Production of inducible antimicrobial peptides offers a first and rapid defense response of epithelial cells against invading microbes. Human beta-defensin-2 (hBD-2) is an antimicrobial peptide induced in various epithelia upon extracellular as well as intracellular bacterial challenge. Nucleotide-binding oligomerization domain protein 2 (NOD2/CARD15) is a cytosolic protein involved in intracellular recognition of microbes by sensing peptidoglycan fragments (e.g. muramyl dipeptide). We used luciferase as a reporter gene for a 2.3-kb hBD-2 promoter to test the hypothesis that NOD2 mediates the induction of hBD-2. Activation of NOD2 in NOD2-overexpressing human embryonic kidney 293 cells through its ligand muramyl dipeptide (MDP) induced hBD-2 expression. In contrast, overexpression of NOD2 containing the 3020insC frameshift mutation, the most frequent NOD2 variant associated with Crohn disease, resulted in defective induction of hBD-2 through MDP. Luciferase gene reporter analyses and site-directed mutagenesis experiments demonstrated that functional binding sites for NF-B and AP-1 in the hBD-2 promoter are required for NOD2-mediated induction of hBD-2 through MDP. Moreover, the NF-B inhibitor Helenalin as well as a super-repressor form of the NF-B inhibitor IB strongly inhibited NOD2-mediated hBD-2 promoter activation. Expression of NOD2 was detected in primary keratinocytes, and stimulation of these cells with MDP induced hBD-2 peptide release. In contrast, small interference RNA-mediated downregulation of NOD2 expression in primary keratinocytes resulted in a defective induction of hBD-2 upon MDP treatment. Together, these data suggest that NOD2 serves as an intracellular pattern recognition receptor to enhance host defense by inducing the production of antimicrobial peptides such as hBD-2.Human epithelia are in permanent contact with various potential pathogenic microorganisms. To overcome these microbial threats, epithelia have developed a chemical defense system based on the production of various antimicrobial proteins (1-4). Human beta-defensin-2 (hBD-2) 2 was the first inducible human antimicrobial protein discovered and was originally isolated from lesional psoriatic skin (5). hBD-2 belongs to the beta-defensin family, a group of small (4 -5 kDa), cationic antibiotic peptides first discovered in cattle (6). hBD-2 exhibits a broad spectrum of antimicrobial activity, and its capacity to kill bacteria in vivo has been demonstrated in a mouse gene therapy study with hBD-2-transfected tumor cells. Following a bacterial infection, mice with hBD-2-bearing tumors bore fewer viable bacteria than controls (7). In addition to its capacity to serve as an antibiotic peptide, hBD-2 may promote adaptive immune responses by recruiting dendritic and T cells to the site of microbial invasion through interaction with CCR6 (8). Furthermore hBD-2 was found to be a specific chemoattractant for tumor necrosis factor-␣ (TNF-␣)-treated human neutrophils (9). hBD-2 is expressed in many epithelia (e.g. skin, respiratory tract, dig...