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


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Abstract

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.

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About the authors

I. I Vorzheva

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

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

Email: ba.chernyak@gmail.com
MD, Prof., Head of the Department of clinical Allergology and Pulmonology

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