Dual Role of Neutrophil α-Defensins in Lung Inflammation

  • H. Zhang


The acute respiratory distress syndrome (ARDS) was first described some 3 decades ago [1] as a syndrome of acute respiratory failure complicated by multiple organ failure [2]. The pathophysiological changes of ARDS, and its less-severe form the acute lung injury (ALI), are fairly well documented. There is a breakdown in the endothelial and epithelial barrier and gas exchange function in the lung, with neutrophil migration and sequestration [3]. A number of mediators, including elastase [4], arachidonic acid metabolities [5], reactive oxygen species [6, 7], and cytokines [8], have been implicated as important in ARDS/ALI. Unfortunately, clinical trials using therapy aimed at these mediators have failed to demonstrate benefit in patients with inflammatory lung conditions [2]. A meta-analysis of 101 studies of ARDS/ALI found no reduction in mortality over time [9], although some suggest that mortality has decreased [10, 11]. Our knowledge of the condition is clearly incomplete and future studies are needed to characterize the mediators of the disease process more completely, and to find a more-suitable model for mechanistic studies of lung injury. In this article, I will briefly introduce the role of a relatively new molecule human neutrophil peptide, also known as defensin, in lung inflammation. This review provides some evidence that defensins exert dual actions in host defense against infection and cause lung injury, depending on local concentrations. Defensins may therefore play an important role in modulating lung injury.


Acute Lung Injury Acute Respiratory Distress Syndrome Bacterial Meningitis Lung Inflammation Peptide Antibiotic 
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© Springer-Verlag Italia, Milano 2002

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  • H. Zhang

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