Related Experiment Videos
Aspirin intolerance and nasal polyposis.
1Servei de Pneumologia, Hospital Clinic, Barcelona, Spain. cpicado@medicina.ub.es
Current Allergy and Asthma Reports
|November 14, 2002
Summary
Aspirin-sensitive asthma patients with nasal polyps show abnormal arachidonic acid metabolism, with low prostaglandin E2 and high leukotriene release. Aspirin nasal challenge is a safe diagnostic tool for aspirin intolerance.
Area of Science:
- Immunology
- Biochemistry
- Otolaryngology
Background:
- Chronic rhinosinusitis with nasal polyposis (CRSwNP) often co-occurs with asthma and aspirin sensitivity.
- Patients with aspirin sensitivity exhibit altered arachidonic acid metabolism in nasal polyps.
Purpose of the Study:
- To investigate the biochemical abnormalities in nasal polyps of aspirin-sensitive patients with asthma.
- To evaluate the diagnostic utility of aspirin nasal challenge in identifying aspirin intolerance.
Main Methods:
- Analysis of prostaglandin E2 (PGE2) production and cysteinyl leukotriene release in nasal polyps.
- Assessment of cyclooxygenase-2 (COX-2) expression.
- Clinical evaluation of aspirin nasal challenge test.
Main Results:
- Nasal polyps from aspirin-sensitive patients showed low PGE2 production and high cysteinyl leukotriene release.
- Cyclooxygenase-2 (COX-2) was downregulated in these polyps, potentially explaining low PGE2 and aspirin sensitivity.
- Aspirin nasal challenge demonstrated moderate sensitivity and high specificity for diagnosing aspirin intolerance, with minimal adverse effects.
Conclusions:
- Abnormal arachidonic acid metabolism, including reduced PGE2 and increased cysteinyl leukotrienes due to COX-2 downregulation, characterizes nasal polyps in aspirin-sensitive asthmatics.
- These findings suggest shared pathogenic mechanisms between CRSwNP, asthma, and aspirin sensitivity.
- Aspirin nasal challenge is a safe and effective diagnostic method for aspirin intolerance.