Pathological Role and Diagnostic Value of Endogenous Host Defense Peptides in Adult and Neonatal Sepsis: A Systematic Review

Jeffery Ho, Lin Zhang, Xiaodong Liu, Sunny H. Wong, Maggie H.T. Wang, Wui Man Lau, Shirley P.C. Ngai, Hung Chan, Gordon Choi, Czarina C.H. Leung, Wai T. Wong, Sharon Tsang, Tony Gin, Jun Yu, Matthew T.V. Chan, William K.K. Wu

Research output: Journal article publicationReview articleAcademic researchpeer-review

20 Citations (Scopus)


Background: Sepsis is a systemic host response to an infection leading to organ failure. This is associated with dynamic expression of endogenous host defense peptides. Dysregulation of these peptides is associated with septic morbidity and mortality. Methods: We performed a systematic search of articles indexed in PubMed, ISI Web of Knowledge, EmBase, and Scopus database from inception to October 2016. Both preclinical and clinical studies investigating the role of host defense peptides in pathogenesis and as biomarkers for sepsis were included. Results: Of the available literature, cathelicidin, defensin, and hepcidin are among the best-characterized peptides. These regulate immune response, and crosstalk with pyroptosis and coagulation cascades. The applicability of these peptides as septic biomarkers has been investigated in vitro and in vivo studies. However, numerous studies were based on endotoxemia without an infection, jeopardizing interpretation of the outcomes. Cathelicidin and defensin were frequently reported in adult sepsis while hepcidin in neonatal sepsis. The expression level of these peptides is significantly associated with septic condition. Most of the studies employed a cross-sectional design, precluding the establishment of a temporal relationship between candidate peptide biomarkers and sepsis. Conclusions: Innate defense peptides have been insufficiently evaluated as either diagnostic or prognostic biomarkers. In the future, evaluation of host defense peptides as septic biomarkers may employ a longitudinal design and consider a panel of multiple peptides.
Original languageEnglish
Pages (from-to)673-679
Number of pages7
Issue number6
Publication statusPublished - 1 Jun 2017


  • Antimicrobial peptides
  • cathelicidin
  • defensin
  • hepcidin
  • systemic inflammation
  • trauma

ASJC Scopus subject areas

  • Emergency Medicine
  • Critical Care and Intensive Care Medicine


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