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Nasal Polyposis and Aspirin-Exacerbated Respiratory Disease
Kathleen Luskin1, Hiral Thakrar1, Andrew White1
1Allergy-Immunology, Scripps Health, San Diego, CA, USA; Scripps Clinic Carmel Valley, 3811 Valley Centre Drive, San Diego, CA 92130, USA.
Abstract:
Aspirin-exacerbated respiratory disease (AERD) is characterized by eosinophilic chronic rhinosinusitis with nasal polyps, asthma, and upper-/lower-respiratory tract reactions to nonsteroidal antiinflammatory drugs. Persistent, severe disease, anosmia, and alcohol sensitivity is typical. AERD is mediated by multiple pathways, including aberrant arachidonic acid metabolism leading to elevated leukotriene E4 and decreased prostaglandin E2. Mast cell mediators (prostaglandin D2) and unique properties of eosinophils and type 2 innate lymphoid cells, along with receptor-mediated signaling, also contribute to AERD pathogenesis. Pharmacologic therapies are a cornerstone of AERD treatment and include leukotriene modifiers, corticosteroids, biologics, and aspirin.
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