Heterogeneity of lower airway inflammation in patients with NSAID-exacerbated respiratory disease

Jakieła, Bogdan; Soja, Jerzy; Sładek, Krzysztof; Przybyszowski, Marek; Plutecka, Hanna; Gielicz, Anna; Rebane, Ana; Bochenek, Grażyna

doi:10.1016/j.jaci.2020.08.007

Cited by 21 publications

(22 citation statements)

References 51 publications

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“…In support of this, AERD patients clinically respond to type-2 biologics 94,95 and, in some studies, even more so than patients with CRSwNP 96 . As with observations in CRSwNP and CRSsNP, Type 1 and type 3 endotypes have recently been described in AERD 93,97 . A dysregulation of arachidonic acid metabolism uniquely distinguishes pathogenesis of AERD from CRSwNP.…”

Section: Aerd As An Informative Phenotypic Variantsupporting

confidence: 80%

Endotypes of Chronic Rhinosinusitis; relationships to disease phenotypes, pathogenesis, clinical findings and treatment approaches.

Kato¹,

Peters²,

Stevens³

et al. 2021

Preprint

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Chronic rhinosinusitis (CRS) is a common clinical syndrome that produces significant morbidity and costs to our health system. The study of CRS has progressed from an era focused on phenotype to include endotype based information. Phenotypic classification has identified clinical heterogeneity in CRS based on endoscopically observed features such as presence of nasal polyps, presence of comorbid or systemic diseases and timing of disease onset. More recently, laboratory-based findings have established CRS endotype based upon specific mechanisms or molecular biomarkers. Understanding the basis of widespread heterogeneity in the manifestations of CRS is advanced by findings that the three main endotypes, Type 1, 2 and 3, orchestrate the expression of three distinct large sets of genes. The development and use of improved methods of endotyping disease in the clinic is ushering in an expansion of the use of biological therapies targeting Type 2 inflammation now and perhaps other inflammatory endotypes in the near future. The purpose of this review is to discuss the phenotypic and endotypic heterogeneity of CRS from the perspective of advancing the understanding of the pathogenesis and improvement of treatment approaches and outcomes.

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Section: Aerd As An Informative Phenotypic Variantsupporting

confidence: 80%

Endotypes of Chronic Rhinosinusitis; relationships to disease phenotypes, pathogenesis, clinical findings and treatment approaches.

Kato¹,

Peters²,

Stevens³

et al. 2021

Preprint

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show abstract

“…Recently, some studies have shown that the type of inflammation varies between NERD patients ( 27 , 28 ). Due to the study design, we did not register blood eosinophilia, prick test or serum immunoglobulin E (IgE) positivity.…”

Section: Discussionmentioning

confidence: 99%

Patient-Reported Control of Asthma, Nasal Polyposis, and Middle-Ear Symptoms in NSAID-Exacerbated Respiratory Disease

et al. 2021

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Non-steroidal anti-inflammatory drug (NSAID)—exacerbated respiratory disease (NERD) is an adult-onset inflammatory condition of the upper and lower airways. It is characterized by the co-existence of asthma, nasal polyposis, and hypersensitivity to NSAIDs. Over one-fourth of patients also have symptoms of chronic middle-ear infection. The clinical course of NERD is often severe and generally requires multimodal treatment with recurrent surgical measures. Studies presenting the disease burden and subjective symptom control of NERD are limited. In this qualitative questionnaire study, we present the clinical characteristics of asthma, nasal polyposis, NSAID intolerance and possible recurrent or chronic middle-ear infection of 66 confirmed NERD patients treated at our tertiary referral center between January 2016 and May 2017. Additionally, we present the patient-reported disease control of asthma, nasal polyposis, and middle-ear symptoms on a four-category Likert scale. The proportion of NERD patients with recurrent or chronic middle-ear infection was 18%. The proportion of good or very good subjective disease control was 83% for asthma, 58% for nasal polyposis, and 33% for chronic middle-ear infection, if present. Chronic middle-ear infection is common among NERD patients and should more often be recognized as part of the entity. Together with nasal polyposis, chronic middle-ear infection seems to affect patients more than asthma. The patient's perspective of disease control should be considered when planning the interdisciplinary follow-up and treatment of NERD.

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“…8,9 Similarly, some patients with AERD have a non-type 2 inflammatory profile with enhanced numbers of neutrophils and reduced eosinophils. 7,10,11 Higher levels of IFN-g have also been reported in NPs of a subset of patients with AERD. 7,12 Why certain patients develop a type 2 versus a non-type 2 inflammatory endotype remains unknown.…”

Section: Eosinophilsmentioning

confidence: 92%

Innate immune cell dysregulation drives inflammation and disease in aspirin-exacerbated respiratory disease

Eid

Yan

Stevens

et al. 2021

Journal of Allergy and Clinical Immunology

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Heterogeneity of lower airway inflammation in patients with NSAID-exacerbated respiratory disease

Cited by 21 publications

References 51 publications

Endotypes of Chronic Rhinosinusitis; relationships to disease phenotypes, pathogenesis, clinical findings and treatment approaches.

Endotypes of Chronic Rhinosinusitis; relationships to disease phenotypes, pathogenesis, clinical findings and treatment approaches.

Patient-Reported Control of Asthma, Nasal Polyposis, and Middle-Ear Symptoms in NSAID-Exacerbated Respiratory Disease

Innate immune cell dysregulation drives inflammation and disease in aspirin-exacerbated respiratory disease

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