Aspirin intolerance and the cyclooxygenase-leukotriene pathways.

Abstract

PURPOSE OF REVIEW:

In up to 10% of patients with bronchial asthma, aspirin and other nonsteroidal antiinflammatory drugs precipitate asthmatic attacks. This is a hallmark of a distinct clinical syndrome that develops according to a characteristic sequence of symptoms. Here we discuss its clinical picture and management as related to the abnormalities in arachidonic acid transformations.

RECENT FINDINGS:

At the biochemical level, the characteristic feature is profound alteration in eicosanoid biosynthesis and metabolism. Major advances in the molecular biology of eicosanoids, exemplified by the cloning of cysteinyl-leukotriene receptors and discovery of a whole family of cyclooxygenase enzymes, offer new insights into mechanisms operating in aspirin-induced asthma. Clinical interest has been enhanced by the introduction into therapy of highly specific cyclooxygenase-2 inhibitors and antileukotriene drugs.

SUMMARY:

Recent studies have improved our understanding of mechanisms operating in asthma and unvieled the role of eicosanoid mediators in pulmonary disease.

• Authors: Andrew Szczeklik, Marek Sanak, Ewa Nizankowska-Mogilnicka, Bogumila Kiełbasa
• Journal: Current opinion in pulmonary medicine (Curr Opin Pulm Med) Vol. 10 Issue 1 Pg. 51-6 (Jan 2004) ISSN: 1070-5287 [Print] United States
• PMID: 14749606 (Publication Type: Journal Article, Review)

Chemical References

• Cyclooxygenase 2 Inhibitors
• Cyclooxygenase Inhibitors
• Isoenzymes
• Leukotrienes
• Lipoxins
• Membrane Proteins
• Cyclooxygenase 2
• PTGS2 protein, human
• Prostaglandin-Endoperoxide Synthases
• Aspirin

Topics

• Aspirin (adverse effects)
• Asthma (chemically induced, diagnosis, drug therapy, epidemiology, physiopathology)
• Cyclooxygenase 2
• Cyclooxygenase 2 Inhibitors
• Cyclooxygenase Inhibitors (adverse effects)
• Desensitization, Immunologic
• Humans
• Isoenzymes (antagonists & inhibitors)
• Leukotrienes (metabolism)
• Lipoxins (physiology)
• Mast Cells (physiology)
• Membrane Proteins
• Prostaglandin-Endoperoxide Synthases
• Rhinitis (epidemiology)
• Sinusitis (epidemiology)