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10:22
Basophil Activation Test for Investigation of IgE-Mediated Mechanisms in Drug Hypersensitivity
Published on: September 16, 2011
Aspirin sensitivity and desensitization for asthma and sinusitis.
1Scripps Clinic at Carmel Valley, San Diego, CA 92130, USA. stevenson.donald@scrippshealth.org
Current Allergy and Asthma Reports
|February 13, 2009
Summary
Aspirin (ASA) and other NSAIDs inhibiting COX-1 can trigger asthma and rhinitis attacks in patients with nasal polyps. This condition, aspirin-exacerbated respiratory disease, is reviewed for diagnosis and treatment.
Area of Science:
- Immunology
- Pulmonology
- Otolaryngology
Background:
- Non-allergic hypersensitivity reactions to NSAIDs, including aspirin (ASA), manifest as rhinitis and asthma attacks.
- These reactions are specific to a subset of asthmatic patients with nasal polyps and chronic hyperplastic eosinophilic sinusitis.
- This underlying inflammatory condition is termed aspirin-exacerbated respiratory disease (AERD).
Purpose of the Study:
- To review the clinical characteristics of patients with AERD.
- To discuss diagnostic methods for AERD.
- To explore the cross-reactivity of NSAIDs, pathogenesis, and treatment options for AERD.
Main Methods:
- Review of existing literature on aspirin-exacerbated respiratory disease.
- Analysis of NSAID cross-reactivity patterns, focusing on COX-1 and COX-2 inhibition.
- Examination of current treatment strategies, including ASA desensitization.
Main Results:
- NSAIDs inhibiting cyclooxygenase (COX)-1 induce hypersensitivity reactions in AERD patients.
- All NSAIDs inhibiting COX-1 exhibit cross-reactivity with ASA.
- NSAIDs selectively inhibiting COX-2 do not show cross-reactivity.
Conclusions:
- Aspirin-exacerbated respiratory disease is a distinct clinical entity characterized by specific patient profiles and NSAID hypersensitivity.
- Understanding NSAID cross-reactivity is crucial for diagnosis and management.
- Treatment options like ASA desensitization offer therapeutic benefits for AERD patients.
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