NACHT, LRR, and PYD domains-containing Protein 3 and LL-37: prognostic value of new biomarkers in community-acquired pneumonia

LL-37: Structures, Antimicrobial Activity, and Influence on Amyloid-Related Diseases

Antimicrobial peptides (AMPs), as well as host defense peptides (HDPs), constitute the first line of defense as part of the innate immune system. Humans are known to express antimicrobial precursor proteins, which are further processed to generate AMPs, including several types of α/β defensins, histatins, and cathelicidin-derived AMPs like LL37. The broad-spectrum activity of AMPs is crucial to defend against infections caused by pathogenic bacteria, viruses, fungi, and parasites. The emergence of multi-drug resistant pathogenic bacteria is of global concern for public health. The prospects of targeting antibiotic-resistant strains of bacteria with AMPs are of high significance for developing new generations of antimicrobial agents. The 37-residue long LL37, the only cathelicidin family of AMP in humans, has been the major focus for the past few decades of research. The host defense activity of LL37 is likely underscored by its expression throughout the body, spanning from the epithelial cells of various organs-testis, skin, respiratory tract, and gastrointestinal tract-to immune cells. Remarkably, apart from canonical direct killing of pathogenic organisms, LL37 exerts several other host defense activities, including inflammatory response modulation, chemo-attraction, and wound healing and closure at the infected sites. In addition, LL37 and its derived peptides are bestowed with anti-cancer and anti-amyloidogenic properties. In this review article, we aim to develop integrative, mechanistic insight into LL37 and its derived peptides, based on the known biophysical, structural, and functional studies in recent years. We believe that this review will pave the way for future research on the structures, biochemical and biophysical properties, and design of novel LL37-based molecules.

Expression and significance of serum vitamin D and LL-37 levels in infants with bacterial pneumonia

OBJECTIVE

To investigate the significance of vitamin D and human antimicrobial peptide LL-37 in the occurrence and development of bacterial pneumonia in infants.

METHODS

From January 2021 to January 2022, 80 infants with bacterial pneumonia were selected, including 33 cases of gram-positive bacterial infection (GP) and 47 cases of gram-negative bacterial infection (GN). During the same period, 40 infants who underwent health examination in The Affiliated Hospital of Hangzhou Normal University served as the healthy control group. On the day of admission, peripheral blood was collected from pneumonia patients, and during physical examination of controls; and serum LL-37 levels were measured by enzyme-linked immunosorbent assay (ELISA) and serum 25-hydroxyvitamin D [25(OH)D] levels were measured by electrochemiluminescence. The differences in serum LL-37 and 25(OH)D levels and their correlation with disease severity were compared. Pearson correlation was used to analyze the correlation between serum 25(OH)D and LL-37 levels in infants with bacterial pneumonia.

RESULTS

The levels of 25(OH)D and 25(OH)D deficiency were significantly lower in patients than in controls (all P < 0.05), and the levels of serum LL-37 were significantly higher in pneumonia patients than in controls (P < 0.05). There was no significant difference in serum 25(OH)D and LL-37 levels between cases with GP and GN (all P > 0.05). The serum 25(OH)D level was lower in the severe pneumonia group than in the mild pneumonia group and controls, and the 25(OH)D deficiency rate was higher; the difference was statistically significant (all P < 0.05). The LL-37 level in the severe pneumonia group was lower than that in the mild pneumonia group but higher than that in the control group, and the difference was statistically significant (P < 0.05). The 25(OH)D level was positively correlated with the LL-37 level (r = 0.8, P < 0.05), and the 25(OH)D level was negatively correlated with procalcitonin (PCT) and length of hospital stay (r_s = -0.3, -0.3, P < 0.05); the LL-37 level was negatively correlated with PCT and length of hospital stay (r_s  = -0.4, -0.2, P < 0.05) in infants with bacterial pneumonia.

CONCLUSION

A low level of vitamin D is present in infants with bacterial pneumonia, and its status affects the severity and outcome of pneumonia. The level of LL-37 is increased in infants with bacterial pneumonia, but it shows a downward trend with progression of the disease.