Aspirin sensitive rhinosinusitis and asthma.
Although aspirin sensitive asthma has been recognized as a clinical entity since the beginning of this century, the mechanism for the production of this syndrome still remains obscure. Recent studies have indicated a higher than previously appreciated incidence of aspirin sensitive asthma, perhaps approaching 40% of steroid-dependent asthmatics. Challenge with both oral and bronchial instilled aspirin may be useful to identify aspirin-sensitive individuals. During aspirin-induced reactions, increased vascular permeability is noted. In addition, aspirin-sensitive individuals have altered levels of production of leukotriene E4 and enhanced sensitivity to inhaled leukotriene E4. However, nasal secretions of aspirin-sensitive individuals demonstrate enhanced leukotriene C4 concentration after aspirin challenge. It has also been noted that nonaspirin-sensitive patients have enhanced leukotriene C4 concentration. Thus, the specific defect leading to the pathogenesis of aspirin-sensitive asthma and rhinosinusitis in selected individuals remains obscure. Eosinophil activation has been noted in aspirin-sensitive rhinosinusitis patients; however, other cell types, including platelets and monocytes, have also been noted to exhibit metabolic abnormalities in this syndrome. Aspirin desensitization may be a useful option in selected patients with significant aspirin sensitive rhinosinusitis and asthma.
Kowalski
M L
ML
Department of Clinical Immunology and Allergy, Medical Academy of Lödz, Poland.
D001241:Aspirin / Q000009:adverse effects*; D001249:Asthma / Q000139:chemically induced* / Q000175:diagnosis; D001985:Bronchial Provocation Tests; D003888:Desensitization, Immunologic; D004342:Drug Hypersensitivity / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D012220:Rhinitis / Q000139:chemically induced*; D012852:Sinusitis / Q000139:chemically induced*
D001241:Aspirin