dCA-MA is a hybrid antimicrobial peptide (AMP) derived from two naturally occurring AMPs, cecropin A and magainin 2. CA-MA shows strong antimicrobial activity against Gram-negative and Gram-positive bacteria but also exhibits cytotoxicity toward mammalian cells. Our objective was to identify CA-MA analogues with reduced cytotoxicity by systematic replacement of amino acids with positively charged R groups (His and Lys), aliphatic R groups (Leu), or polar R groups (Glu). Among the CA-MA analogues studied (CMA1 to -6), CMA3 showed the strongest antimicrobial activity, including against drug-resistant Escherichia coli and Pseudomonas aeruginosa strains isolated from hospital patients. CMA3 appeared to act by inducing pore formation (toroidal model) in the bacterial membrane. In cytotoxicity assays, CMA3 showed little cytotoxicity toward human red blood cells (hRBCs) or HaCaT cells. Additionally, no fluorescence was released from small or giant unilamellar vesicles exposed to 60 M CMA3 for 80 s, whereas fluorescence was released within 35 s upon exposure to CA-MA. CMA3 also exerted strong lipopolysaccharide (LPS)-neutralizing activity in RAW 264.7 cells, and BALB/c mice exposed to LPS after infection by Escherichia coli showed improved survival after administration of one 0.5-mg/kg of body weight or 1-mg/kg dose of CMA3. Finally, in a mouse model of septic shock, CMA3 reduced the levels of proinflammatory factors, including both nitric oxide and white blood cells, and correspondingly reduced lung tissue damage. This study suggests that CMA3 is an antimicrobial/antiendotoxin peptide that could serve as the basis for the development of anti-inflammatory and/or antimicrobial agents with low cytotoxicity. W hen microorganisms infect vertebrate or invertebrate animals, the secretion of cytokines, chemokines, and other peptides is an important component of the animals' innate immune response (1, 2). Among those other peptides are antimicrobial peptides (AMPs), which play key roles in the innate immune responses of mammals, amphibians, and insects, among others (3, 4). Indeed, more than 2,300 different AMPs have been identified and isolated from a wide range of organisms, including bacteria (n ϭ 322), protozoa (n ϭ 6), fungi (n ϭ 12), plants (n ϭ 306), and animals (n ϭ 1,801). Most AMPs contain at least 10 amino acid residues, have a net charge ranging from Ϫ3 to ϩ20, and exhibit Ͻ60% hydrophobicity (5). Together, these features underlie the bactericidal activity of AMPs, enabling them to bind and form damaging pores in the membranes of Gram-negative and Gram-positive bacteria. To induce pore formation, AMPs have an ␣-helical structure and the ability to interact with anionic components of the cytoplasmic membrane, resulting in the formation of toroidal, carpet, or barrel stave pores (6). Additionally, many AMPs can potentially prevent septic shock via their antiendotoxic activity through electrostatic interaction with lipopolysaccharides (LPS) and lipoteichoic acid in the bacterial membrane (7-9).CA-MA is a hybrid AMP syn...