title: Eicosanoid imbalance correlates in vitro with the pattern of clinical symptoms of Samter's triad.
abstract: BACKGROUND
  Hypersensitivity to non-steroidal anti-inflammatory drugs (NSAIDs) is often associated with chronic rhinosinusitis (CRS), nasal polyps (CRSwNP) and asthma, together known as Samter's triad. The disease is characterised by eicosanoid imbalance. In our study, we determined clinical and laboratory parameters in respect of three groups of patients: 1) CRSwNP, 2) CRSwNP and asthma (CRSwNP-A), and 3) CRSwNP with asthma and NSAID-triggered hypersensitivity (CRSwNP-AA). Our main goal was to improve the characterisation of the stages of development in Samter's triad, pointing to the homogeneous or heterogeneous course of disease.
  
  
  METHODS
  Forty-three patients (10 CRSwNP, 14 CRSwNP-A, 19 CRSwNP-AA) and 10 control subjects were included in the study. Nasal assessment using the CRS visual analogue score, endoscopy- and computer tomography scores, allergy tests, analysis of sinus surgeries, asthma severity and in vitro functional eicosanoid tests (FET) with peripheral blood leucocytes were performed.
  
  
  RESULTS
  The scores reflecting CRS symptoms such as nasal congestion, nasal discharge and smell impairment differed between the patients groups reflecting the severity of disease (CRSwNP-AA > CRSwNP-A > CRSwNP). Eicosanoid imbalance correlated with nasal congestion, nasal discharge and loss of smell.
  
  
  CONCLUSIONS
  The data presented support the hypothesis of the continuous development of NSAID-triggered hypersensitivity, culminating in Samter's triad.
authors: Department of Otorhinolaryngology, Charite-Universitatsmedizin, Berlin, Germany. ulrike.foerster@charite.de
authors: U
authors: U
authors: Forster
authors: S
authors: S
authors: Strathmann
authors: D
authors: D
authors: Schafer
authors: A J
authors: AJ
authors: Szczepek
authors: H
authors: H
authors: Olze
mesh_terms: D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000276:immunology; D001249:Asthma / Q000139:chemically induced* / Q000150:complications / Q000276:immunology; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D004342:Drug Hypersensitivity / Q000276:immunology*; D015777:Eicosanoids / Q000097:blood* / Q000276:immunology; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000139:chemically induced* / Q000150:complications / Q000276:immunology; D012220:Rhinitis / Q000139:chemically induced* / Q000150:complications / Q000276:immunology; D012720:Severity of Illness Index; D012852:Sinusitis / Q000139:chemically induced* / Q000150:complications / Q000276:immunology; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D015777:Eicosanoids