Immunomodulatory approaches to the treatment of infections

Sa？etak The immune system offers a wide variety of potential targets for modulation in the treatment of infectious diseases. Available possibilities permit both prophylactic and therapeutic immunomodulation for supportive and direct treatment of infections. In addition to regular moderate exercise, an adequate diet containing plant polyphenols, particularly from fruit, and micronutrients such as selenium and zinc helps maintain effective host defence against mild to moderate infections. Supplementation with these dietary constituents is usually necessary in critically ill patients and like some standardized phytopharmaceuticals, may also reduce the severity and/or duration of upper airways infections. Administration of probiotics also promotes gastrointestinal immune defence. Several antibiotics, especially the macrolides and tetracyclines, possess in addition to their antibacterial actions, immunomodulatory and/or anti-inflammatory properties which facilitate bacterial killing and/or protect tissue from bystander injury. They may also be useful in prevention of the virally-induced cytokine storm. Immunoglobulins, several recombinant human cytokines and selective agonists of Toll-like receptors are effective against many infections in their own right because of highly specific receptor-mediated actions on defined immune processes. The development of novel receptor-targeted immunomodulators is likely to replace the use of non-specific modulators of innate immunity in promoting host defence during infection