The study found that two small molecules—andrographolide (from the herb Andrographis) and 4‑phenylbutyric acid—can roughly double the blood levels of natural antimicrobial proteins hBD‑1 and LL‑37 in rats, and that this boost helped the animals survive a deadly infection with a drug‑resistant bacteria. While the results are promising for boosting innate immunity, they are only in animals, so we don’t yet know the right doses or safety in people.

Antibiotic resistance is a global threat and requires the search for new treatment strategies. Natural antimicrobial peptides (AMPs) have pronounced antibacterial, antiviral, antifungal, and antitumor activity. AMPs' clinical use is complicated by the high synthesis costs and rapid proteolytic degradation. The search for small molecules, inducers of endogenous AMP expression, could become a new approach. Here, we investigated for the first time the effect of seven small molecules (andrographolide, levofloxacin, azithromycin, montelukast, 4-phenylbutyric acid, rosuvastatin and valsartan) on AMP (beta-defensin-1, hBD-1 and cathelicidin, LL-37) serum levels in rats. In control groups, the level of hBD-1 was 295.0 (292.9-315.4) pg/mL, and for LL-37, it was 223.8 (213.3-233.6) pg/mL. Andrographolide (ANDR) and 4-phenylbutyric acid (4-PHBA) administration significantly enhanced the level of both AMPs. The hBD-1 level was 581.5 (476.3-607.7) pg/mL for ANDR and 436.9 (399.0-531.6) pg/mL for 4-PHBA. The LL-37 level was 415.4 (376.2-453.8) pg/mL for ANDR and 398.9 (355.7-410.1) pg/mL for 4-PHBA. Moreover, we have shown that these compounds reduce mortality in a murine model of sepsis caused by a carbapenem-resistant <i>Klebsiella aerogenes</i> isolate. From our point of view, these small molecules are promising candidates for further study as potent AMP inducers. The data obtained allow the development of new strategies to combat antibiotic resistance and infectious diseases.