Lipoxygenase inhibitor-provoked acute asthma in a patient with asthma relieved by aspirin.
BACKGROUND
A very small number of patients with asthma show symptomatic improvement after administration of aspirin and other cyclooxygenase inhibitors. The clinical features of such patients with so-called aspirin-relieved asthma are similar to those with aspirin-induced asthma, but the pathogenesis is unclear.


METHODS
We encountered one confirmed aspirin-relieved asthma patient and investigated the effects of cyclooxygenase and lipoxygenase inhibitors on his condition.


RESULTS
Our patient showed a marked improvement of the forced expiratory volume in one second (FEV1) after administration of aspirin and three other cyclooxygenase inhibitors (indomethacin, mefenamic acid, and ketoprofen). A 5-lipoxygenase inhibitor (AA861, Takeda, Japan), however, evoked acute asthma, and repeated administration of this drug resulted in some desensitization, but not complete tolerance.


CONCLUSIONS
These results suggest an altered balance of arachidonic acid metabolism may play a critical role in the pathophysiology of aspirin-relieved asthma.
Imokawa
S
S
Second Department of Internal Medicine, Hamamatsu University School of Medicine, Japan.
Sato
A
A
Taniguchi
M
M
Toyoshima
M
M
Hayakawa
H
H
Chida
K
K
D000208:Acute Disease; D001241:Aspirin / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D016227:Benzoquinones / Q000276:immunology*; D006801:Humans; D016859:Lipoxygenase Inhibitors / Q000276:immunology*; D008297:Male; D008875:Middle Aged
D016227:Benzoquinones; D016859:Lipoxygenase Inhibitors; C036837:2,3,5-trimethyl-6-(12-hydroxy-5,10-dodecadiynyl)-1,4-benzoquinone; D001241:Aspirin