Λεξικό .. Aspirin sensitivity

NSAIDs-including aspirin (ASA)-that inhibit cyclooxygenase (COX)-1 induce nonallergic hypersensitivity reactions consisting of attacks of rhinitis and asthma. Such reactions occur exclusively in a subset of asthmatic patients who also have underlying nasal polyps and chronic hyperplastic eosinophilic sinusitis. We now refer to their underlying inflammatory disease of the entire respiratory tract as aspirin-exacerbated respiratory disease [1].All asthmatic patients should be presumed to be aspirin-sensitive unless it is proved that they can tolerate the durg without respiratory or other side effects. The same recommendation applies to nonsteroidal antiinflammatory drugs. The cross-reactivity of aspirin with analgesics that do not block cyclooxygenase activity or with yellow, red, and blue food dyes or preservatives need a convincing evidence. (See aspirin intolerance).See Aspirin idiosyncrasy [2].

Here we demonstrate that aspirin modulates LTC(4) secretion in mast cells. Therapeutic levels of aspirin and salicylates (<or=0.3 mM, i.e., the concentrations observed in vivo in the use of antipyretic analgesic) increased IgE-mediated LTC(4) secretion. Aspirin-induced stimulation was accompanied by increased Ser-505 phosphorylation of cytosolic phospholipase A(2), which occurred independently of extracellular signal-regulated protein kinase-1/2 and p38 mitogen-activated protein kinase pathways. Aspirin also increased IgE-mediated Ca(2+) influx, whereas aspirin at concentrations of >or=0.3 mM dose-dependently reduced Ca(2+) store emptying and Ca(2+) release-activated Ca(2+) channel activation. Instead, aspirin facilitated a dihydropyridine receptor-mediated Ca(2+) influx, resulting in increased LTC(4) secretion. This novel action of aspirin may play roles in exacerbation of immediate allergy and aspirin intolerance [3]..

1. Stevenson DD. Aspirin sensitivity and desensitization for asthma and sinusitis. Curr Allergy Asthma Rep. 2009 Mar;9(2):155-63.

2. Stevenson, D.D., Mathison, D.A.: Aspirin sensitivity in asthmatics. Postgrad. Med. 78, No. 3, p. 119. 1985.

3. Togo K, Suzuki Y, Yoshimaru T, Inoue T, Terui T, Ochiai T, Ra C. Aspirin and salicylates modulate IgE-mediated leukotriene secretion in mast cells through a dihydropyridine receptor-mediated Ca(2+) influx. Clin Immunol. 2009 Apr;131(1):145-56. Epub 2009 Jan 14.