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Human beta-defensin-2 (hBD-2) is an endogenous, cysteine-rich, cationic, low-molecular-weight host defense peptide (HDP) first isolated from psoriatic skin lesions. It is produced by epithelial cells and keratinocytes in response to inflammatory stimuli and microbial contact. Recombinant hBD-2 is being developed as a therapeutic biologic for inflammatory and infectious diseases, including inflammatory bowel disease (IBD), colitis, atopic dermatitis, asthma, and glioblastoma. Mechanistically, hBD-2 acts as a multifunctional immunomodulator and antimicrobial agent. It selectively blocks the voltage-gated potassium channel Kv1.3, acts as an agonist for chemokine receptors CCR2 and CCR6, and activates Toll-like receptor 4 (TLR4) and Mas-related G-protein coupled receptor member X2 (MRGPRX2). It also binds directly to phosphatidylinositol 4,5-bisphosphate (PI(4,5)P2) to mediate membrane permeabilization and cytolysis of target pathogens and tumor cells. Preclinical development has been led by Novozymes (now Novonesis) and Defensin Therapeutics.
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