[Mechanisms of aspirin intolerance]

Aspirin intolerance brings on cutaneous and/or respiratory reactions. The mechanisms are to be elucidated precisely, but are not IgE-mediated. 193 patients with nasal polyps are studied. With systematic aspirin oral challenge, 27% belong to the classical triad: asthma, polyps and aspirin sensitivity. Other drugs or chemicals intolerance are associated in 42%: alcohol, metabisulfites, benzoates, tartrazine, codeine... A link with the non-allergic eosinophilic rhinitis is suggested. A short review of several pathogenic hypothesis is discussed. Among a comparative study, the authors showed that the aspirin-intolerant patients' platelets have a quite normal arachidonic acid metabolism. The clue is probably towards an abnormal instability of cells membranes and excessive receptors sensitivity to leukotrienes.