Determination of the immunoglobulin E postoperative variation as a measureof surgical injury

The aim of this study was to ascertain postoperative changes in immunoglobu lin E (IgE) in patients undergoing different types of surgery and the possi ble correlation with the duration and type of surgery. Evidence suggests th at surgery induces a predominant activation pattern through the T-helper-2 (Th2) cell pathway, increasing interleukins (IL-4, IL-5, IL-10, IL-13), inh ibiting Th1 cell activation, and promoting B and Th2 cell activation. IgE p roduction may indicate predominant Th1 pathway activation and may be a more persistent and easily measurable postoperative marker than IL-6 for measur ing surgical trauma. Altogether, 180 patients undergoing different types of surgery for nonneoplastic and nonparasitic diseases were studied. All pati ents received the same type of anesthesia. Before surgery and on the first (1PO) and 7th (7PO) postoperative days we determined in peripheral blood th e CD3, CD4, CD8, CD16, and CD19 cell percentages; IL-1, IL-2, IL-4, IL-6, a nd tumor necrosis factor (TNF) levels; and the IgA, Igc, IgM, total IgE, C3 , C4, and CIC levels. On 1PO, all variables decreased except IgE, IL-1, IL- 2, IL-4, IL-6, CIC, and CD19. Only IgE, IL-6, and CD19 increases showed a s ignificantly statistical (ss) difference regarding preoperative values (0.0 1, 0.05, 0.0011 respectively). Relations between the IL-4 and IgE increases (p < 0.01) and between the IgG decrease and IgE increase (p < 0.001) were found. On 7PO, only IgE was increased (p < 0.001). The IgE increase correla ted with surgical trauma intensity (p < 0.05). We concluded that IgE increa ses during the early postoperative period, correlating with surgical injury intensity. The increase in the IgE level may be detected 24 hours after su rgery and during the first 7 postoperative days depending on the type of su rgery.