Chromogranin A (CGA) and chromogranin B (CGB) are acidic proteins stored in secretory organelles of endocrine cells and neurons. In addition to their roles as helper proteins in the packaging of pep-tides, they may serve as prohormones to generate biologically active peptides such as vasostatin-1 and secretolytin. These molecules derived from CGA and CGB, respectively, possess antimicrobial properties. The present study demonstrates that plasmatic levels of both vasostatin-1 and secretolytin increase during surgery in patients undergoing cardiopulmonary bypass (CPB). Vasostatin-1 and secretoly-tin, initially present in plasma at low levels , are released just after skin incision. Consequently, they can be added to enk-elytin, an antibacterial peptide derived from proenkephalin A, for the panoply of components acting as a first protective barrier against hypothetical invasion of pathogens, which may occur during surgery. CGA and CGB, more commonly viewed as markers for endocrine and neuronal cells, were also found to have an immune origin. RNA messengers coding for CGB were amplified by reverse transcription-polymerase chain reaction in human monocytes, and immunocyto-chemical analysis by confocal micros-copy revealed the presence of CGA or CGB or both in monocytes and neutro-phils. A combination of techniques including confocal microscopic analysis, mass spectrometry measurement, and antibac-terial tests allowed for the identification of the positive role of interleukin 6 (IL-6) in the secretolytin release from mono-cytes in vitro. Because IL-6 release is known to be strongly enhanced during CPB, we suggest a possible relationship between IL-6 and the increased level of secretolytin in patients undergoing CPB. (Blood. 2002;100:553-559)