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Aspirin and asthma
1Department of Respiratory Cell and Molecular Biology, University of Southampton, Southampton General Hospital, Southampton, UK. ksb@soton.ac.uk
Chest
|November 18, 2000
Summary
Aspirin-induced asthma (AIA) affects 5-6% of people, with 20% of asthmatics sensitive to NSAIDs. Understanding AIA pathogenesis and management is crucial for patient care.
Area of Science:
- Pharmacology and Immunology
- Respiratory Medicine
Background:
- Aspirin is a widely used analgesic and increasingly used for preventing ischemic heart disease and strokes.
- Aspirin intolerance affects 5-6% of the general population, with up to 20% of asthmatics exhibiting sensitivity.
- Aspirin-induced asthma (AIA) is characterized by rhinitis, sinusitis, and asthma upon exposure to NSAIDs.
Purpose of the Study:
- To review the latest understanding of the pathogenesis, clinical features, and management of aspirin-induced asthma (AIA).
Main Methods:
- Review of existing literature on aspirin intolerance and aspirin-induced asthma.
- Discussion of the roles of the lipoxygenase (LO) and cyclooxygenase (COX) pathways in AIA pathogenesis.
- Examination of the efficacy of LT-modifying drugs and aspirin desensitization in managing AIA.
Main Results:
- Aspirin inhibits the COX pathway, shunting arachidonic acid to the LO pathway.
- This leads to decreased prostaglandin E(2) and increased cysteinyl leukotrienes (LTs) synthesis.
- Elevated LTC(4) synthase activity in bronchial biopsies of AIA patients promotes inflammation.
Conclusions:
- LT-modifying drugs effectively block aspirin-induced bronchoconstriction and are used in AIA treatment.
- Aspirin desensitization is a valuable management strategy for AIA, particularly for patients requiring thromboembolic prophylaxis.
- This review synthesizes current knowledge on AIA, aiding in clinical decision-making and patient management.