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Antimicrobial Peptides and Innate Lung Defenses: Role in Infectious and Noninfectious Lung Diseases and Therapeutic Applications

Pieter S. Hiemstra, PhD; Gimano D. Amatngalim; Anne M. van der Does, PhD; Christian Taube, MD, PhD
Author and Funding Information

FUNDING/SUPPORT: Research on antimicrobial peptides in the author’s laboratory is supported by grants from the Netherlands Lung Foundation, European Union (Marie Curie Actions Intra-European Fellowship #622815), and Galapagos NV.

CORRESPONDENCE TO: Pieter S. Hiemstra, PhD, Department of Pulmonology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;149(2):545-551. doi:10.1378/chest.15-1353
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Respiratory infections are a major clinical problem, and treatment is increasingly complicated by the emergence of microbial antibiotic resistance. Development of new antibiotics is notoriously costly and slow; therefore, alternative strategies are needed. Antimicrobial peptides, central effector molecules of the immune system, are being considered as alternatives to conventional antibiotics. These peptides display a range of activities, including not only direct antimicrobial activity, but also immunomodulation and wound repair. In the lung, airway epithelial cells and neutrophils in particular contribute to their synthesis. The relevance of antimicrobial peptides for host defense against infection has been demonstrated in animal models and is supported by observations in patient studies, showing altered expression and/or unfavorable circumstances for their action in a variety of lung diseases. Importantly, antimicrobial peptides are active against microorganisms that are resistant against conventional antibiotics, including multidrug-resistant bacteria. Several strategies have been proposed to use these peptides in the treatment of infections, including direct administration of antimicrobial peptides, enhancement of their local production, and creation of more favorable circumstances for their action. In this review, recent developments in antimicrobial peptides research in the lung and clinical applications for novel therapies of lung diseases are discussed.

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