The role of microbicidal lipids in host defense against pathogens and their potential as therapeutic agents.

Lipids such as fatty alcohols, free fatty acids and monoglycerides of fatty acids are known to be potent antimicrobial/microbicidal agents in vitro and to kill enveloped viruses, Gram-positive and Gram-negative bacteria and fungi on contact. For over half a century several studies have tried to answer the question of whether or not lipids play a role in the natural host defense against pathogens. A comprehensive review is given of these studies, particularly concerning infections in skin and in mucosal membranes of the respiratory tract, and of the role of lipids in the antimicrobial activity of breast milk. Based on studies of the microbicidal activities of lipids, both in vitro and in vivo, the possibility of using such lipids as active ingredients in prophylactic and therapeutic dosage forms is considered and examples are given of studies of such pharmaceutical dosage forms in experimental animal models and in clinical trials.