IMMUNOGLOBULIN-E AND EOSINOPHIL COUNTS ARE INCREASED AFTER SEPSIS IN TRAUMA PATIENTS

Objectives: To determine the time course of plasma immuno globulin E ( IgE) concentration increases after traumatic injury, if increased IgE concentrations were related to clinical events or complications, and i f increased peripheral eosinophil counts could be related to trauma, s epsis, or organ-specific complications. Design: Data relating to sever ity of injury, clinical complications, plasma concentrations of IgE, a nd peripheral eosinophil counts were prospectively collected. Setting: Trauma service, tertiary-care medical center. Patients: One hundred a dult trauma patients admitted to the intensive care unit. intervention s: None. Measurements and Main Results: Plasma IgE concentrations incr eased in most patients. However, the greatest increases were observed in patients with sepsis (p = .03), renal dysfunction (p = .04), or pne umonia (p = .02). IgE increases were not related to severity or mechan ism of injury, allergy history, or age. The day of highest observed Ig E concentration was related to the day of onset of sepsis Ca = .012, r = .39), and occurred a mean of 3.8 days after sepsis. Most patients h ad increased peripheral eosinophil counts and eosinophil percentages o f white blood cells during their intensive care unit stays. Eosinophil counts were greater in patients with sepsis (p<.0001), severe sepsis (p<.0001), or pneumonia (p < .002). Conclusions: Increased IgE concent rations and eosinophil counts were found after sepsis and do not appea r to be related to the initial injury. Since IgE and eosinophil produc tion are enhanced by interleukin-4 and interleukin-5, respectively, th ese findings suggest that T-helper lymphocyte type 2 cytokines are act ivated in response to sepsis after traumatic injury.