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Published on: May 6, 2019
Clinical and pathologic perspectives on aspirin sensitivity and asthma
Donald D Stevenson1, Andrew Szczeklik
1Division of Allergy, Asthma and Immunology and the Department of Medicine, Scripps Clinic and the Scripps Research Institute, La Jolla, USA. dstevemd@AOL.com
Aspirin and NSAIDs cause nonallergic respiratory reactions in some asthmatics, leading to aspirin-exacerbated respiratory disease (AERD). This condition involves severe eosinophilic inflammation of the airways.
Area of Science:
- Immunology
- Pulmonology
- Pharmacology
Background:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) inhibiting COX-1 can trigger nonallergic reactions like rhinitis and asthma attacks.
- These reactions are observed in a specific group of asthmatic patients.
- This clinical presentation defines aspirin-exacerbated respiratory disease (AERD).
Purpose of the Study:
- To describe patients diagnosed with AERD.
- To review diagnostic methods for AERD.
- To discuss the cross-reactivity of NSAIDs, pathogenesis, and treatment options for AERD.
Main Methods:
- Literature review focusing on AERD.
- Analysis of clinical presentations and diagnostic criteria.
- Examination of pharmacological mechanisms and treatment strategies.
Main Results:
- Aspirin-exacerbated respiratory disease is characterized by eosinophilic inflammation in the upper and lower respiratory tracts.
- All NSAIDs inhibiting COX-1 demonstrate cross-reactivity.
- Current understanding of pathogenesis and treatment is evolving.
Conclusions:
- AERD is a distinct clinical entity in asthmatic patients triggered by NSAIDs.
- Accurate diagnosis and understanding of cross-reactivity are crucial for management.
- Further research into pathogenesis may lead to improved therapeutic approaches.
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