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Despite the high incidence, only limited data on the pathophysiological changes exist; in particular, the innate immune responses involved are largely unknown. Real-time PCR analysis of tissue samples from inflamed and normal appendices demonstrated differentially regulated expression patterns of epithelial-derived antimicrobial peptides (AMP). The \u03b1-defensins human neutrophil peptides 1\u20133, HD5 and HD6, as well as the two \u03b2-defensins, human \u03b2-defensins (hBD)-2 and hBD-3, were up-regulated, whereas hBD-1 was down-regulated in acute appendicitis. Expression of upstream regulators of AMP expression, NOD-2 and TLRs 1, 2, 4, 5, 7, 8 and 10 was significantly increased as detected by real-time PCR. Finally, we confirmed the involvement of the pro-inflammatory cytokines IL-1\u03b2 and IL-8, and detected characteristic changes in microbial community composition in appendicitis tissue specimens by 16S rDNA based detection techniques. In this study, we demonstrate a differential regulation of the innate immune system along with an altered bacterial diversity in acute appendicitis.<\/jats:p>","DOI":"10.1177\/1753425913515033","type":"journal-article","created":{"date-parts":[[2013,12,12]],"date-time":"2013-12-12T00:29:46Z","timestamp":1386808186000},"page":"30-41","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":27,"title":["Characteristic changes in microbial community composition and expression of innate immune genes in acute appendicitis"],"prefix":"10.1177","volume":"21","author":[{"given":"Alexander","family":"Arlt","sequence":"first","affiliation":[{"name":"Department of Internal Medicine I, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richa","family":"Bharti","sequence":"additional","affiliation":[{"name":"Institute of Clinical Molecular Biology, 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