Immunoglobulin E and eosinophil counts are increased after sepsis in trauma patients

Area of Science:

• Immunology
• Critical Care Medicine
• Trauma Research

Background:

• Plasma immunoglobulin E (IgE) levels can change after severe illness.
• Eosinophil counts are often monitored in intensive care unit (ICU) patients.
• The relationship between IgE, eosinophils, and complications in trauma patients requires further investigation.

Purpose of the Study:

• To investigate the temporal changes in plasma IgE concentrations following traumatic injury.
• To determine if elevated IgE levels correlate with specific clinical events or complications.
• To assess the relationship between peripheral eosinophil counts and trauma, sepsis, or organ-specific complications.

Main Methods:

• Prospective data collection on injury severity, clinical complications, plasma IgE, and peripheral eosinophil counts.
• Study conducted in a tertiary-care medical center's trauma service.
• Inclusion of 100 adult trauma patients admitted to the ICU.

Main Results:

• Plasma IgE concentrations increased in most trauma patients.
• Greatest IgE increases were observed in patients with sepsis, renal dysfunction, or pneumonia.
• Elevated IgE concentrations correlated with the onset of sepsis, occurring approximately 3.8 days after sepsis onset.
• Increased peripheral eosinophil counts and eosinophil percentages were common during ICU stays.
• Eosinophil counts were significantly higher in patients with sepsis or pneumonia.

Conclusions:

• Elevated IgE concentrations and eosinophil counts post-trauma are associated with sepsis, not the initial injury.
• These findings suggest activation of T-helper lymphocyte type 2 cytokines in response to sepsis following traumatic injury.
• Interleukin-4 and interleukin-5 likely play a role in enhanced IgE and eosinophil production, respectively.