Pathogenesis and Management of Aspirin-Intolerant Asthma

Treatments in Respiratory Medicine - Tập 4 - Trang 325-336 - 2012
Yasushi Obase1,2, Hiroto Matsuse2, Terufumi Shimoda3, Tari Haahtela1, Shigeru Kohno2
1Skin and Allergy Hospital, Helsinki University Central Hospital, Helsinki, Finland
2Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan
3Clinical Research Center, National Fukuoka Hospital, Fukuoka, Japan

Tóm tắt

In 2–23% of adults with asthma, and rarely in children with asthma, aspirin (acetylsalicylic acid) and non-steroidal anti-inflammatory drugs (NSAIDs) cause asthma exacerbations. Within 3 hours of ingestion of aspirin/NSAIDs, individuals with aspirin-intolerant asthma (AIA) develop bronchoconstriction, often accompanied by rhinorrhea, conjunctival irritation, and scarlet flush. In severe cases, a single therapeutic dose of aspirin/NSAIDs can provoke violent bronchospasm, loss of consciousness, and respiratory arrest. In order to diagnose AIA, oral, inhaled, nasal or intravenous aspirin challenge tests are performed in facilities where experienced physicians are present and emergency treatment is available. The exact differences in the pathogenesis of AIA and other types of asthma are not fully understood. The interference of aspirin/NSAIDs with arachidonic acid metabolism in the lungs plays an important role in the mechanism of AIA; inhibition of cyclo-oxygenase is accompanied by overproduction of cysteinyl leukotrienes (cys-LTs). It has been proposed that overproduction of cys-LTs, together with removal by aspirin/NSAIDs of the ‘brake’ imposed by the bronchodilator prostaglandin E2, may cause an asthma attack in patients with AIA. Development of a suitable animal model to investigate the pathogenesis of AIA would help to clarify this question. Although it is still controversial whether leukotriene modifiers are more effective in patients with AIA compared with other types of asthma, because LT plays an important role in the pathogenesis of AIA, leukotriene modifiers are the preferred medication for the long-term control of AIA. Add-on efficacy of leukotriene modifiers has been confirmed in patients with AIA already treated with inhaled corticosteroids. However, this does not mean that aspirin/NSAIDs can be safely taken by aspirin-sensitive patients treated with leukotriene modifiers. To prevent attacks of AIA, sensitive patients should avoid the use of aspirin/NSAIDs or use selective cyclo-oxygenase 2 inhibitors when required. When patients with AIA need aspirin for specific situations they should receive aspirin desensitization therapy or treatment with selective cyclo-oxygenase 2 inhibitors.

Tài liệu tham khảo

Vane SJ. Aspirin and other anti-inflammatory drugs. Thorax 2000; 55 Suppl. 2: S3–9 Widal F, Abrami P, Lermoyez J. First complete description of the aspirin idiosyncrasy-asthma-nasal polyposis syndrome (plus urticaria): 1922 (with a note on aspirin desensitization). J Asthma 1987; 24: 297–300 Samter M, Beers Jr RF. Intolerance to aspirin: clinical studies and consideration of its pathogenesis. Ann Intern Med 1968; 68: 975–83 Szczeklik A, Stevenson DD. Aspirin-induced asthma: advances in pathogenesis and management. J Allergy Clin Immunol 1999; 104: 5–13 Settipane GA. Aspirin sensitivity and allergy. Biomed Pharmacother 1988; 42: 493–8 Quiralte J, Blanco C, Castillo R, et al. Intolerance to nonsteroidal antiinflammatory drugs: results of controlled drug challenges in 98 patients. J Allergy Clin Immunol 1996; 98: 678–85 Stevenson DD, Hankammer MA, Mathison DA, et al. Aspirin desensitization treatment of aspirin-sensitive patients with rhinosinusitis-asthma: long-term outcomes. J Allergy Clin Immunol 1996; 98: 751–8 Christie PE, Tagari P, Ford Hutchinson AW, et al. Urinary leukotriene E4 concentrations increase after aspirin challenge in aspirin-sensitive asthmatic subjects. Am Rev Respir Dis 1991; 143: 1025–9 Kalyoncu AF, Karakaya G, Sahin AA, et al. Occurrence of allergic conditions in asthmatics with analgesic intolerance. Allergy 1999; 54: 428–35 Hedman J, Kaprio J, Poussa T, et al. Prevalence of asthma, aspirin intolerance, nasal polyposis and chronic obstructive pulmonary disease in a population-based study. Int J Epidemiol 1999; 28: 717–22 McDonald JR, Mathison DA, Stevenson DD. Aspirin intolerance in asthma: detection by oral challenge. J Allergy Clin Immunol 1972; 50: 198–207 Vally H, Taylor ML, Thompson PJ. The prevalence of aspirin intolerant asthma (AIA) in Australian asthmatic patients. Thorax 2002; 57: 569–74 Johnson AG, Day RO. The problems and pitfalls of NSAID therapy in the elderly (Part I). Drugs Aging 1991; 1: 130–43 Faich GA. Adverse-drug-reaction monitoring. N Engl J Med 1986; 314: 1589–92 Szczeklik A, Nizankowska E, Duplaga M. Natural history of aspirin-induced asthma. AIANE Investigators. European Network on Aspirin-Induced Asthma. Eur Respir J 2000; 16: 432–6 Marquette CH, Saulnier F, Leroy O, et al. Long-term prognosis of near-fatal asthma: a 6-year follow-up study of 145 asthmatic patients who underwent mechanical ventilation for a near-fatal attack of asthma. Am Rev Respir Dis 1992; 146: 76–81 Matsuse H, Shimoda T, Matsuo N, et al. Aspirin-induced asthma as a risk factor for asthma mortality. J Asthma 1997; 34: 413–7 Bochenek G, Szczeklik A, Niz Ankowska E. Testing for aspirin hypersensitivity. Allergy 2002; 57: 562–5 Melillo G, Balzano G, Bianco S, et al. Report of the INTERASMA Working Group on Standardization of Inhalation Provocation Tests in Aspirin-induced Asthma: oral and inhalation provocation tests for the diagnosis of aspirin-induced asthma. Allergy 2001; 56: 899–911 Melillo G, Bonini S, Cocco G, et al. EAACI provocation tests with allergens: report prepared by the European Academy of Allergology and Clinical Immunology Subcommittee on provocation tests with allergens. Allergy 1997; 52: 1–35 Martelli NA. Bronchial and intravenous provocation tests with indomethacin in aspirin-sensitive asthmatics. Am Rev Respir Dis 1979; 120: 1073–9 Mita H, Endoh S, Kudoh M, et al. Possible involvement of mast-cell activation in aspirin provocation of aspirin-induced asthma. Allergy 2001; 56: 1061–7 Kawagishi Y, Mita H, Taniguchi M, et al. Leukotriene C4 synthase promoter polymorphism in Japanese patients with aspirin-induced asthma. J Allergy Clin Immunol 2002; 109: 936–42 Obase Y, Shimoda T, Tomari SY, et al. Effects of pranlukast on chemical mediators in induced sputum on provocation tests in atopic and aspirin-intolerant asthmatic patients. Chest 2002; 121: 143–50 Bianco S, Robuschi M, Petrigni G. Apsirin sensitivity in asthmatics. Br Med J 1981; 282: 146 Nizankowska E, Cmiel A, Bestynska Krypel A, et al. Oral and bronchial provocation tests with aspirin for diagnosis of aspirin-induced asthma. Eur Respir J 2000; 15: 863–9 Melillo G, Padovano A, Cocco G, et al. Dosimeter inhalation test with lysine acetylsalicylate for the detection of aspirin-induced asthma. Ann Allergy 1993; 71: 61–5 Dahlen B, Melillo G. Inhalation challenge in aspirin-induced asthma. Respir Med 1998; 92: 378–84 Phillips GD, Foord R, Holgate ST. Inhaled lysine-aspirin as a bronchoprovocation procedure in aspirin-sensitive asthma: its repeatability, absence of a late-phase reaction, and the role of histamine. J Allergy Clin Immunol 1989; 84: 232–41 Casadevall J, Ventura PJ, Mullol J, et al. Intranasal challenge with aspirin in the diagnosis of aspirin intolerant asthma: evaluation of nasal response by acoustic rhinometry. Thorax 2000; 55: 921–4 Bochenek G, Nizankowska E, Szczeklik A. The atopy trait in hypersensitivity to nonsteroidal anti-inflammatory drugs. Allergy 1996; 51: 16–23 Szczeklik A, Gryglewski RJ, Czerniawska Mysik G. Relationship of inhibition of prostaglandin biosynthesis by analgesics to asthma attacks in aspirin-sensitive patients. BMJ 1975; 1: 67–9 Nasser SM, Pfister R, Christie PE, et al. Inflammatory cell populations in bronchial biopsies from aspirin-sensitive asthmatic subjects. Am J Respir Crit Care Med 1996; 153: 90–6 Sousa AR, Lams BE, Pfister R, et al. Expression of interleukin-5 and granulocyte-macrophage colony-stimulating factor in aspirin-sensitive and non-aspirin-sensitive asthmatic airways. Am J Respir Crit Care Med 1997; 156: 1384–9 Cowburn AS, Sladek K, Soja J, et al. Overexpression of leukotriene C4 synthase in bronchial biopsies from patients with aspirin-intolerant asthma. J Clin Invest 1998; 101: 834–46 Hawkey CJ. COX-2 inhibitors. Lancet 1999; 353: 307–14 Funk CD. Prostaglandins and leukotrienes: advances in eicosanoid biology. Science 2001; 294: 1871–5 Jawien J. A new insight into aspirin-induced asthma. Eur J Clin Invest 2002; 32: 134–8 Szczeklik A. The cyclooxygenase theory of aspirin-induced asthma. Eur Respir J 1990; 3: 588–93 Picado C, Juan M, Fernandez Morata JC, et al. Cyclooxygenase-2 mRNA is downexpressed in nasal polyps from aspirin-sensitive asthmatics. Am J Respir Crit Care Med 1999; 160: 291–6 Sampson AP, Cowburn AS, Sladek K, et al. Profound overexpression of leukotriene C4 synthase in bronchial biopsies from aspirin-intolerant asthmatic patients. Int Arch Allergy Immunol 1997; 113: 355–7 Sousa A, Pfister R, Christie PE, et al. Enhanced expression of cyclo-oxygenase isoenzyme 2 (COX-2) in asthmatic airways and its cellular distribution in aspirin-sensitive asthma. Thorax 1997; 52: 940–5 Picado C. Aspirin-intolerant asthma: role of cyclo-oxygenase enzymes. Allergy 2002; 57 Suppl. 72: 58–60 Holgate ST, Burns GB, Robinson C, et al. Anaphylactic- and calcium-dependent generation of prostaglandin D2 (PGD2), thromboxane B2, and other cyclooxygenase products of arachidonic acid by dispersed human lung cells and relationship to histamine release. J Immunol 1984; 133: 2138–44 Higashi N, Taniguchi M, Mita H, et al. A comparative study of eicosanoid concentrations in sputum and urine in patients with aspirin-intolerant asthma. Clin Exp Allergy 2002; 32: 1484–90 Szczeklik A, Sladek K, Dworski R, et al. Bronchial aspirin challenge causes specific eicosanoid response in aspirin-sensitive asthmatics. Am J Respir Crit Care Med 1996; 154: 1608–14 Szczeklik A, Mastalerz L, Nizankowska E, et al. Protective and bronchodilator effects of prostaglandin E and salbutamol in aspirin-induced asthma. Am J Respir Crit Care Med 1996; 153: 567–71 Sestini P, Armetti L, Gambaro G, et al. Inhaled PGE2 prevents aspirin-induced bronchoconstriction and urinary LTE4 excretion in aspirin-sensitive asthma. Am J Respir Crit Care Med 1996; 153: 572–5 Kuehl Jr FA, Dougherty HW, Ham EA. Interactions between prostaglandins and leukotrienes. Biochem Pharmacol 1984; 33: 1–5 Christman BW, Christman JW, Dworski R, et al. Prostaglandin E2 limits arachidonic acid availability and inhibits leukotriene B4 synthesis in rat alveolar macrophages by a nonphospholipase A2 mechanism. J Immunol 1993; 151: 2096–104 Schafer D, Schmid M, Gode UC, et al. Dynamics of eicosanoids in peripheral blood cells during bronchial provocation in aspirin-intolerant asthmatics. Eur Respir J 1999; 13: 638–46 Kowalski ML, Pawliczak R, Wozniak J, et al. Differential metabolism of arachidonic acid in nasal polyp epithelial cells cultured from aspirin-sensitive and aspirin-tolerant patients. Am J Respir Crit Care Med 2000; 161: 391–8 Sladek K, Dworski R, Soja J, et al. Eicosanoids in bronchoalveolar lavage fluid of aspirin-intolerant patients with asthma after aspirin challenge. Am J Respir Crit Care Med 1994; 149: 940–6 Picado C, Ramis I, Rosello J, et al. Release of peptide leukotriene into nasal secretions after local instillation of aspirin in aspirin-sensitive asthmatic patients. Am Rev Respir Dis 1992; 145: 65–9 Lanmack EL, Wenzel SE. Mast cell and eosinophil responses after indomethacin in asthmatics tolerant and intolerant to aspirin. In: Szczeklik A, Gryglewski RJ, Vane JR, editors. Eicosanoids, aspirin, and asthma. New York: Marcel Dekker, 1998: 337–50 Sanak M, Sampson AP. Biosynthesis of cysteinyl-leucotrienes in aspirin-intolerant asthma. Clin Exp Allergy 1999; 29: 306–13 Abramovitz M, Wong E, Cox ME, et al. 5-lipoxygenase-activating protein stimulates the utilization of arachidonic acid by 5-lipoxygenase. Eur J Biochem 1993; 215: 105–11 In KH, Asano K, Beier D, et al. Naturally occurring mutations in the human 5-lipoxygenase gene promoter that modify transcription factor binding and reporter gene transcription. J Clin Invest 1997; 99: 1130–7 Kellaway CH, Trethewie WR. The liberation of a slow reacting smoth muscle-stimulating substance in anaphylaxis Q J Exp Physiol 1940; 30: 121–45 Murphy RC, Hammarstrom S, Samuelsson B. Leukotriene C: a slow-reacting substance from murine mastocytoma cells. Proc Natl Acad Sci U S A 1979; 76: 4275–9 Radmark O, Malmsten C, Samuelsson B. Leukotriene A4: enzymatic conversion to leukotriene C4. Biochem Biophys Res Commun 1980; 96: 1679–87 Peters Golden M, Brock TG. Intracellular compartmentalization of leukotriene biosynthesis. Am J Respir Crit Care Med 2000; 161: S36–40 Bach MK, Brashler JR, Morton DR. Solubilization and characterization of the leukotriene C4 synthetase of rat basophil leukemia cells: a novel, particulate glutathione S-transferase. Arch Biochem Biophys 1984; 230: 455–65 Lynch KR, O’Neill GP, Liu Q, et al. Characterization of the human cysteinyl leukotriene CysLT1 receptor. Nature 1999; 399: 789–93 Takasaki J, Kamohara M, Matsumoto M, et al. The molecular characterization and tissue distribution of the human cysteinyl leukotriene CysLT(2) receptor. Biochem Biophys Res Commun 2000; 274: 316–22 Lewis RA, Austen KF, Soberman RJ. Leukotrienes and other products of the 5-lipoxygenase pathway: biochemistry and relation to pathobiology in human diseases. N Engl J Med 1990; 323: 645–55 Holgate ST, Bradding P, Sampson AP. Leukotriene antagonists and synthesis inhibitors: new directions in asthma therapy. J Allergy Clin Immunol 1996; 98: 1–13 Kumlin M, Dahlen B, Bjorck T, et al. Urinary excretion of leukotriene E4 and 11-dehydro-thromboxane B2 in response to bronchial provocations with allergen, aspirin, leukotriene D4, and histamine in asthmatics. Am Rev Respir Dis 1992; 146: 96–103 Israel E, Fischer AR, Rosenberg MA, et al. The pivotal role of 5-lipoxygenase products in the reaction of aspirin-sensitive asthmatics to aspirin. Am Rev Respir Dis 1993; 148: 1447–51 Obase Y, Shimoda T, Tomari S, et al. Effects of pranlukast on aspirin-induced bronchoconstriction: differences in chemical mediators between aspirin-intolerant and tolerant asthmatic patients. Ann Allergy Asthma Immunol 2001; 87: 74–9 Antczak A, Montuschi P, Kharitonov S, et al. Increased exhaled cysteinyl-leukotrienes and 8-isoprostane in aspirin-induced asthma. Am J Respir Crit Care Med 2002; 166: 301–6 Dahlen B, Margolskee DJ, Zetterstrom O, et al. Effect of the leukotriene receptor antagonist MK-0679 on baseline pulmonary function in aspirin sensitive asthmatic subjects. Thorax 1993; 48: 1205–10 Pavord ID, Tattersfield AE. Bronchoprotective role for endogenous prostaglandin E2. Lancet 1995; 345: 436–8 Vane JR. Inhibition of prostaglandin synthesis as a mechanism of action for aspirin-like drugs. Nat New Biol 1971; 231: 232–5 Penrose JF, Baldasaro MH. Leukotriene C4 synthase: a candidate gene for the aspirin-intolerant asthmatic phenotype. Allergy Asthma Proc 1999; 20: 353–60 Sanak M, Simon HU, Szczeklik A. Leukotriene C4 synthase promoter polymorphism and risk of aspirin-induced asthma. Lancet 1997; 350: 1599–600 Sanak M, Pierzchalska M, Bazan Socha S, et al. Enhanced expression of the leukotriene C(4) synthase due to overactive transcription of an allelic variant associated with aspirin-intolerant asthma. Am J Respir Cell Mol Biol 2000; 23: 290–6 Van Sambeek R, Stevenson DD, Baldasaro M, et al. 5′ flanking region polymorphism of the gene encoding leukotriene C4 synthase does not correlate with the aspirin-intolerant asthma phenotype in the United States. J Allergy Clin Immunol 2000; 106: 72–6 Sanak M, Szczeklik A. Leukotriene C4 synthase polymorphism and aspirin-induced asthma. J Allergy Clin Immunol 2001; 107: 561–2 Asano K, Shiomi T, Hasegawa N, et al. Leukotriene C4 synthase gene A(−444)C polymorphism and clinical response to a CYS-LT(1) antagonist, pranlukast, in Japanese patients with moderate asthma. Pharmacogenetics 2002; 12: 565–70 Arm JP, O’Hickey SP, Spur BW, et al. Airway responsiveness to histamine and leukotriene E4 in subjects with aspirin-induced asthma. Am Rev Respir Dis 1989; 140: 148–53 Sousa AR, Parikh A, Scadding G, et al. Leukotriene-receptor expression on nasal mucosal inflammatory cells in aspirin-sensitive rhinosinusitis. N Engl J Med 2002; 347: 1493–9 Christie PE, Spur BW, Schmitz Schumann M, et al. Airway responsiveness to leukotriene C4 (LTC4), leukotriene E4 (LTE4) and histamine in aspirin-sensitive asthmatic subjects. Eur Respir J 1993; 6: 1468–73 Arm JP, Austen KF. Leukotriene receptors and aspirin sensitivity. N Engl J Med 2002; 347: 1524–6 Dworski R, Sheller JR. Urinary mediators and asthma. Clin Exp Allergy 1998; 28: 1309–12 Serhan CN, Oliw E. Unorthodox routes to prostanoid formation: new twists in cyclooxygenase-initiated pathways. J Clin Invest 2001; 107: 1481–9 Mitchell JA, Belvisi MG. Too many COX (cyclo-oxygenase) spoil the broth: aspirin-sensitive asthma and 5-lypoxygenase. Thorax 1997; 52: 933–5 Sanak M, Levy BD, Clish CB, et al. Aspirin-tolerant asthmatics generate more lipoxins than aspirin-intolerant asthmatics. Eur Respir J 2000; 16: 44–9 Levy BD, Devchand PR, De Sanctis GT, et al. Multi-pronged inhibition of airway hyper-responsiveness and inflammation by lipoxin A(4). Nat Med 2002; 8: 1018–23 Szczeklik A. Aspirin-induced asthma as a viral disease. Clin Allergy 1988; 18: 15–20 Levy M. Role of viral infections in the induction of adverse drug reactions. Drug Saf 1997; 16: 1–8 Yoshida S, Sakamoto H, Yamawaki Y, et al. Effect of acyclovir on bronchoconstriction and urinary leukotriene E4 excretion in aspirin-induced asthma. J Allergy Clin Immunol 1998; 102: 909–14 Lassalle P, Delneste Y, Gosset P, et al. T and B cell immune response to a 55-kDa endothelial cell-derived antigen in severe asthma. Eur J Immunol 1993; 23: 796–803 Szczeklik A, Musial J, Pulka G. Autoimmune vasculitis and aortic stenosis in aspirin-induced asthma (AIA). Allergy 1997; 52: 352–4 Szczeklik A, Nizankowska E, Schmitz Schumann M, et al. Altered distribution of IgG subclasses in aspirin-induced asthma: high IgG4, low IgG1. Clin Exp Allergy 1992; 22: 283–7 Dekker JW, Nizankowska E, Schmitz Schumann M, et al. Aspirin-induced asthma and HLA-DRB1 and HLA-DPB1 genotypes. Clin Exp Allergy 1997; 27: 574–7 Global initiative for asthma. Global strategy for asthma management and prevention: a practical guide for public health officials and health care professionals. Bethesda (MD): NIH Publication No. 02-3659 2002 Drazen JM, Israel E, O’Byrne PM. Treatment of asthma with drugs modifying the leukotriene pathway. N Engl J Med 1999; 340: 197–206 Lipworth BJ. Leukotriene-receptor antagonists. Lancet 1999; 353: 57–62 Babu KS, Salvi SS. Aspirin and asthma. Chest 2000; 118: 1470–6 Dahlen B, Nizankowska E, Szczeklik A, et al. Benefits from adding the 5-lipoxygenase inhibitor zileuton to conventional therapy in aspirin-intolerant asthmatics. Am J Respir Crit Care Med 1998; 157: 1187–94 Sebaldt RJ, Sheller JR, Oates JA, et al. Inhibition of eicosanoid biosynthesis by glucocorticoids in humans. Proc Natl Acad Sci U S A 1990; 87: 6974–8 Tomari S, Matsuse H, Machida I, et al. Pranlukast, a cysteinyl leukotoriene receptor 1 antagonist, atenuates allergen specific TNF-alpha production and NF-kappaB nuclear translocation in peripheral blood monocytes from atopic asthmatics Clin Exp Allergy 2003 Jun; 33(6): 795–801 Manso G, Baker AJ, Taylor IK, et al. In vivo and in vitro effects of glucocorticosteroids on arachidonic acid metabolism and monocyte function in nonasthmatic humans. Eur Respir J 1992; 5: 712–6 O’Shaughnessy KM, Wellings R, Gillies B, et al. Differential effects of fluticasone propionate on allergen-evoked bronchoconstriction and increased urinary leukotriene E4 excretion. Am Rev Respir Dis 1993; 147: 1472–6 Dworski R, Fitzgerald GA, Oates JA, et al. Effect of oral prednisone on airway inflammatory mediators in atopic asthma. Am J Respir Crit Care Med 1994; 149: 953–9 Aksoy MO, Li X, Borenstein M, et al. Effects of topical corticosteroids on inflammatory mediator-induced eicosanoid release by human airway epithelial cells. J Allergy Clin Immunol 1999; 103: 1081–91 Tomari S, Shimoda T, Kawano T, et al. Effects of pranlukast, a cysteinyl leukotriene receptor 1 antagonist, combined with inhaled beclomethasone in patients with moderate or severe asthma. Ann Allergy Asthma Immunol 2001; 87: 156–61 Dahlen B. Treatment of aspirin-intolerant asthma with antileukotrienes. Am J Respir Crit Care Med 2000; 161: S137–41 Dahlen SE, Malmstrom K, Nizankowska E, et al. Improvement of aspirin-intolerant asthma by montelukast, a leukotriene antagonist: a randomized, double-blind, placebo-controlled trial. Am J Respir Crit Care Med 2002; 165: 9–14 Dahlen B, Nizankowska E, Szczeklik A. Benefits from adding the 5-lipoxgenase inhibitor zileuton to conventional therapy in aspirin-intolerant asthmatics. Am J Respirt Crit Care Med 1998; 157: 1187–94 Ragab S, Parikh A, Darby YC, et al. An open audit of montelukast, a leukotriene receptor antagonist, in nasal polyposis associated with asthma. Clin Exp Allergy 2001; 31: 1385–91 Mastalerz L, Nizankowska E, Sanak M, et al. Clinical and genetic features underlying the response of patients with bronchial asthma to treatment with a leukotriene receptor antagonist. Eur J Clin Invest 2002; 32: 949–55 Mastalerz L, Nizankowska E, Gawlewicz Mroczka A, et al. Protection against exercise-induced bronchoconstriction by montelukast in aspirin-sensitive and aspirin-tolerant patients with asthma. Clin Exp Allergy 2002; 32: 1360–5 NAEPP Expert Panel. Guidelines for the Diagnosis and Management of Asthma: Update on Selected Topics 2002. Bethesda (MD): National Institutes of Health 1997; NIH publication no. 97-4051 Demoly P, Jaffuel D, Mathieu M, et al. Glucocorticoid insensitive asthma: a one year clinical follow up pilot study. Thorax 1998; 53: 1063–5 Greening AP, Ind PW, Northfield M, et al. Added salmeterol versus higher-dose corticosteroid in asthma patients with symptoms on existing inhaled corticosteroid. Allen & Hanburys Limited UK Study Group. Lancet 1994; 344: 219–24 Woolcock A, Lundback B, Ringdal N, et al. Comparison of addition of salmeterol to inhaled steroids with doubling of the dose of inhaled steroids. Am J Respir Crit Care Med 1996; 153: 1481–8 Pauwels RA, Lofdahl CG, Postma DS, et al. Effect of inhaled formoterol and budesonide on exacerbations of asthma: Formoterol and Corticosteroids Establishing Therapy (FACET) International Study Group. N Engl J Med 1997; 337: 1405–11 Wechsler ME, Garpestad E, Flier SR, et al. Pulmonary infiltrates, eosinophilia, and cardiomyopathy following corticosteroid withdrawal in patients with asthma receiving zafirlukast. JAMA 1998; 279: 455–7 Guilpain P, Viallard JF, Lagarde P, et al. Churg-Strauss syndrome in two patients receiving montelukast. Rheumatology (Oxford) 2002; 41: 535–9 Churg J, Churg A. Zafirlukast and Churg-Strauss syndrome. JAMA 1998; 279: 1949–50 Green RL, Vayonis AG. Churg-Strauss syndrome after zafirlukast in two patients not receiving systemic steroid treatment. Lancet 1999; 353: 725–6 Bianco S, Robuschi M, Petrigni G, et al. Efficacy and tolerability of nimesulide in asthmatic patients intolerant to aspirin. Drugs 1993; 46 Suppl. 1: 115–20 Kosnik M, Music E, Matjaz F, et al. Relative safety of meloxicam in NSAID-intolerant patients. Allergy 1998; 53: 1231–3 Szczeklik A, Nizankowska E, Bochenek G, et al. Safety of a specific COX-2 inhibitor in aspirin-induced asthma. Clin Exp Allergy 2001; 31: 219–25 Gyllfors P, Bochenek G, Overholt J, et al. Biochemical and clinical evidence that aspirin-intolerant ashtmatic subjects tolerate that cyclooxygenase 2-selective analgetic drug celecoxib. J Allergy Clin Immunol 2003; 111: 142 Martin-Garcia C, Hinojosa M, Berges P, et al. Safety of a cyclooxygenase-2 inhibitor in patients with aspirin-sensitive asthma. Chest 2002; 121: 1812–7 Woessner KM, Simon RA, Stevenson DD. The safety of celecoxib in patients with aspirin-sensitive asthma. Arthritis Rheum 2002; 46: 2201–6 Walenga RW, Kester M, Coroneos E, et al. Constitutive expression of prostaglandin endoperoxide G/H synthetase (PGHS)-2 but not PGHS-1 in human tracheal epithelial cells in vitro. Prostaglandins 1996; 52: 341–59 Tocco G, Freire Moar J, Schreiber SS, et al. Maturational regulation and regional induction of cyclooxygenase-2 in rat brain: implications for Alzheimer’s disease. Exp Neurol 1997; 144: 339–49 Zimmermann KC, Sarbia M, Schror K, et al. Constitutive cyclooxygenase-2 expression in healthy human and rabbit gastric mucosa. Mol Pharmacol 1998; 54: 536–40 Petkova DK, Pang L, Range SP, et al. Immunocytochemical localization of cyclo-oxygenase isoforms in cultured human airway structural cells. Clin Exp Allergy 1999; 29: 965–72 Langenbach R, Morham SG, Tiano HF, et al. Prostaglandin synthase 1 gene disruption in mice reduces arachidonic acid-induced inflammation and indomethacin-induced gastric ulceration. Cell 1995; 83: 483–92 Fitzgerald GA. Coxibs and cardiovascular disease. N Engl J Med 2004; 21(351): 1709–11 Settipane RA, Schrank PJ, Simon RA, et al. Prevalence of cross-sensitivity with acetaminophen in aspirin-sensitive asthmatic subjects. J Allergy Clin Immunol 1995; 96: 480–5 Chandrasekharan NV, Dai H, Roos KL, et al. COX-3, a cyclooxygenase-1 variant inhibited by acetaminophen and other analgesic/antipyretic drugs: cloning, structure, and expression. Proc Natl Acad Sci U S A 2002; 99: 13926–31 Babu KS, Salvi SS. Aspirin and asthma. Chest 2000; 118: 1470–6 Chiu JT. Improvement in aspirin-sensitive asthmatic subjects after rapid aspirin desensitization and aspirin maintenance (ADAM) treatment. J Allergy Clin Immunol 1983; 71: 560–7 Sweet JM, Stevenson DD, Simon RA, et al. Long-term effects of aspirin desensitization: treatment for aspirin-sensitive rhinosinusitis-asthma. J Allergy Clin Immunol 1990; 85: 59–65 Berges Gimeno MP, Simon RA, Stevenson DD. Long-term treatment with aspirin desensitization in asthmatic patients with aspirin-exacerbated respiratory disease. J Allergy Clin Immunol 2003; 111: 180–6 Schaefer OP, Gore JM. Aspirin sensitivity: the role for aspirin challenge and desensitization in postmyocardial infarction patients. Cardiology 1999; 91: 8–13 Szmidt M, Grzelewska Rzymowska I, Rozniecki J. Tolerance to aspirin in aspirin-sensitive asthmatics: methods of inducing the tolerance state and its influence on the course of asthma and rhinosinusitis. J Investig Allergol Clin Immunol 1993; 3: 156–9 Pleskow WW, Stevenson DD, Mathison DA, et al. Aspirin desensitization in aspirin-sensitive asthmatic patients: clinical manifestations and characterization of the refractory period. J Allergy Clin Immunol 1982; 69: 11–9 Juergens UR, Christiansen SC, Stevenson DD, et al. Inhibition of monocyte leukotriene B4 production after aspirin desensitization. J Allergy Clin Immunol 1995; 96: 148–56 Nasser SM, Patel M, Bell GS, et al. The effect of aspirin desensitization on urinary leukotriene E4 concentrations in aspirin-sensitive asthma. Am J Respir Crit Care Med 1995; 151: 1326–30 Szczeklik A, Nizankowska E, Czerniawska Mysik G, et al. Hydrocortisone and airflow impairment in aspirin-induced asthma. J Allergy Clin Immunol 1985; 76: 530–6 Nakamura H, Matsuse H, Obase Y, et al. Clinical evaluation of anaphylactic reactions to intravenous corticosteroids in adult asthmatics. Respiration 2002; 69: 309–13 Goldstein DA, Zimmerman B, Spielberg SP. Anaphylactic response to hydrocortisone in childhood: a case report. Ann Allergy 1985; 55: 599–600 Preuss L. Allergic reactions to systemic glucocorticoids: a review. Ann Allergy 1985; 55: 772–5 Feigenbaum BA, Stevenson DD, Simon RA. Hydrocortisone sodium succinate does not cross-react with aspirin in aspirin-sensitive patients with asthma. J Allergy Clin Immunol 1995; 96: 545–8 Comaish S. A case of hypersensitivity to corticosteroids. Br J Dermatol 1969; 81: 919–25