title: Immunomodulatory treatments for aspirin exacerbated respiratory disease.
abstract: BACKGROUND
  Aspirin triad is a subclass of chronic sinusitis characterized by nasal polyposis, nonallergic induced asthma, and aspirin sensitivity. Also known as Samter's triad or aspirin-exacerbated respiratory disease, aspirin triad commonly affects the adult population  and is seldom found in pediatric patients.
  
  
  METHODS
  This rhinosinusitis has multiple layers of pathological process, but the ultimate predicament is caused by cysteinyl leukotrienes (cysLTs).
  
  
  RESULTS
  Pharmacotherapies include oral steroid, lipoxygenase  inhibitor, and cysLT receptor inhibitor drugs, which can provide some relief for these patients.
  
  
  CONCLUSIONS
  Immunomodulation via aspirin desensitization is considered when pharmacotherapy has failed. When aspirin triad is unmanageable with medical treatment alone,  endoscopic sinus surgery with polypectomy can alleviate the patient's symptoms, allowing for a better response to postoperative medical management such as topical medication as well as delivery of topical medications.
authors.affiliation: Department of Otolaryngology and Head and Neck Surgery, Eastern Virginia Medical School, Norfolk, Virginia 23507, USA.
authors.forename: Rachel G
authors.initials: RG
authors.lastname: Moebus
authors.forename: Joseph K
authors.initials: JK
authors.lastname: Han
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001241:Aspirin / Q000008:administration & dosage / Q000009:adverse effects*; D055963:Asthma, Aspirin-Induced / Q000150:complications / Q000276:immunology / Q000628:therapy*; D003888:Desensitization, Immunologic / Q000379:methods*; D004724:Endoscopy; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D006801:Humans; D056747:Immunomodulation; D015289:Leukotrienes / Q000378:metabolism; D008084:Lipoxygenase / Q000378:metabolism; D009298:Nasal Polyps / Q000150:complications / Q000276:immunology / Q000628:therapy*; D012220:Rhinitis / Q000150:complications / Q000276:immunology / Q000628:therapy*; D012852:Sinusitis / Q000150:complications / Q000276:immunology / Q000628:therapy*
chemical_list: D000305:Adrenal Cortex Hormones; D004791:Enzyme Inhibitors; D015289:Leukotrienes; D008084:Lipoxygenase; D001241:Aspirin