Endogenous Antimicrobial Peptides and Skin Infections in Atopic Dermatitis

• Published in: The New England journal of medicine Vol. 347; no. 15; pp. 1151 - 1160
• Main Authors: Ong, Peck Y, Ohtake, Takaaki, Brandt, Corinne, Strickland, Ian, Boguniewicz, Mark, Ganz, Tomas, Gallo, Richard L, Leung, Donald Y.M
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 10.10.2002
• Subjects: Adult; Allergic diseases; Antimicrobial agents; Antimicrobial Cationic Peptides - genetics; Antimicrobial Cationic Peptides - metabolism; Antimicrobial Cationic Peptides - pharmacology; Bacterial infections; beta-Defensins - genetics; beta-Defensins - metabolism; beta-Defensins - pharmacology; Biological and medical sciences; Cathelicidins; Cell Line; Dermatitis; Dermatitis, Atopic - immunology; Dermatology; Gene Expression - drug effects; Gene Expression Regulation; Humans; Immune system; Immunoblotting; Immunopathology; Keratinocytes - cytology; Keratinocytes - immunology; Keratinocytes - metabolism; Medical sciences; Peptides; Psoriasis; Psoriasis - immunology; Psoriasis. Parapsoriasis. Lichen; RNA, Messenger - genetics; RNA, Messenger - metabolism; Skin - immunology; Skin - pathology; Skin allergic diseases. Stinging insect allergies; Staphylococcus aureus - drug effects; Tumor Necrosis Factor-alpha - pharmacology; Viral infections; Human; Immunohistochemistry; Measurement; Allergy; Immunopathology; Skin disease; Peptides; Psoriasis; Activity; Exploration; Antimicrobial agent; Atopy; Infection; Pathology; Endogenous; Atopic dermatitis; Skin; Molecular biology; Reverse transcription polymerase chain reaction; Comparative study; Immune system
• ISSN: 0028-4793; 1533-4406; 1533-4406
• DOI: 10.1056/NEJMoa021481

Staphylococcal infections of the skin are more common in patients with atopic dermatitis than they are in normal persons or patients with psoriasis. In this study, the investigators hypothesized that the elevated rate of skin infections in atopic dermatitis could be attributed to reduced levels of the endogenous antimicrobial peptides LL-37 and human β-defensin 2. They found that the levels of these peptides were lower in skin from patients with atopic dermatitis. The skin's first line of defense against invasion by microbial agents is the stratum corneum, a nonviable, desiccated layer of the epidermis. 1 However, this physical barrier is susceptible to injuries that allow the entry of opportunistic microbial agents into the skin. The innate immune system can immediately respond to this intrusion by helping to prevent further invasion. This immune response includes phagocytosis by neutrophils and macrophages and their production of reactive oxygen intermediates that kill microbial agents. 2 A number of endogenous antimicrobial peptides have been shown to play an integral part in innate immunity. 3 Two major classes of peptides in . . .