Nasal Polyposis and Aspirin-Exacerbated Respiratory Disease

Immunol Allergy Clin North Am. 2020 May;40(2):329-343. doi: 10.1016/j.iac.2019.12.002. Epub 2020 Jan 27.

Abstract

Aspirin-exacerbated respiratory disease (AERD) is characterized by eosinophilic chronic rhinosinusitis with nasal polyps, asthma, and upper-/lower-respiratory tract reactions to nonsteroidal antiinflammatory drugs. Persistent, severe disease, anosmia, and alcohol sensitivity is typical. AERD is mediated by multiple pathways, including aberrant arachidonic acid metabolism leading to elevated leukotriene E4 and decreased prostaglandin E2. Mast cell mediators (prostaglandin D2) and unique properties of eosinophils and type 2 innate lymphoid cells, along with receptor-mediated signaling, also contribute to AERD pathogenesis. Pharmacologic therapies are a cornerstone of AERD treatment and include leukotriene modifiers, corticosteroids, biologics, and aspirin.

Keywords: AERD; Aspirin; Exacerbated; Nasal; Polyp; Respiratory; disease.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Anosmia
  • Aspirin / therapeutic use*
  • Asthma, Aspirin-Induced / diagnosis
  • Asthma, Aspirin-Induced / therapy*
  • Biological Products / therapeutic use*
  • Humans
  • Immunity, Innate
  • Leukotriene Antagonists / therapeutic use*
  • Nasal Polyps / diagnosis
  • Nasal Polyps / therapy*
  • Th2 Cells / immunology*

Substances

  • Adrenal Cortex Hormones
  • Biological Products
  • Leukotriene Antagonists
  • Aspirin