This paper reviews how natural antimicrobial peptides like LL‑37 act as the body’s first line of defense in skin and gut, killing microbes and shaping immune responses. It notes that LL‑37 levels rise in psoriasis but drop in eczema, linking these peptides to inflammation and disease states, but it doesn’t give any dosing or treatment tips.

Antimicrobial peptides are major components of the innate immune defence. They are well conserved along evolution, non-toxic and they ensure potent defences against a large number of pathogens. They act by direct killing of microorganisms and they possess additional roles in the regulation of adaptive immune responses, by recruting or stimulating immune cells. Skin and gut are positioned at the interface of internal milieu and external environment. They represent a physical and chemical barrier against pathogens invasion and the antimicrobial peptides limit pathogen growth in normal conditions. During infection or injury, some of these peptides are overexpressed and disrupt microbial membranes and/or stimulate immune cell recruitment, allowing to return to homeostasis or to increase inflammation. Antimicrobial peptides expression is altered in several diseases: alpha-defensins deficiency is related with Crohn's disease and in skin, cathelicidin LL-37 and beta-defensin-2 are overexpressed in psoriasis, while in atopic dermatitis, their expression is decreased. The present review provides an up-to-date summary of the expression and the biological roles of the antimicrobial peptides found in the skin and gastrointestinal mucosa of the host, in normal and pathological conditions. The involvement of these natural antimicrobial peptides in inflammation, is also discussed.