title: Aspirin intolerance and the cyclooxygenase-leukotriene pathways.
abstract: OBJECTIVE
  In up to 10% of patients with bronchial asthma, aspirin and other nonsteroidal antiinflammatory drugs precipitate asthmatic attacks. This is a hallmark of a distinct clinical syndrome that develops according to a characteristic sequence of symptoms. Here we discuss its clinical picture and management as related to the abnormalities in arachidonic acid transformations.
  
  
  RESULTS
  At the biochemical level, the characteristic feature is profound alteration in eicosanoid biosynthesis and metabolism. Major advances in the molecular biology of eicosanoids, exemplified by the cloning of cysteinyl-leukotriene receptors and discovery of a whole family of cyclooxygenase enzymes, offer new insights into mechanisms operating in aspirin-induced asthma. Clinical interest has been enhanced by the introduction into therapy of highly specific cyclooxygenase-2 inhibitors and antileukotriene drugs.
  
  
  CONCLUSIONS
  Recent studies have improved our understanding of mechanisms operating in asthma and unvieled the role of eicosanoid mediators in pulmonary disease.
authors.affiliation: Department of Medicine, Jagiellonian University School of Medicine, Kraków, Poland. mmszczek@cyf-kr-edu.pl
authors.forename: Andrew
authors.initials: A
authors.lastname: Szczeklik
authors.forename: Marek
authors.initials: M
authors.lastname: Sanak
authors.forename: Ewa
authors.initials: E
authors.lastname: Nizankowska-Mogilnicka
authors.forename: Bogumila
authors.initials: B
authors.lastname: Kiełbasa
mesh_terms: D001241:Aspirin / Q000009:adverse effects*; D001249:Asthma / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*; D051546:Cyclooxygenase 2; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors / Q000009:adverse effects*; D003888:Desensitization, Immunologic; D006801:Humans; D007527:Isoenzymes / Q000037:antagonists & inhibitors; D015289:Leukotrienes / Q000378:metabolism; D044045:Lipoxins / Q000502:physiology; D008407:Mast Cells / Q000502:physiology; D008565:Membrane Proteins; D011451:Prostaglandin-Endoperoxide Synthases; D012220:Rhinitis / Q000453:epidemiology; D012852:Sinusitis / Q000453:epidemiology
chemical_list: D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors; D007527:Isoenzymes; D015289:Leukotrienes; D044045:Lipoxins; D008565:Membrane Proteins; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases; D001241:Aspirin