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Cross sensitivity with acetaminophen in aspirin-sensitive subjects with asthma
1Scripps Clinic and Research Foundation, La Jolla, Calif. 92037.
The Journal of Allergy and Clinical Immunology
|July 1, 1989
Summary
Aspirin-sensitive asthma patients can react to acetaminophen (ACETM), indicating cross-reactivity. Desensitization therapies suggest shared mechanisms for reactions to NSAIDs and ACETM in these individuals.
Area of Science:
- Pharmacology
- Immunology
- Pulmonology
Background:
- Cyclooxygenase inhibitors often cross-react with aspirin (ASA).
- Acetaminophen's (ACETM) cross-reactivity with ASA in human lung tissue remains controversial.
- Previous studies have not investigated ACETM's cyclooxygenase inhibition in human lung tissue.
Observation:
- Three aspirin-sensitive asthma patients with a history of ACETM reactions were challenged.
- Patients reacted to 1000 mg of ACETM with significant FEV1 decline (>20%).
- Two patients desensitized to ASA tolerated a 1000 mg ACETM rechallenge.
Findings:
- Cross-sensitivity between ASA and ACETM was confirmed at a 1000 mg ACETM dose.
- Cross-desensitization occurred in patients treated with ASA or ACETM.
- Similar immunological mechanisms likely underlie reactions to ASA, NSAIDs, and ACETM in sensitive asthma patients.
Implications:
- This study documents cross-reactivity between aspirin and acetaminophen in sensitive asthma patients.
- Findings suggest shared mechanisms for hypersensitivity reactions to NSAIDs and acetaminophen.
- Clinical management of aspirin-sensitive asthma may require careful consideration of acetaminophen use and desensitization strategies.