Chronic Rhinosinusitis and Aspirin-Exacerbated Respiratory Disease

Dunn, Neha M.; Katial, Rohit

doi:10.1016/j.iac.2016.03.011

Cited by 6 publications

(8 citation statements)

References 92 publications

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“…Sinus surgery to treat CRSwNP should be considered when medical treatment fails [16]. The goals of surgery are the improvement of nasal obstructive symptoms with reduced rhinorrhea and postnasal discharge; the achievement of a stable and sustained improvement of smell; and finally, a better control of bronchial asthma [168]. The surgical procedures most frequently used are polypectomy, endoscopic sinus surgery, and ethmoidectomy [7].…”

Section: Surgerymentioning

confidence: 99%

Aspirin exacerbated respiratory disease: Current topics and trends

Rodríguez-Jiménez

Moreno-Paz

Terán

et al. 2018

Respiratory Medicine

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Aspirin-exacerbated respiratory disease is a chronic and treatment-resistant disease, characterized by the presence of eosinophilic rhinosinusitis, nasal polyposis, bronchial asthma, and nonsteroidal anti-inflammatory drugs hypersensitivity. Alterations in arachidonic acid metabolism may induce an imbalance between pro-inflammatory and anti-inflammatory substances, expressed as an overproduction of cysteinyl leukotrienes and an underproduction of prostaglandin E2. Although eosinophils play a key role, recent studies have shown the importance of other cells and molecules in the development of the disease like mast cells, basophils, lymphocytes, platelets, neutrophils, macrophages, epithelial respiratory cells, IL-33 and thymic stromal lymphopoietin, making each of them promissory diagnostic and treatment targets. In this review, we summarize the most important clinical aspects of the disease, including the current topics about diagnosis and treatment, like provocation challenges and aspirin desensitization. We also discuss recent findings in the pathogenesis of the disease, as well as future trends in diagnosis and treatment, including monoclonal antibodies and a low salicylate diet as a treatment option.

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Section: Surgerymentioning

confidence: 99%

Aspirin exacerbated respiratory disease: Current topics and trends

Rodríguez-Jiménez

Moreno-Paz

Terán

et al. 2018

Respiratory Medicine

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“…Despite the significant importance of disturbances in the metabolism of arachidonic acid leading to the overproduction of proinflammatory CysLTs, drugs blocking receptor or leukotriene C4 synthase (LTC4S) are not recommended [1]. This is in contradiction with reports from the literature [3, 6, 8, 12, 16]. The last update of the ARIA document (Allergic Rhinitis and its Impact on Asthma) from 2016 allows to use antileukotrienes (LTRAs) as a supplement to therapy, especially in patients with asthma, in the case of seasonal allergic rhinitis [22].…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, Gudziol et al [23], based on their own research, suggest that patients with CRSwNP and hypersensitivity to NSAIDs have an impaired sense of smell significantly more often than patients with CRSwNP but without NSAID hypersensitivity. Several studies have shown that greater olfactory disturbances indicate greater sinonasal disease and correlate with the degree of inflammation in patients with CRSwNP [3]. Based on the literature review, Levy et al [8] recommend 6-week LTRA administration to patients with polyps and NERD.…”

Section: Discussionmentioning

confidence: 99%

“…Among Caucasians, inflammation with a predominance of Th2 cytokines (IL-4, IL-5, IL-13) and greater numbers of eosinophils, mastocytes, B lymphocytes, and neutrophils in tissues are observed in CRSwNP. Epithelial cytokines such as thymic stromal lymphopoietin, IL-25, and IL-33 support Th2-type inflammation by directly activating innate lymphoid cells-2, which are the source of IL-4, IL-5, IL-9, and IL-13 [3, 4]. Inflammation with a predominance of IL-5 and eosinophilic infiltrates is associated with a severer clinical course, and CRS is often accompanied by bronchial asthma.…”

Section: Introductionmentioning

confidence: 99%

“…Inflammation with a predominance of IL-5 and eosinophilic infiltrates is associated with a severer clinical course, and CRS is often accompanied by bronchial asthma. In the CRSsNP phenotype, the incidence of asthma is approximately 18%, whereas in CRSwNP it is 45–65% [3]. Eosinophilic CRSwNP with coexisting bronchial asthma and hypersensitivity to non-steroidal anti-inflammatory drugs (NSAIDs) is characterized by a higher CT sinus score, multiple sinus reoperations and more frequent use of systemic steroids, constituting a real therapeutic challenge [3, 5-7].…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Antileukotrienes on the Results of Postoperative Treatment of Paranasal Sinuses in Patients with Non-Steroidal Anti-Inflammatory Drug-Exacerbated Respiratory Disease

Stryjewska-Makuch¹,

Humeniuk-Arasiewicz²,

Jura-Szołtys³

et al. 2019

Int Arch Allergy Immunol

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Background: Based on endoscopic examination, chronic rhinosinusitis (CRS) is divided into chronic inflammation with (CRSwNP) or without nasal polyps (CRSsNP). On the basis of the pathomechanism of inflammation, CRS is divided into endotypes. Eosinophilic CRSwNP with coexisting bronchial asthma and hypersensitivity to non-steroidal anti-inflammatory drugs (NSAIDs) is a real therapeutic challenge. Aim: Comparative analysis of the results of treatment of patients with CRSwNP, bronchial asthma, or hypersensitivity to NSAIDs (NSAID-exacerbated respiratory disease, NERD), using antileukotrienes (leukotriene receptor antagonists, LTRAs) or intranasal glucocorticoids or both drugs together after endoscopic sinus surgery (ESS). Material and Methods: 33 patients (11 male, 33%) with NERD divided into three groups treated with LTRAs or intranasal glucocorticoids or both drugs together were assessed in terms of general well-being, state of pathological changes, and olfactory disorders using the following tools: Sino-Nasal Outcome Test, Visual Analogue Scale, Brief Identification Smell Test, and Lund-Kennedy score before and at 12 months after surgery. CT assessments were made prior to surgery using the Lund-MacKay scale. Results: Comparable efficacy of treatment with nasal steroids and antileukotrienes was found after 12 months of observation of patients. Conclusions: The results suggest comparable efficacy of treatment with nasal steroids and antileukotrienes in patients with NERD after ESS. Treatment with montelukast and mometasone has not been shown to be superior to both drugs administered separately.

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