SLPI and bacterial infectious disease: Studies of naturally occurring and experimentally induced exacerbations have demonstrated the occurrence of secondary bacterial infections following an initial rhinovirus infection64–66 Neutrophil elastase-mediated cleavage and reduction of the antimicrobial peptide Secretory Leukocyte Protease Inhibitor (SLPI) is believed to be important mechanistically65 and may be worsened by chronic use of inhaled corticosteroids (ICSs).67