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https://www.readbyqxmd.com/read/27888917/aspirin-exacerbated-respiratory-disease
#1
REVIEW
Evan S Walgama, Peter H Hwang
Aspirin-exacerbated respiratory disease (AERD) is characterized by the triad of asthma, sinonasal polyposis, and aspirin intolerance. The hallmark of the disease is baseline overproduction of cysteinyl leukotrienes via the 5-lipoxygenase pathway, exacerbated by ingestion of aspirin. Patients with AERD have high rates of recidivistic polyposis following sinus surgery, although the improvement in quality of life following surgery is similar to aspirin-tolerant patients. The diagnosis is secured by a positive aspirin provocation test, usually administered by a medical allergist...
February 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27849653/the-role-of-aspirin-desensitization-in-the-management-of-aspirin-exacerbated-respiratory-disease
#2
Bobby A Tajudeen, Joseph S Schwartz, John V Bosso
PURPOSE OF REVIEW: Aspirin-exacerbated respiratory disease (AERD) is a progressive inflammatory disease of the upper and lower airways characterized by marked eosinophilic nasal polyposis, asthma, and respiratory reactions to medications that inhibit the cyclooxygenase pathway. Aspirin desensitization has proven to be an effective tool in the management of this disease when used in a multidisciplinary setting. The purpose of this article is to review the current literature regarding AERD, aspirin desensitization, and share our opinion regarding the most optimal multidisciplinary approach to these complex patients...
November 15, 2016: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/27830727/exploration-of-the-sphingolipid-metabolite-sphingosine-1-phosphate-and-sphingosine-as-novel-biomarkers-for-aspirin-exacerbated-respiratory-disease
#3
Hoang Kim Tu Trinh, Su-Chin Kim, Kumsun Cho, Su-Jung Kim, Ga-Young Ban, Hyun-Ju Yoo, Joo-Youn Cho, Hae-Sim Park, Seung-Hyun Kim
Sphingolipid (SL) metabolites have been suggested to be important inflammatory mediators in airway inflammation and asthma. However, little is known about SL metabolites in aspirin-exacerbated respiratory disease (AERD). We aimed to explore the potential AERD biomarkers by conducting lipidomics targeting SL metabolites. The levels of SL metabolites in serum and urine samples from 45 AERD patients and 45 aspirin-tolerant asthma (ATA) patients were quantified through mass spectrometry. During the lysine-aspirin bronchoprovocation test (ASA-BPT), the levels of serum sphingomyelin (SM) were significantly decreased in AERD (P < 0...
November 10, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27830335/olfaction-and-sinonasal-symptoms-in-patients-with-crswnp-and-aerd-and-without-aerd-a-cross-sectional-and-longitudinal-study
#4
V Gudziol, M Michel, C Sonnefeld, D Koschel, T Hummel
Oral aspirin challenge (OAC) reveals aspirin-exacerbated respiratory disease (AERD) in approximately 50% of unselected patients with chronic rhinosinusitis with nasal polyposis (CRSwNP). Smell loss is one factor that predicts the outcome of OAC. The present study aims to unveil differences in olfactory function between patients with CRSwNP with and without AERD by means of a validated reliable test for odor threshold, discrimination and identification. Additionally, Beck Depression Inventory (BDI) and Sinonasal Outcome Test 22 (SNOT 22) were applied...
November 9, 2016: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/27817219/current-complications-and-treatment-of-aspirin-exacerbated-respiratory-disease
#5
Kevin A Cook, Donald D Stevenson
Aspirin-exacerbated respiratory disease is defined by the clinical tetrad of aspirin sensitivity, nasal polyps, asthma, and chronic rhinosinusitis. Patients experience acute upper and lower airway reactions with exposure to aspirin and other cyclooxygenase-1 inhibiting medications. However, airway inflammation and disease progression occur even in the absence of exposure to these medications, often leading to aggressive polyp formation and need for systemic corticosteroids to treat exacerbations in asthma and rhinosinusitis...
November 17, 2016: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/27758759/nasal-ketorolac-challenge-using-an-acoustic-rhinomether-in-patients-with-aspirin-exacerbated-respiratory-disease
#6
J Quiralte-Castillo, M Del Robledo Ávila-Castellano, S Cimbollek, P Benaixa, S Leguisamo, K Baynova, M Labella, J Quiralte
BACKGROUND: Safer and less time consuming alternatives to single-blind placebo-controlled oral challenge (SBPCOC) in order to diagnose aspirin-exacerbated respiratory disease (AERD) have been searched for. Nasal challenges with different non-steroidal anti-inflammatory drugs and assessment methods have been developed. OBJECTIVE: Our objective was to evaluate the utility and safety of nasal ketorolac challenge (NKC) using an acoustic rhinomether in patients with suspected AERD Methods: Thirty-six patients with suspected AERD were included in the study...
October 19, 2016: Journal of Investigational Allergology & Clinical Immunology
https://www.readbyqxmd.com/read/27719658/aspirin-intolerance-experimental-models-for-bed-to-bench
#7
Masamichi Yamashita
Aspirin is the oldest non-steroidal anti-inflammatory drug (NSAID), and it sometimes causes asthma-like symptoms known as aspirin-exacerbated respiratory disease (AERD), which can be serious. Unwanted effects of aspirin (aspirin intolerance) are also observed in patients with food-dependent exercise-induced anaphylaxis, a type I allergy disease, and aspirin-induced urticaria (AIU). However the target and the mechanism of the aspirin intolerance are still unknown. There is no animal or cellular model of AERD, because its pathophysiological mechanism is still unknown, but it is thought that inhibition of cyclooxygenase by causative agents lead to an increase of free arachidonic acid, which is metabolized into cysteinyl leukotrienes (cysLTs) that provoke airway smooth muscle constriction and asthma symptoms...
October 5, 2016: Current Drug Targets
https://www.readbyqxmd.com/read/27712769/genetic-and-epigenetic-components-of-aspirin-exacerbated-respiratory-disease
#8
Amber Dahlin, Scott T Weiss
Aspirin-exacerbated respiratory disease (AERD) severity and its clinical phenotypes are characterized by genetic variation within pathways for arachidonic acid metabolism, inflammation, and immune responses. Epigenetic effects, including DNA methylation and histone protein modification, contribute to regulation of many genes that contribute to inflammatory states in AERD. The development of noninvasive, predictive clinical tests using data from genetic, epigenetic, pharmacogenetic, and biomarker studies will improve precision medicine efforts for AERD and asthma treatment...
November 2016: Immunology and Allergy Clinics of North America
https://www.readbyqxmd.com/read/27712768/lipid-mediators-in-aspirin-exacerbated-respiratory-disease
#9
Andrew R Parker, Andrew G Ayars, Matthew C Altman, William R Henderson
Aspirin-exacerbated respiratory disease (AERD) is a syndrome of severe asthma and rhinosinusitis with nasal polyposis with exacerbations of baseline eosinophil-driven and mast cell-driven inflammation after nonsteroidal antiinflammatory drug ingestion. Although the underlying pathophysiology is poorly understood, dysregulation of the cyclooxygenase and 5-lipoxygenase pathways of arachidonic acid metabolism is thought to be key. Central features of AERD pathogenesis are overproduction of proinflammatory and bronchoconstrictor cysteinyl leukotrienes and prostaglandin (PG) D2 and inhibition of bronchoprotective and antiinflammatory PGE2...
November 2016: Immunology and Allergy Clinics of North America
https://www.readbyqxmd.com/read/27712767/mechanisms-of-benefit-with-aspirin-therapy-in-aspirin-exacerbated-respiratory-disease
#10
Jennifer Hill, Trever Burnett, Rohit Katial
Aspirin-exacerbated respiratory disease (AERD) is a clinical syndrome characterized by severe persistent asthma, hyperplastic eosinophilic sinusitis with nasal polyps, and an intolerance to aspirin and other NSAIDs that preferentially inhibit COX-1. For more than 30 years, aspirin desensitization has proven to be of significant long-term benefit in carefully selected patients with AERD. Despite this, the exact mechanisms behind the therapeutic effects of aspirin desensitization remain poorly understood. In this article, we review the current understanding of the mechanisms of aspirin desensitization and discuss future areas of investigation...
November 2016: Immunology and Allergy Clinics of North America
https://www.readbyqxmd.com/read/27712766/eosinophils-and-mast-cells-in-aspirin-exacerbated-respiratory-disease
#11
John W Steinke, Spencer C Payne, Larry Borish
Aspirin-exacerbated respiratory disease (AERD) involves overexpression of proinflammatory mediators, including 5-lipoxygenase and leukotriene C4 synthase (LTC4S), resulting in constitutive overproduction of cysteinyl leukotrienes. Mast cells and eosinophils have roles in mediating many of the observed effects. Increased levels of both interleukin-4 (IL-4) and interferon (IFN)-γ are present in the tissue of patients with AERD. Previous studies showed that IL-4 is primarily responsible for the upregulation of LTC4S by mast cells...
November 2016: Immunology and Allergy Clinics of North America
https://www.readbyqxmd.com/read/27712764/performing-aspirin-desensitization-in-aspirin-exacerbated-respiratory-disease
#12
Jeremy D Waldram, Ronald A Simon
Aspirin-exacerbated respiratory disease (AERD) is characterized by chronic rhinosinusitis with nasal polyps, asthma, and reactions to cyclooxygenase-1-inhibiting drugs. This condition is often refractory to standard medical treatments and results in aggressive nasal polyposis that often requires multiple sinus surgeries. Aspirin desensitization followed by daily aspirin therapy is an important treatment option, and its efficacy has been validated in multiple research studies. Aspirin desensitization is not without risk, but specific protocols and recommendations exist to mitigate the risk...
November 2016: Immunology and Allergy Clinics of North America
https://www.readbyqxmd.com/read/27712762/aspirin-exacerbated-respiratory-disease-as-an-endotype-of-chronic-rhinosinusitis
#13
Whitney W Stevens, Robert P Schleimer
Aspirin-Exacerbated Respiratory Disease (AERD) and Chronic Rhinosinusitis with Nasal Polyps (CRSwNP) are both characterized by the presence of chronic sinonasal inflammation and nasal polyps. Unlike in CRSwNP, AERD patients develop respiratory reactions following ingestion of COX-1 inhibitors. AERD patients also, on average, have worse upper respiratory disease with increased sinonasal symptoms, mucosal inflammation and requirements for revision sinus surgery when compared to CRSwNP patients. While no single genetic factor has been identified in either CRSwNP or AERD to date, differences in the metabolism of arachidonic acid as well as innate immune cell activation may uniquely contribute to AERD pathogenesis...
November 2016: Immunology and Allergy Clinics of North America
https://www.readbyqxmd.com/read/27712761/diagnostic-evaluation-in-aspirin-exacerbated-respiratory-disease
#14
Adam N Williams
Aspirin-exacerbated respiratory disease (AERD) is a distinct clinical condition characterized by chronic sinusitis with nasal polyps, asthma, and hypersensitivity reactions to nonsteroidal anti-inflammatory drugs (NSAIDs). Distinguishing AERD from other forms of chronic sinusitis, asthma, and NSAID reactivity has important clinical implications for management. The clinical history is helpful, but not adequate for confirming the diagnosis of AERD, in most cases. Diagnostic provocation challenge remains the only way to confirm or exclude the diagnosis of AERD...
November 2016: Immunology and Allergy Clinics of North America
https://www.readbyqxmd.com/read/27685608/omalizumab-in-patient-with-aspirin-exacerbated-respiratory-disease-and-chronic-idiopathic-urticaria
#15
Federica Porcaro, Antonio Di Marco, Renato Cutrera
Aspirin hypersensitivity associated with chronic rhinosinusitis-with or without nasal polyposis-and asthma resistant to conventional therapy defines the aspirin-exacerbated respiratory disease (AERD). We describe the case of a 15-year-old female patient with adverse reaction to aspirin, chronic rhinosinusitis, and severe asthma. She also experienced chronic idiopathic urticaria worsened by non-steroidal anti-inflammatory drug administration. AERD was diagnosed based on clinical history and symptoms. Given the poor responsiveness to standard therapy for respiratory and cutaneous symptoms, omalizumab was administered for 24 weeks with control of respiratory symptoms and short term improvement of cutaneous symptoms...
September 29, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27658758/antibodies-and-superantibodies-in-chronic-rhinosinusitis-with-nasal-polyps
#16
Jiun-Bo Chen, Louisa K James, Anna M Davies, Y-C Wu, Joanne Rimmer, Valerie J Lund, Jou-Han Chen, James M McDonnell, Yih-Chih Chan, George H Hutchins, Tse Wen Chang, Brian J Sutton, Harsha H Kariyawasam, Hannah J Gould
BACKGROUND: Chronic rhinosinusitis with nasal polyps (CRSwNP) is associated with local immunoglobulin hyperproduction and the presence of IgE antibodies against Staphylococcus aureus enterotoxins (SAEs). Aspirin-exacerbated respiratory disease (AERD) is a severe form of CRSwNP in which nearly all patients express anti-SAEs. OBJECTIVES: We aimed to understand antibodies reactive to SAEs and determine whether they recognize SAEs through their complementarity-determining regions (CDRs) or framework regions (FRs)...
September 19, 2016: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27578463/nonsteroidal-anti-inflammatory-drug-nsaid-exacerbated-respiratory-disease-phenotype-topical-nsaid-and-asthma-control-a-possible-oversight-link
#17
Jessica Han Ying Tan, Anne Ann Ling Hsu
BACKGROUND: Patients with aspirin-exacerbated respiratory disease (AERD) also recently known as nonsteroidal anti-inflammatory drug (NSAID) exacerbated respiratory disease (NERD) must avoid aspirin and all other oral NSAIDs. The effect of topical NSAID (tNSAID), especially salicylates which are commonly present in topical medicated preparations, on asthma control of this phenotype is studied. METHODS: The study inclusion criteria were adults with: 1) NSAID hypersensitivity; 2) nasal polyposis/chronic rhinosinusitis; 3) not well-/poorly controlled asthma and 4) exposure to tNSAID...
September 2016: Respiratory Medicine
https://www.readbyqxmd.com/read/27567328/automated-identification-of-an-aspirin-exacerbated-respiratory-disease-cohort
#18
Katherine N Cahill, Christina B Johns, Jing Cui, Paige Wickner, David W Bates, Tanya M Laidlaw, Patrick E Beeler
BACKGROUND: Aspirin-exacerbated respiratory disease (AERD) is characterized by 3 clinical features: asthma, nasal polyposis, and respiratory reactions to cyclooxygenase-1 inhibitors (nonsteroidal anti-inflammatory drugs). Electronic health records (EHRs) contain information on each feature of this triad. OBJECTIVE: We sought to determine whether an informatics algorithm applied to the EHR could electronically identify patients with AERD. METHODS: We developed an informatics algorithm to search the EHRs of patients aged 18 years and older from the Partners Healthcare system over a 10-year period (2004-2014)...
July 25, 2016: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27538737/aspirin-exacerbated-respiratory-disease-and-current-treatment-modalities
#19
Emine Güven Sakalar, Nuray Bayar Muluk, Murat Kar, Cemal Cingi
Aspirin-exacerbated respiratory disease (AERD) refers to the combination of asthma, chronic rhinosinusitis with nasal polyposis, and acute upper and lower respiratory tract reactions to the ingestion of aspirin (acetylsalicylic acid, ASA) and other cyclooxygenase-1 inhibiting non-steroidal anti-inflammatory drugs. AERD affects 0.3-0.9 % of the general population. AERD generally occurs due to abnormalities in mediators and expression of arachidonic acid biosynthesis. Local IgE responses to staphylococcal enterotoxins may also be responsible for eosinophilic activation in the nasal polyp tissues of AERD patients...
August 18, 2016: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/27534531/aspirin-induces-il-4-production-augmented-il-4-production-in-aspirin-exacerbated-respiratory-disease
#20
Su-Kang Kong, Byung Soo Kim, Tae Gi Uhm, Hun Soo Chang, Jong Sook Park, Sung Woo Park, Choon-Sik Park, Il Yup Chung
Aspirin hypersensitivity is a hallmark of aspirin-exacerbated respiratory disease (AERD), a clinical syndrome characterized by the severe inflammation of the respiratory tract after ingestion of cyclooxygenase-1 inhibitors. We investigated the capacity of aspirin to induce interleukin-4 (IL-4) production in inflammatory cells relevant to AERD pathogenesis and examined the associated biochemical and molecular pathways. We also compared IL-4 production in peripheral blood mononuclear cells (PBMCs) from patients with AERD vs aspirin-tolerant asthma (ATA) upon exposure to aspirin...
January 8, 2016: Experimental & Molecular Medicine
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