Bacterial endotoxin or lipopolysaccharide (LPS) is an important causative agent of sepsis. This study determines the expression of defensins NP-2 and NP-5 and the function of polymorphonuclear leukocytes (PMN) in rabbits treated with LPS. PMN functional activity was assessed by measuring CD18 expression and H 2 O 2 production and by examining the lungs. NP-2 and, to a minor extent, NP-5 of circulating PMN increase during endotoxemia. This early increase is concomitant with neutrophilia and elevated CD18 expression and H 2 O 2 production, as well as with enhanced NP-2 immunoreactivity in pulmonary microvessels. A decline in defensins, shortly after the last LPS treatment, is associated with a decrease in the circulating activated PMN and enhanced immunoreactivity in the inflammatory cells, as well as with lung tissue damage. This study shows that LPS-induced changes in the defensins of circulating PMN correlate with the number and activated condition of these cells and suggests that PMN-derived products implement the inflammatory reaction that leads to lung injury and sepsis.Endotoxin from gram-negative bacteria causes a number of pathophysiological effects that can lead to the adult respiratory distress syndrome (ARDS). Despite the progress made over the years, ARDS is still a major cause of death among patients who develop sepsis or pneumonia (17). A major factor that contributes to this high mortality is multiple organ failure associated with tissue injury. Lung injury typical of this syndrome has been associated with polymorphonuclear leukocytes (PMN) (12). These short-lived, bone marrow-derived cells are recruited to inflamed sites by responding to bacterial products and inflammatory mediators such as interleukins, tumor necrosis factor, and complement fragments. During this process PMN play a key role in the body's defense, but they can also damage the tissue that they are attempting to protect (33). Their granules carry a wide range of powerful antimicrobial enzymes and peptides (7,19). Six of these neutrophil peptides (NP-1, -2, -3A, -3B, -4, and -5) or defensins have been isolated and characterized in rabbits. Among these, NP-2 of PMN is structurally and functionally identical to MCP-2 of adult rabbit alveolar macrophages (30). Defensins are known to mediate inflammation (40) and cause damage to endothelial (29), epithelial (23, 24), and tumor (20) cells. We have previously shown that immature marrow PMN contain elevated levels of NP-2 and NP-5 (16), and it has been shown that PMN transit time through the marrow decreases with bacterial infection (34, 37). The present study was designed to extend these observations by determining the level of defensins and the functional activity of circulating PMN during endotoxemia. PMN functional activity was assessed by measuring the expression of  2 integrin CD18 and production of H 2 O 2 and by examining the lungs.
MATERIALS AND METHODSExperimental protocol. Adult female New Zealand White rabbits (2.2 Ϯ 0.2 kg) were injected daily for 5 days via the marginal ear v...