Antimicrobial peptides with pH dependent activity and alkaline optima: their origins, mechanisms of action and potential applications

: A number of disorders and diseases are associated with conditions of high pH and many conventional antibiotics lose their efficacy under these pH conditions, generating a need for novel antimicrobials, and a potential solution to fulfil this need is antimicrobial peptides (AMPs) with high pH optima. This review shows that a variety of anionic and cationic AMPs with this pH dependency are produced by creatures across the eukaryotic kingdom, including humans, rabbits, cattle, sheep, fish and frogs. These AMPs exhibit activity against viruses, bacteria and fungi that involves membrane interactions and appear to be facilitated by a variety of mechanisms that generally promote passage across membranes to attack intracellular targets, such as DNA or protein synthesis, and / or membrane lysis. Some of these mechanisms are unknown but those elucidated include the use of bacterial pores and transporters, the self-promoted uptake pathway and established models of membrane interaction, such as the carpet mechanism, toroidal pore formation, the adoption of tilted peptide and the SHM model. A variety of potential roles have been proposed for these AMPs, including use as antivirals, antibacterials, antifungals, adjuvants to antimicrobial therapy, biomarkers of disease and probes for pathogenic microbes. In this review, these properties are described and discussed, with an emphasis on the antimicrobial mechanisms used by these AMPs and the pH dependency of these mechanisms.