The treatment of respiratory infections is associated with the dissemination of antibiotic resistance in the community and clinical settings. Development of new antibiotics is notoriously costly and slow; therefore, alternative strategies are needed. Antimicrobial peptides (AMPs), the central effector molecules of the immune system, are being considered as alternatives to conventional antibiotics. Most AMPs are epithelium-derived and play a key role in host defense at mucosal surfaces. They are classified on the basis of their structure and amino acid motifs. These peptides display a range of activities, including not only direct antimicrobial activity, but also immunomodulation and wound repair. In the lung, airway epithelial cells and neutrophils, in particular, contribute to AMP synthesis. The relevance of AMPs for host defense against infection has been demonstrated in animal models and is supported by observations in patient studies, showing altered expression and/or unfavorable circumstances for their action in a variety of lung diseases. Of note, AMPs are active against bacterial strains that are resistant to conventional antibiotics, including multidrug-resistant bacteria. Several strategies have been proposed to use these peptides in the treatment of infections, including direct administration of AMPs. In this review, we focus on studies related to direct bactericidal effects of AMPs and their potential clinical applications with a particular focus on cystic fibrosis.

呼吸道感染的治疗与社区和临床环境中抗生素耐药性的传播有关。众所周知，新抗生素的开发昂贵且缓慢。因此，需要替代策略。抗菌肽（AMPs）是免疫系统的主要效应分子，被认为是常规抗生素的替代品。大多数AMPs是上皮来源的，并且在粘膜表面的宿主防御中起关键作用。根据它们的结构和氨基酸基序对其进行分类。这些肽表现出一系列活性，不仅包括直接的抗菌活性，还包括免疫调节和伤口修复。在肺中，气道上皮细胞和嗜中性粒细胞特别有助于AMP的合成。在动物模型中已经证明了AMP与宿主抵抗感染的相关性，并在患者研究中得到了支持，显示了其在多种肺部疾病中的表达改变和/或不利作用。值得注意的是，AMPs具有抵抗常规抗生素（包括耐多药细菌）的能力。已经提出了几种策略来使用这些肽来治疗感染，包括直接给予AMP。在这篇综述中，我们重点研究与AMPs的直接杀菌作用有关的研究及其潜在的临床应用，特别是囊性纤维化。在多种肺部疾病中表现出改变的表达和/或不利的作用。值得注意的是，AMPs具有抵抗常规抗生素（包括耐多药细菌）的能力。已经提出了几种策略来使用这些肽来治疗感染，包括直接给予AMP。在这篇综述中，我们重点研究与AMPs的直接杀菌作用有关的研究及其潜在的临床应用，特别是囊性纤维化。在各种肺部疾病中表现出改变的表达和/或不利的作用。值得注意的是，AMPs具有抵抗传统抗生素（包括耐多药细菌）的能力。已经提出了几种策略来使用这些肽来治疗感染，包括直接给予AMP。在这篇综述中，我们重点研究与AMPs的直接杀菌作用有关的研究及其潜在的临床应用，特别是囊性纤维化。