Vaccines and antibody immunotherapy in surgical patients

Use of novel therapeutic agents for the treatment of serious infection

The use of biologic reagents directed against invading microbes and deleterious aspects of the host response is presently under intense investigation. The development and use of these reagents have contributed significantly to our understanding of the host response to infection, and they probably represent the first true foray into the area of immunotherapeutic manipulation. Thus, the effects of the administration of anti-endotoxin and antitumor necrosis factor-alpha monoclonal antibodies and the interleukin-1 receptor antagonist are being examined in large-scale clinical trials, and tumor necrosis factor-binding protein and bactericidal/permeability-increasing protein also may undergo clinical testing. Much controversy has already arisen regarding the manner in which these therapeutic reagents will be best utilized. The enormous amount of information that has already been obtained concerning the use of these reagents assuredly will contribute significantly to our understanding of the diagnosis and treatment of serious infection and will set the stage for the development and appropriate testing of additional new diagnostic and therapeutic reagents during the current decade.