The New England Journal of Medicine
e-mail icon  FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |    Advanced Search
Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe
 
Original Article
PreviousPrevious
Volume 347:1151-1160 October 10, 2002 Number 15
NextNext

Endogenous Antimicrobial Peptides and Skin Infections in Atopic Dermatitis
Peck Y. Ong, M.D., Takaaki Ohtake, M.D., Ph.D., Corinne Brandt, B.S., Ian Strickland, Ph.D., Mark Boguniewicz, M.D., Tomas Ganz, M.D., Ph.D., Richard L. Gallo, M.D., Ph.D., and Donald Y.M. Leung, M.D., Ph.D.

 Sign up for free e-toc
 

This Article
-Full Text
- PDF
-PDA Full Text
-PowerPoint Slide Set

Commentary
-Editorial
 by Zasloff, M.
-Letters

Tools and Services
-Add to Personal Archive
-Add to Citation Manager
-Notify a Friend
-E-mail When Cited

More Information
-PubMed Citation
ABSTRACT

Background The innate immune system of human skin contains antimicrobial peptides known as cathelicidins (LL-37) and {beta}-defensins. In normal skin these peptides are negligible, but they accumulate in skin affected by inflammatory diseases such as psoriasis. We compared the levels of expression of LL-37 and human {beta}-defensin 2 (HBD-2) in inflamed skin from patients with atopic dermatitis and from those with psoriasis.

Methods The expression of LL-37 and HBD-2 protein in skin-biopsy specimens from patients with psoriasis, patients with atopic dermatitis, and normal subjects was determined by immunohistochemical analysis. The amount of antimicrobial peptides in extracts of skin samples was also analyzed by immunodot blot analysis (for LL-37) and Western blot analysis (for HBD-2). Quantitative, real-time reverse-transcriptase–polymerase-chain-reaction (RT-PCR) assays were used to confirm the relative expression of HBD-2 and LL-37 messenger RNA (mRNA) in the skin-biopsy specimens. These peptides were also tested for antimicrobial activity against Staphylococcus aureus with the use of a colony-forming assay.

Results Immunohistochemical analysis confirmed the presence of abundant LL-37 and HBD-2 in the superficial epidermis of all patients with psoriasis. In comparison, immunostaining for these peptides was significantly decreased in acute and chronic lesions from patients with atopic dermatitis (P=0.006 and P=0.03, respectively). These results were confirmed by immunodot blot and Western blot analyses. Real-time RT-PCR showed significantly lower expression of HBD-2 mRNA and LL-37 mRNA in atopic lesions than in psoriatic lesions (P=0.009 and P=0.02, respectively). The combination of LL-37 and HBD-2 showed synergistic antimicrobial activity by effectively killing S. aureus.

Conclusions A deficiency in the expression of antimicrobial peptides may account for the susceptibility of patients with atopic dermatitis to skin infection with S. aureus.


Source Information

From the Division of Allergy and Immunology, Department of Pediatrics, National Jewish Medical and Research Center, Denver (P.Y.O., I.S., M.B., D.Y.M.L.); the Department of Pediatrics, University of Colorado Health Sciences Center, Denver (M.B., D.Y.M.L.); the Division of Dermatology, Department of Medicine and Pediatrics, University of California, San Diego, and the Veterans Affairs San Diego Health Care System, San Diego (T.O., C.B., R.L.G.); and the Division of Pulmonary and Critical Care Medicine, Departments of Medicine and Pathology, School of Medicine, University of California, Los Angeles (T.G.).

Address reprint requests to Dr. Leung at the National Jewish Medical and Research Center, Department of Pediatrics, Rm. K926, 1400 Jackson St., Denver, CO 80206.

Full Text of this Article


Related Letters:

Antimicrobial Peptides in the Skin
Fellermann K., Wehkamp J., Stange E. F., Gallo R. L., Leung D. Y.M., Zasloff M.
Extract | Full Text | PDF  
N Engl J Med 2003; 348:361-363, Jan 23, 2003. Correspondence

This article has been cited by other articles:



HOME  |  SUBSCRIBE  |  SEARCH  |  CURRENT ISSUE  |  PAST ISSUES  |  COLLECTIONS  |  PRIVACY  |  HELP  |  beta.nejm.org

Comments and questions? Please contact us.

The New England Journal of Medicine is owned, published, and copyrighted © 2008 Massachusetts Medical Society. All rights reserved.