title: Hypersensitivity Reactions to Non-Steroidal Anti-Inflammatory Drugs.
abstract: Non-steroidal anti-inflammatory drugs (NSAIDs) are one of the leading causes of hypersensitivity reactions to drugs, and they are classified in two groups: those induced by nonspecific immunological mechanisms (non-allergic or cross-intolerance (CI) reactions), or by specific immunological mechanisms (allergic or selective reactions (SR)). The pathogenesis of CI is associated with their pharmacological activity (COX-1 inhibition), with symptoms due to an imbalance in the arachidonic acid pathway, independently of their chemical structure. SRs are mediated by specific IgE- or by a T-cell response and can be induced by a single NSAID or a class of chemically related NSAIDs, with patients tolerating chemically unrelated compounds. NSAIDs hypersensitivity reactions have been classified in five main groups: i) NSAIDs-exacerbated respiratory disease (NERD); ii) NSAIDs-exacerbated cutaneous disease (NECD); iii) NSAIDs-induced urticaria/angioedema (NIUA); iv) Single NSAID-induced urticaria/angioedema or anaphylaxis (SNIUAA); v) Single NSAID-induced delayed reactions (SNIDRs). Although this classification described above is widely accepted by most authors some phenotypes such as blended reactions do not fit. Therefore more research is needed in this topic.
authors: Allergy Unit, pabellon 6, 1º planta, Hospital Regional Universitario de Malaga (Pabellon C), Plaza del Hospital Civil, 29009 Malaga, Spain.
authors: Inmaculada
authors: I
authors: Dona
authors: Maria
authors: M
authors: Salas
authors: James R
authors: JR
authors: Perkins
authors: Esther
authors: E
authors: Barrionuevo
authors: Francesco
authors: F
authors: Gaeta
authors: Jose A
authors: JA
authors: Cornejo-Garcia
authors: Paloma
authors: P
authors: Campo
authors: Maria Jose
authors: MJ
authors: Torres
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000276:immunology* / Q000627:therapeutic use; D004342:Drug Hypersensitivity / Q000276:immunology*; D006801:Humans
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal
keywords: IgE; Non-steroidal anti-inflammatory drugs; T-cell response; blended reactions.; classification; cross-intolerance; hypersensitivity reactions; selective reactions