai Jiao Tong University (Medical Science)Shanghai Jiaotong Daxue xuebao. Yixue ban1674-81152025-06-0145678479110.3969/j.issn.1674-8115.2025.06.0141674-8115(2025)06-0784-08Pathogenic mechanisms and therapeutic advances of small colony variantsLIANG Xiaoning0SHI Tingwang1CHEN Yunfeng2Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200233, ChinaDepartment of Orthopedic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200233, ChinaDepartment of Orthopedic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200233, ChinaSmall colony variants (SCVs) are unique phenotypic variants produced by bacteria such as Staphylococcus aureus under environmental selective pressure, with specific biological characteristics, including slow growth, reduced pigment synthesis, auxotrophy, enhanced drug resistance, and easier intracellular colonization and biofilm formation. In recent years, it has been increasingly recognized that SCVs play a crucial role in the chronic progression of infections and poor prognosis. SCVs exhibit significant heterogeneity with complex and diverse molecular profiles. Compared with wild-type strains, SCVs have low virulence and significantly enhanced adherence, and they can effectively evade immune system recognition and clearance. SCVs invade host cells, including macrophages, and form dormant intracellular forms, causing antimicrobial resistance. These variants can revert to wild-type bacteria when environmental conditions improve, causing persistent and refractory infections such as osteomyelitis, cystic fibrosis, and implant-associated infections. However, current treatments for SCV-related infections are limited to long-term antibiotic therapy combined with debridement of infected tissue, and understanding of SCVs, their pathogenic mechanisms, and treatments remains limited. Traditional therapies, such as rifampicin combined with vancomycin, have limited efficacy against intracellular SCVs. Novel strategies, such as targeting ATP synthase inhibitors (eg. lycopene), using nanocarrier-delivered antibiotics to enhance intracellular penetration, alkalinizing of the microenvironment, or disrupting biofilms by physical therapies, are important breakthroughs in the fight against SCV-associated infections. This paper summarizes the biological characteristics, pathogenic mechanisms, and therapeutic progress of SCVs, providing reference for research and treatment of SCV-related infections.https://xuebao.shsmu.edu.cn/article/2025/1674-8115/1674-8115-2025-45-6-784.shtmlsmall colony variant (scv)antibacterialdrug resistancetargeted infection
spellingShingle LIANG Xiaoning
SHI Tingwang
CHEN Yunfeng
Pathogenic mechanisms and therapeutic advances of small colony variants
Shanghai Jiaotong Daxue xuebao. Yixue ban
small colony variant (scv)
antibacterial
drug resistance
targeted infection
title Pathogenic mechanisms and therapeutic advances of small colony variants
title_full Pathogenic mechanisms and therapeutic advances of small colony variants
title_fullStr Pathogenic mechanisms and therapeutic advances of small colony variants
title_full_unstemmed Pathogenic mechanisms and therapeutic advances of small colony variants
title_short Pathogenic mechanisms and therapeutic advances of small colony variants
title_sort pathogenic mechanisms and therapeutic advances of small colony variants
topic small colony variant (scv)
antibacterial
drug resistance
targeted infection
url https://xuebao.shsmu.edu.cn/article/2025/1674-8115/1674-8115-2025-45-6-784.shtml
work_keys_str_mv AT liangxiaoning pathogenicmechanismsandtherapeuticadvancesofsmallcolonyvariants
AT shitingwang pathogenicmechanismsandtherapeuticadvancesofsmallcolonyvariants
AT chenyunfeng pathogenicmechanismsandtherapeuticadvancesofsmallcolonyvariants