The antimicrobial and hemolytic activities of a host defense peptide can be controlled by its modification as a propeptide of reduced net charge, which can then be processed by neutrophil elastase, a serine protease involved in chronic airway inflammation and infections associated with cystic fibrosis.Host defense peptides (HDPs) are multifunctional molecular effectors of innate immunity in multicellular organisms (3,8,26). Deficiencies in their activity or expression levels can be associated with enhanced susceptibility to infections (6) and to chronic infections in conditions such as cystic fibrosis (CF) (19). While there is a sound underlying principle in compensating disease-associated deficiencies in HDPs with exogenous peptides, their potential toxicities contend with their localized administration to sites of infection (10,26). The activities of endogenous HDPs themselves can be stringently controlled (24). HDPs expressed as inactive prepropeptides are activated by proteolytic cleavage of an anionic profragment masking the net positive charge of the C-terminal mature sequence (9). Human cathelicidin hCAP18/LL-37, for example, is activated by proteinase 3, while other neutrophilic serine proteases, such as neutrophil elastase (NE), can also cleave the profragment in vitro (1, 25). As this enzyme is associated with chronic airway inflammation and infections in CF patients (13), a prodrug approach analogous to the natural control mechanism exerted on HDPs and that exploits the abnormal concentrations of NE in the CF lung is reported here.Synthetic propeptides were prepared by modification of an HDP with an anionic profragment, using L-P18, an ␣-helical, salt-resistant, cecropin A-magainin 2 hybrid sequence, identified by K.-S. Hahm's group (20, 21). Peptides were assembled by solid-phase synthesis (14), purified by reversed-phase highperformance liquid chromatography, and characterized by matrix-assisted laser desorption ionization-time of flight mass spectrometry. Six propeptides were synthesized by elongating the parent sequence (KWKLFKKIPKFLHLAKKF-NH 2 ) at its N terminus with a trialanine linker as an NE substrate (2) and from 2 to 7 glutamic acids to mask the net charge determinant (ϩ8) of the mature peptide's antimicrobial activity. When more than 4 glutamic acids were added, a -alanine spacer was introduced between the fourth and fifth glutamates, to reduce interchain association effects (11).The antimicrobial activities of these peptides were assessed for two representative CF pathogens, Staphylococcus aureus (SH1000) and Pseudomonas aeruginosa (PAO1). MICs (Table 1) were determined by the broth microdilution method, as recommended by the Clinical and Laboratory Standards Institute. Typical MICs of L-P18 for P. aeruginosa and S. aureus were 32 M and 64 M, respectively, while MICs of all propeptides were higher than 128 M. As the activities of ␣-helical membrane-active peptides have been suggested to be independent of the stereochemistry of their constitutive amino acids (23), the enantiomeric D-P18...