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Nsaids hypersensitivity

Jelena M Janjic, Kiran Vasudeva, Muzamil Saleem, Andrea Stevens, Lu Liu, Sravan Patel, John A Pollock
Neuroinflammation involving macrophages elevates Prostaglandin E2 , associated with neuropathic pain. Treatment with non-steroidal anti-inflammatory drugs (NSAIDs) inhibits cyclooxygenase, reducing PGE2 . However, NSAIDs cause physiological complications. We developed nanoemulsions incorporating celecoxib and near infrared dye. Intravenous injected nanoemulsion is incorporated into monocytes that accumulate at the injury; revealed in live animals by fluorescence. A single dose (celecoxib 0.24 mg/kg) provides targeted delivery in chronic constriction injury rats, resulting in significant reduction in the visualized inflammation, infiltration of macrophages, COX-2 and PGE2 ...
February 25, 2018: Journal of Neuroimmunology
M A W Hermans, R Otten, A F Karim, M S van Maaren
Nonsteroidal anti-inflammatory drugs (NSAIDs) are a major cause of hypersensitivity reactions. Several distinct clinical syndromes are described regarding NSAID hypersensitivity. Such a reaction is generally caused by a non-immunological mechanism. In susceptible patients, COX-1 inhibition leads to an imbalance in lipid mediators such as leukotrienes and prostaglandins. It is essential to distinguish multiple nonspecific NSAID hypersensitivity from single NSAID hypersensitivity, since the management of these respective syndromes is essentially different...
March 2018: Netherlands Journal of Medicine
Isabel Coman, Beatriz Pola-Bibián, Pilar Barranco, Gemma Vila-Nadal, Javier Dominguez-Ortega, David Romero, Carlos Villasante, Santiago Quirce
BACKGROUND: Bronchiectasis are increasingly identified in subjects with severe asthma and could contribute to disease severity. OBJECTIVE: We aimed to determine the prevalence of bronchiectasis in our population of subjects with severe asthma and to better characterize the clinical features of these patients and their outcomes. METHODS: We retrospectively reviewed the medical files of 184 subjects with confirmed severe asthma who had undergone a high resolution thoracic computed tomography and compared the characteristics and outcomes of subjects with and without bronchiectasis...
February 26, 2018: Annals of Allergy, Asthma & Immunology
Mona Al-Ahmad, Tito Rodriguez-Bouza, Midhat Nurkic
BACKGROUND: A history of nonsteroidal anti-inflammatory drug (NSAID) hypersensitivity with cross-intolerance to several drugs is common in some patients with coronary artery disease. We present a series of patients with acute coronary syndrome undergoing ASA desensitization prior to a possible stent to evaluate the short- and long-term efficacy and safety. The aim was to evaluate the outcomes of an ASA desensitization protocol developed by our center based on the guidelines proposed by the EAACI drug allergy expert recommendations...
January 26, 2018: International Archives of Allergy and Immunology
R Asero
Up to 30% of cases of chronic spontaneous urticaria (CSU) are exacerbated by COX-1 inhibit-ing nonsteroidal anti-inflammatory drugs (NSAID); this clinical picture is termed NECD (NSAID-exacerbated cutaneous disease). On the other hand, multiple NSAID hypersensitivity may occur in the absence of an underlying CSU also, a situation that is termed NIUA (NSAID-induced urticaria / angioedema). The present study reports a case of multiple NSAID hypersensitivity that occurred in a man much before he developed severe CSU...
November 30, 2017: European Annals of Allergy and Clinical Immunology
Melissa Yelehe-Okouma, Julie Czmil-Garon, Elise Pape, Nadine Petitpain, Pierre Gillet
Aseptic meningitis associates a typical clinical picture of meningitis with the absence of bacterial or fungal material in the cerebrospinal fluid. Drug-induced aseptic meningitis (DIAM) may be due to two mechanisms: (i) a direct meningeal irritation caused by the intrathecal administration of drugs and (ii) an immunologic hypersensitivity reaction to a systemic administration. If the direct meningeal irritation allows a rather easy recognition, the immunologic hypersensitivity reaction is a source of challenging diagnostics...
January 24, 2018: Fundamental & Clinical Pharmacology
Aoife B Monk, Jayne E Harrison, Helen V Worthington, Annabel Teague
BACKGROUND: Pain is a common side effect of orthodontic treatment. It increases in proportion to the amount of force applied to the teeth, and the type of orthodontic appliance used can affect the intensity of the pain. Pain during orthodontic treatment has been shown to be the most common reason for people wanting to discontinue treatment, and has been ranked as the worst aspect of treatment. Although pharmacological methods of pain relief have been investigated, there remains some uncertainty among orthodontists about which painkillers are most suitable and whether pre-emptive analgesia is beneficial...
November 28, 2017: Cochrane Database of Systematic Reviews
Stephan A Schug, Bruce Parsons, Chunming Li, Feng Xia
BACKGROUND: Nonselective, nonsteroidal anti-inflammatory drugs (NSAIDs) and selective cyclooxygenase-2 (COX-2) inhibitors are associated with safety issues including cardiovascular, renal, and gastrointestinal (GI) events. OBJECTIVE: To examine the safety of parecoxib, a COX-2 inhibitor, for the management of postoperative pain. DESIGN: Pooled analysis of 28 placebo-controlled trials of parecoxib and review of postauthorization safety data...
2017: Journal of Pain Research
S Adamo, J Nilsson, A Krebs, U Steiner, A Cozzio, L E French, A G A Kolios
Synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome is a rare disease with inflammatory osteoarticular and skin involvement. The pathogenesis of SAPHO syndrome remains unclear, but evidence suggests it may be an autoinflammatory disease triggered upon exposure to infectious agents in genetically predisposed individuals. Induction of the IL-23/Th17 axis as well as neutrophil activation seem to play a key role, and therapies targeting these immunological pathways, including TNF-inhibitors, ustekinumab, secukinumab and the IL-1 inhibitor anakinra are potential treatment options that need further investigation...
October 16, 2017: British Journal of Dermatology
Natalia Blanca-López, Elisa Haroun-Diaz, Francisco Javier Ruano, Diana Pérez-Alzate, María Luisa Somoza, María Vázquez de la Torre Gaspar, Francisco Rivas-Ruiz, Elena García-Martin, Miguel Blanca, Gabriela Canto
BACKGROUND: Hypersensitivity reactions to nonsteroidal anti-inflammatory drugs (NSAIDs) in children are becoming a great concern. Most studies have focused on adults, with noted discrepancies observed in the classification of hypersensitivity reactions to NSAIDs in children when compared with adults. OBJECTIVE: To phenotype a group of children with hypersensitivity reactions to NSAIDs, including paracetamol, and analyze the degree of agreement with the entities reported in adults and how they fit the proposed classifications...
October 3, 2017: Journal of Allergy and Clinical Immunology in Practice
Michele Hummel, Terri Knappenberger, Meghan Reilly, Garth T Whiteside
AIM: To evaluate whether non-steroidal anti-inflammatory drugs (NSAIDs)-induced gastropathy is a clinically predictive model of referred visceral hypersensitivity. METHODS: Gastric ulcer pain was induced by the oral administration of indomethacin to male, CD1 mice (n = 10/group) and then assessed by measuring referred abdominal hypersensitivity to tactile application. A diverse range of pharmacological mechanisms contributing to the pain were subsequently investigated...
September 7, 2017: World Journal of Gastroenterology: WJG
Brian Modena, Andrew A White, Katharine M Woessner
Aspirin and nonsteroidal antiinflammatory drugs (NSAIDs) are widely used in the United States and throughout the world for a variety of indications. Several unique hypersensitivity syndromes exist to this class of medications, making them one of the common reasons for consultation to the allergist. The lack of any laboratory-based diagnostic studies to assist in identifying the culprits in these reactions make evaluation of aspirin and NSAID hypersensitivity challenging. Identifying patients appropriate for oral challenge and/or desensitization protocols is the standard pragmatic approach to this issue when it arises...
November 2017: Immunology and Allergy Clinics of North America
Natalia Blanca-Lopez, Diana Perez-Alzate, Gabriela Canto, Miguel Blanca
Non-steroidal anti-inflammatory drugs (NSAIDs) are the most frequently involved in drug hypersensitivity reactions (DHR). NSAIDs are prescribed for different processes and some NSAIDs can be obtained over the counter. Areas covered: We analyse the practical approaches for managing and treating NSAID-DHR considering the five major groups of entities recognised, divided into two categories: those responding to strong COX-1 inhibitors and possibly weak COX-1 or selective COX-2 inhibitors named cross-intolerant (CI), and those induced by a single drug or drug group with good tolerance to strong COX-1 inhibitors, known as allergic reactions (SR)...
November 2017: Expert Review of Clinical Immunology
Kirti Johal, Kevin Welch, Anju Peters
BACKGROUND: Immunoglobulin G4 (IgG4) related disease is a systemic inflammatory disease characterized by tumor-like tissue infiltration with IgG4 positive (IgG4+) plasma cells. Aspirin-exacerbated respiratory disease (AERD) is defined as asthma, chronic rhinosinusitis with nasal polyposis, and hypersensitivity to cyclooxygenase-1 inhibitors. OBJECTIVE: We described a case of a non-smoking 61-year-old male with prior NSAID sensitivity who presented with a 1-year history of left eye proptosis associated with chronic nasal symptoms, ultimately identified as concurrent AERD and IgG4 sinusitis...
September 1, 2017: American Journal of Rhinology & Allergy
Hanki Park, Youngwoo Choi, Chang-Gyu Jung, Hae-Sim Park
Asthma is a common chronic disease with several variant phenotypes and endotypes. NSAID-exacerbated respiratory disease (NERD) is one such endotype characterized by asthma, chronic rhinosinusitis (CRS) with nasal polyps, and hypersensitivity to aspirin/cyclooxygenase-1 inhibitors. NERD is more associated with severe asthma than other asthma phenotypes. Regarding diagnosis, aspirin challenge tests via the oral or bronchial route are a standard diagnostic method; reliable in vitro diagnostic tests are not available...
2017: Mediators of Inflammation
Maurizio Sessa, Liberata Sportiello, Annamaria Mascolo, Cristina Scavone, Silvia Gallipoli, Gabriella di Mauro, Daniela Cimmaruta, Concetta Rafaniello, Annalisa Capuano
Purpose: This study aims to investigate preventability criteria of adverse drug reactions (ADRs) involving non-steroidal anti-inflammatory drugs (NSAIDs) by analyzing individual case safety reports (ICSRs) sent through Campania region (Italy) spontaneous reporting system from July 2012 to October 2016. Methods: For all the ICSRs that reported NSAIDs as suspected drug, a trained multidisciplinary team of Campania Pharmacovigilance Regional Centre composed of clinical pharmacologists and pharmacists with pluriannual experience in Pharmacovigilance assessed preventability by using the P-method...
2017: Frontiers in Pharmacology
Tanya M Laidlaw, Katherine N Cahill
Aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) are some of the most common culprits of drug-induced hypersensitivity reactions, and can lead to a wide array of adverse effects. The accurate and timely diagnosis of aspirin and NSAID-induced hypersensitivity reactions is important for both patient safety and for the initiation of appropriate disease-specific management and treatment. Because there are no reliably validated in vitro tests available, aspirin and NSAID challenges are considered to be the criterion standard for the diagnosis of these hypersensitivity reactions, though in some patients the diagnosis can be made on the basis of a clear clinical history...
May 2017: Journal of Allergy and Clinical Immunology in Practice
J E Aguirre, J H Winston, S K Sarna
BACKGROUND: Abdominal pain is one of the major symptoms of inflammatory Bowel Disease (IBD). The inflammatory mediators released by colon inflammation are known to sensitize the afferent neurons, which is one of the contributors to abdominal pain. However, not all IBD patients have abdominal pain, and some patients report abdominal pain during remission, suggesting contributions of other pathological factors to abdominal pain in IBD. Epidemiological studies found early-life gastrointestinal infections a risk factor for IBD symptoms and adult-life gastrointestinal infections may trigger the onset of IBD...
September 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Galina Balakirski, Hans F Merk
Important changes in the understanding and management of drug hypersensitivity reactions during the last years result from the increasing importance of biologics in medical practice, which differ in their spectrum of adverse drug reactions (ADRs) from the classical covalent drugs. With regard to covalent drugs, ampicillin and amoxicillin as well as clavulanic acid play an increasing role among ADRs to betalactam antibiotics. Fluoroquinolones are mainly the cause of anaphylactic and photosensitivity reactions...
December 2017: Cutaneous and Ocular Toxicology
Hossein Esmaeilzedeh, Elmira Esmaeilzadeh, Mohammad Faramarzi, Mohammad Nabavi, Mohammad Farhadi
BACKGROUND: A clear association between allergy and nasal polyposis (NP) is not determined and the role of food intolerance in patients with NP is not investigated by oral food challenge (OFC). OBJECTIVE: To investigate the relation of salicylate food intolerance and atopy in patients with NP according to recurrence and aspirin sensitivity. METHODS: A cross sectional multicenter study was done in two tertiary centers for allergy in Iran. Adult patients with NP were selected for the study that had been referred to allergy clinics...
March 2017: Iranian Journal of Immunology: IJI
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