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Aspirin-Intolerant Asthma: A Comprehensive Review of Biomarkers and Pathophysiology

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Abstract

Aspirin-exacerbated respiratory disease is a tetrad of nasal polyps, chronic hypertrophic eosinophilic sinusitis, asthma, and sensitivity to aspirin. Unawareness of this clinical condition by patients and physicians may have grave consequences because of its association with near-fatal asthma. The pathogenesis of aspirin-intolerant asthma is not related with an immunoglobin E mechanism, but with an abnormal metabolism of the lipoxygenase (LO) and cyclooxygenase (COX) pathways. At present, a diagnosis of aspirin sensitivity can be established only by provocative aspirin challenge, which represents a health risk for the patient. This circumstance has encouraged the search for aspirin intolerance-specific biomarkers. Major attempts have focused on mediators related with inflammation and eicosanoid regulation. The use of modern laboratory techniques including high-throughput methods has facilitated the detection of dozens of biological metabolites associated with aspirin-intolerant asthma disease. Not surprisingly, the majority of these is implicated in the LO and COX pathways. However, substantial amounts of data reveal the participation of many genes deriving from different ontologies. Biomarkers may represent a powerful, noninvasive tool in the diagnosis of aspirin sensitivity; moreover, they could provide a new way to classify asthma phenotypes.

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Acknowledgments

This work was supported by the Mexican National Council of Science and Technology (CONACyT-México) grant no. 160489. The style review of the manuscript by Maggie Brunner, M.A., is greatly appreciated.

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  1. Departamento de Inmunogenética y Alergia, Instituto Nacional de Enfermedades Respiratorias (INER), Mexico City, Mexico

    Juan R. Velazquez & Luis M. Teran

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Correspondence to Juan R. Velazquez.

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Velazquez, J.R., Teran, L.M. Aspirin-Intolerant Asthma: A Comprehensive Review of Biomarkers and Pathophysiology. Clinic Rev Allerg Immunol 45, 75–86 (2013). https://doi.org/10.1007/s12016-012-8340-0

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