Sputum biomarkers during aspirin desensitization in nonsteroidal anti-inflammatory drugs exacerbated respiratory disease.

Abstract

BACKGROUND:

Aspirin desensitization (AD) is an effective and safe therapeutic option for patients with nonsteroidal anti-inflammatory drugs (NSAIDs)-exacerbated respiratory disease (N-ERD). The mechanisms driving its beneficial effects remain poorly understood.

OBJECTIVE:

To investigate the effect of long-term AD on clinical, biochemical and radiological changes in N-ERD patients.

METHODS:

The study group consisted of twenty-three individuals with N-ERD who underwent AD, followed by ingestion of 325 mg aspirin twice daily. Twenty patients completed the 52 weeks of AD. The following evaluations were conducted at baseline and in the 52nd week of AD: (i) clinical: asthma exacerbations, Asthma Control Test (ACT), Visual Analogue Scale (VAS) for the assessment of nasal symptoms; (ii) blood and induced sputum supernatant (ISS) periostin, (iii) phenotypes based on induced sputum (IS) cells, (iiii) ISS and nasal lavage (NL) concentration of prostaglandin D2 (PGD2), prostaglandin E2 (PGE2), tetranor-PGD-M, tetranor-PGE-M, 8-iso-PGE2, leukotriene B4 (LTB4), LTC4, LTD4 and LTE4, and urine LTE4.

RESULTS:

A significant improvement was observed in ACT (P = 0.02) and VAS score (P = 0.008) in the 52nd week of AD. ISS periostin and IS eosinophil count decreased significantly in the 52nd week of AD (P = 0.04 and P = 0.01, respectively). ISS and NL eicosanoid concentrations did not change following long-term AD.

CONCLUSION:

and Clinical Relevance: AD is associated with a decrease in sputum periostin biosynthesis, which may prevent the recruitment of eosinophils into respiratory tissue and be one of explanation of the clinical benefits of AD. Long-term aspirin administration does not lead to an imbalance between pro- and anti-inflammatory ISS eicosanoids.

• Authors: Katarzyna Ewa Tyrak, Izabela Kupryś-Lipińska, Ewa Czarnobilska, Bogdan Jakieła, Kinga Pajdzik, Adam Ćmiel, Hanna Plutecka, Mateusz Koziej, Aleksandra Gawrońska, Ewa Konduracka, Piotr Kuna, Marek Sanak, Lucyna Mastalerz
• Journal: Respiratory medicine (Respir Med) Vol. 152 Pg. 51-59 (06 2019) ISSN: 1532-3064 [Electronic] England
• PMID: 31128610 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2019 Elsevier Ltd. All rights reserved.

Chemical References

• Anti-Inflammatory Agents, Non-Steroidal
• Biomarkers
• Carrier Proteins
• Cell Adhesion Molecules
• Eicosanoids
• Lipoproteins
• POSTN protein, human
• SEC14L2 protein, human
• Trans-Activators
• Aspirin

Topics

• Adult
• Aged
• Anti-Inflammatory Agents, Non-Steroidal (administration & dosage, adverse effects, therapeutic use)
• Aspirin (administration & dosage, adverse effects, therapeutic use)
• Asthma (chemically induced, metabolism, physiopathology)
• Biomarkers (blood, urine)
• Carrier Proteins (metabolism)
• Cell Adhesion Molecules (blood, drug effects)
• Desensitization, Immunologic (methods)
• Eicosanoids (metabolism)
• Eosinophils (drug effects)
• Female
• Humans
• Lipoproteins (metabolism)
• Male
• Middle Aged
• Nasal Lavage Fluid (immunology)
• Prospective Studies
• Respiration Disorders (chemically induced, immunology)
• Sputum (metabolism)
• Symptom Flare Up
• Trans-Activators (metabolism)
• Visual Analog Scale