Immunosuppression in the surgical patient.

A review of both the healthy and altered immune response as it relates to the surgical patient is presented. An increasing number of immunosuppressive states have been defined in the surgical patient including trauma, burns, sepsis, malnutrition, cancer, and, more recently, acquired immunodeficiency syndrome (AIDS).Investigations of the healthy and altered immune response have led to the development of immunopharmacology, which involves the study of pharmacologic agents that modify host immune response to achieve desired therapeutic goals. Endogenous and exogenous immunomodulators are described that affect uniquely the host immune response as well as their therapeutic implications.