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Aspirin sensitivity and desensitization for asthma and sinusitis

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Abstract

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. This review focuses on descriptions of these patients; methods available to diagnose ASA-exacerbated respiratory disease; the unique ability of all NSAIDs that inhibit COX-1 to cross-react with ASA; lack of cross-reactivity with selective COX-2 inhibitors; an update on pathogenesis; and current thoughts about treatment, including ASA desensitization and daily ingestion of ASA itself.

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  1. Scripps Clinic at Carmel Valley, 3811 Valley Center Drive, San Diego, CA, 92130, USA

    Donald D. Stevenson

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  1. Donald D. Stevenson
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Correspondence to Donald D. Stevenson.

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Stevenson, D.D. Aspirin sensitivity and desensitization for asthma and sinusitis. Curr Allergy Asthma Rep 9, 155–163 (2009). https://doi.org/10.1007/s11882-009-0023-4

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