ASPIRIN-EXACERBATED RESPIRATORY DISEASE: MECHANISMS OF DEVELOPMENT, DIAGNOSTICS AND TREATMENT


DOI: https://dx.doi.org/10.18565/pharmateca.2018.8.24-33

I.I. Vorzheva, B.A. Chernyak

Irkutsk State Medical Academy of Postgraduate Education – Branch of the Russian State Medical Academy of Postgraduate Education “Russian Medical Academy of Continuous Professional Education” of the Ministry of Health of the Russian Federation (ISMAPGE – Branch of the RMACPE of the Ministry of Health of the Russian Federation), Irkutsk, Russia
Aspirin-exacerbated respiratory disease (AERD) most often includes a triad of symptoms: bronchial asthma, rhinosinusitis polyposa, hypersensitivity to acetylsalicylic acid and non-steroidal anti-inflammatory drugs. There are also variants of AERD, limited only to the involvement of the upper respiratory tract. AERD is a multifactorial pathology; lipid mediators, imbalance of congenital and adaptive immune responses, dysfunction of the epithelial barrier, and various external factors play a role in its development. Characteristic features of AERD include T2-endotypes of inflammation, as well as pronounced eosinophilic infiltration of the upper and lower respiratory tract. Diagnosis is based on anamnestic and clinical signs; in the absence of a typical medical history, the diagnosis is confirmed by aspirin provocation test. Treatment includes anti-inflammatory drugs (corticosteroids, anti-leukotriene drugs), exclusion/restriction of triggers and desensitization with aspirin according to strict indications, as well as a new direction – targeted therapy with biological preparations.
Keywords: aspirin-exacerbated respiratory disease, aspirin-sensitive bronchial asthma, rhinosinusitis polyposa, T2-endotypes of inflammation, treatment of eosinophilic asthma and rhinosinusitis polyposa

About the Autors


Corresponding author: B.A. Chernyak – MD, Prof., Head of the Department of clinical Allergology and Pulmonology, Irkutsk State Medical Academy of Postgraduate Education – Branch of the Russian State Medical Academy of Postgraduate Education “Russian Medical Academy of Continuous Professional Education” of the Ministry of Health of the Russian Federation, Irkutsk, Russia; e-mail: ba.chernyak@gmail.com


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