• Jeffery Ho, Lin Zhang, Xiaodong Liu, Sunny H Wong, Wang Maggie H T MHT, Lau Benson W M BWM, Ngai Shirley P C SPC, Hung Chan, Gordon Choi, Leung Czarina C H CCH, Wai T Wong, Sharon Tsang, Tony Gin, Jun Yu, Chan Matthew T V MTV, and Wu William K K WKK.
• *Department of Anesthesia and Intensive Care, The Chinese University of Hong Kong, Shatin, Hong Kong †State Key Laboratory of Digestive Disease, LKS Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong ‡Department of Medicine §The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong ||Department of Rehabilitation, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
• Shock. 2017 Jun 1; 47 (6): 673-679.

BackgroundSepsis 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.MethodsWe 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.ResultsOf 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.ConclusionsInnate 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.

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