Immunoglobulin E in acute phase response to surgical stress

BACKGROUND: A few years ago we reported that acute myocardial infarction is associated with a distinct, transient rise in serum immunoglobulin (Ig)E. OBJECTIVE: We wondered whether this response is specific only for myocardial infarction or whether it reflects a more generalized phenomenon, precipitated by tissue injury. METHODS: We carried out a large prospective study on 149 patients undergoing various surgical procedures. These were the patients undergoing coronary artery bypass surgery, who did (n = 39) or did not (n = 42) develop perioperative myocardial infarction, patients subjected to various thoracic operations (n = 33), cholecystectomy (n = 17) or repair of the inguinal hernia (n = 18). Thirty healthy volunteers formed the control group. RESULTS: In all groups studied, except the control group, serum IgE levels began to rise shortly after the operation, reached a peak by the fifth postoperative day, and then gradually declined. This was in striking contrast to serum immunoglobulin G which soon after the operation became markedly depressed, and took more than a week to return to preoperative values. Specific IgE against common aeroallergens, measured in a subgroup of patients with initially high total serum IgE, showed no uniform pattern of change. CONCLUSION: Surgical operations are accompanied by a characteristic, transient rise in serum IgE concentration. Immunoglobulin E might be involved in acute phase response to tissue injury.