Immunomodifiers applicable to the prevention and management of infectious diseases in children.

Attempts to augment immune function in infants or children with overwhelming sepsis or immune deficiency have focused on recombinant cytokines and interferons. Although early in their clinical use, the proinflammatory and antiinflammatory effects of the interleukins show promise in regulating the acute inflammatory response. The hematopoietic growth factors have demonstrated considerable clinical effect, especially in individuals with distinct hematopoietic disorders and in patients receiving immunosuppressive chemotherapy. The interferons gamma and alpha have received considerable attention over the last decade as potential immunomodulators. The stimulatory effects of INF-gamma on human neutrophils suggest its therapeutic usefulness in children with specific neutrophil dysfunction, and INF-alpha has shown broad clinical application both as an antitumor as well as an antiviral agent. The most recent studies of the integrins and selectins implicate their potential role in regulating a number of infectious disease states. As we learn more about the complexity of interactions and the delicate balance these molecules have in regulating the immune response, we will be better able to implement their use in regulating disease states in infants and children.