Clinical and pathologic perspectives on aspirin sensitivity and asthma.
Aspirin and other nonsteroidal anti-inflammatory drugs that inhibit COX-1 induce unique nonallergic reactions, consisting of attacks of rhinitis and asthma. These hypersensitivity reactions occur in a subset of asthmatic subjects, thus identifying them as having this exclusive clinical presentation. We refer to these patients as having aspirin-exacerbated respiratory disease, a disease process that produces devastating eosinophilic inflammation of both the upper and lower respiratory tracts. This review focuses on a description of patients with aspirin-exacerbated respiratory disease, methods available to diagnose their condition, the unique ability of all nonsteroidal anti-inflammatory drugs that inhibit COX-1 to cross-react with aspirin, an update on pathogenesis, and current thoughts about treatment.
Stevenson
Donald D
DD
Division of Allergy, Asthma and Immunology and the Department of Medicine, Scripps Clinic and the Scripps Research Institute, La Jolla, USA. dstevemd@AOL.com
Szczeklik
Andrew
A
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000276:immunology; D001241:Aspirin / Q000009:adverse effects* / Q000276:immunology; D001249:Asthma / Q000276:immunology*; D003429:Cross Reactions; D016861:Cyclooxygenase Inhibitors / Q000276:immunology; D004342:Drug Hypersensitivity / Q000276:immunology*; D006801:Humans
D000894:Anti-Inflammatory Agents, Non-Steroidal; D016861:Cyclooxygenase Inhibitors; D001241:Aspirin