Dear Sir,

We read with interest the paper of Boman about antibacterial peptides [1]. It is an excellent and complete review and although the pharmaceutical value of these antibacterial peptides is still to be fully established, we think that there is no doubt that these compounds represent one of the most innovative families of anti-infective agents that have been characterized over the last 25 years. In this letter, we report additional informations about clinical development of these antimicrobial peptides, particularly about the cationic antimicrobial peptides [2, 3]. In fact, these compounds are emerging as ‘veritable’ drugs with several potential applications in future clinical practice. At present, several cationic antimicrobial peptides are being investigated or have completed phase III clinical trials, in topical and/or parenteral use. Our biotechnology company Entomed SA has characterized over 175 novel molecules from around 100 different species of insects ( These compounds are already resulting in promising lead compounds being taken forward into clinical development. One example, ETD151, an antifungal 44 amino acid peptide, variant of a natural peptide from lepidopteran Heliothis virescens, is now in advanced preclinical development for the treatment of life-threatening invasive fungal infections (Table 1) [2]. Other lead compounds are based on native defensin peptides, from a variety of insect species, which have been modified to improve their biological profiles against Gram-positive bacteria.

Table 1.  Update of clinical development of cationic antimicrobial peptides
CompoundBiotechnology companyStructural characteristics SpeciesTopical or parenteral useIndications – phase of clinical trials
  1. i.v., intravenous; FDA, Food and Drugs Administration.

Pexiganan (MSI-78)Magainin Pharmaceuticalsα-helicesSkin of xenopCreamImpetigo and diabetic foot ulcer infections – phase III trial
Iseganan (IB-367)Intrabiotics PharmaceuticalsPeptides that contain disulphide bridgesLeucocytes of pigOral solutionsAnticancer therapies, induced oral mucosistis – phase III trial
AerosolLung infections in cystic fibrosis patients and ventilator-associated pneumonia – phase I trial
Peptides MBI (MBI-226)Micrologix Biotechα-helicesNot communicatedCreamCatheter-related bloodstream infections – phase III trial; acute acne and nasal carriage of Staphylococcus aureus– phase I trial
Histatine variantsPeriondotixα-helicesHumanOral solutions (Histawash and Histagel)Gingivitis and mouth infections – phase II trial; oral candidiasis and Pseudomonas aeruginosa lung infections – phase I trial
Heliomocin variants (ETD151)Entomed SAPeptides that contain disulphide bridgesInsect: lepidopteran Heliothis virescensParenteral use (i.v.)Systemic deep and invasive fungal infections, immunocompromised patients – preclinical development
Insect defensin variants    Systemic multiresistant Gram-positive bacterial infections – preclinical development
Neuprex (RBPI 21)Xoma Ltdα-helicesHumanParenteral use (i.v.)Pediatrics meningococcaemia phase III trial (Orphan Drug status from FDA)
Mycoprex (XMP366)Xoma Ltdα-helicesHumanParenteral use (i.v.)Systemic fungal infections

Conflict of interest statement

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  2. Conflict of interest statement
  3. References

No conflict of interest was declared.


  1. Top of page
  2. Conflict of interest statement
  3. References