Acquired disorders of phagocyte function complicating medical and surgicalillnesses

There is evidence that acquired dysfunction of neutrophils, monocytes, or m acrophages is an important cause of infection in patients with diabetes mel litus, renal or hepatic failure, alcoholism, autoimmune diseases, influenza or human immunodeficiency virus infection, burns, and trauma. Distinguisha ble mechanisms of acquired phagocyte dysfunction include inhibitory effects of metabolic disturbances (e.g., hyperglycemia, uremia), chemical toxins ( e.g., ethanol), viral proteins on phagocyte activation, and pathologic acti vation of phagocytes in the circulation (e.g., after hemodialysis, burns, o r cardiopulmonary bypass). Although the burden of morbidity and mortality r esulting from acquired phagocyte dysfunction appears to be vast, research i n this area has been hampered by the complexity of the underlying illnesses and by limitations of laboratory assays and clinical study methodology. Gi ven the advent of improved assays of phagocyte functions and treatments tha t can enhance these functions, there is a pressing need for more prospectiv e studies of acquired phagocyte dysfunction.