Non-steroidal anti-inflammatory drug hypersensitivity in adults and the factors associated with asthma

Karakaya, Gül; Çelebioğlu, Ebru; Kalyoncu, Alı Fuat

doi:10.1016/j.rmed.2013.03.014

Cited by 23 publications

(19 citation statements)

References 28 publications

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“…NSAIDs are well-recognized as a cause of adverse drug reactions in general [1], and are also the second-most reported cause of drug hypersensitivity (HS) reactions after betalactam antibiotics (BL) [2], and even constitute the first cause according to certain recent studies [3,4,5]. The reported NSAID HS prevalence ranges from 0.6 to 2.5% in the general population, being higher among females, patients with chronic urticaria, and asthmatics [6,7,8,9,10,11]. Atopy has also been described as a risk factor for NSAID HS [5,12,13].…”

Section: Introductionmentioning

confidence: 99%

Hypersensitivity Reactions to Nonsteroidal Anti-Inflammatory Drugs among Adults: Clinical Features and Risk Factors for Diagnosis Confirmation

Gomes

Geraldes²,

Gáspár³

et al. 2016

Int Arch Allergy Immunol

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Background: Nonsteroidal anti-inflammatory drugs (NSAIDS) are among the most common causes of drug hypersensitivity (HS) reactions. The diagnosis is based on a careful clinical history, and provocation tests are considered the gold standard for diagnosis. Skin tests have some value to study reactions to pyrazolones. Laboratory investigations are mostly used for research purposes. Different phenotypes have been described. Objective and Methods: Our aim was to describe the most common clinical manifestations of NSAID HS in a large population of adult patients, the drugs involved, the association with previously described risk factors, and the outcome of diagnostic procedures. The classification of reactions proposed by the European Academy of Allergy and Clinical Immunology (EAACI) Drug Allergy Interest Group was adopted. Results: Acetylsalicylic acid was the drug most often involved in reactions (34%), isolated cutaneous symptoms were the most reported (60%), and immediate reactions (58%) were the most common. There was an overall female predominance (64%) and 35% of the patients were atopic. HS to NSAIDs was confirmed in 21% of the patients. The most common phenotypes encountered among HS patients were NSAID-induced urticaria/angioedema and single-NSAID-induced urticaria/angioedema or anaphylaxis. Logistic regression analysis showed that gender and atopy were not significant risk factors for HS confirmation, but diagnosis depended on the number of previous reactions, the type of reaction, and the time interval between drug intake and reaction. Conclusion: Only 21% of suspected HS reactions were confirmed after diagnostic workup. Patients describing >1 previous reaction and suffering immediate reactions had a higher probability of a positive investigation.

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Section: Introductionmentioning

confidence: 99%

Hypersensitivity Reactions to Nonsteroidal Anti-Inflammatory Drugs among Adults: Clinical Features and Risk Factors for Diagnosis Confirmation

Gomes

Geraldes²,

Gáspár³

et al. 2016

Int Arch Allergy Immunol

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“…12 Studies indicate that during inflammation, lung epithelial cells also express high levels of cyclooxygenase (COX)-2 proteins, leading to increased injury in the lungs. 12 Studies indicate that during inflammation, lung epithelial cells also express high levels of cyclooxygenase (COX)-2 proteins, leading to increased injury in the lungs.…”

Section: Introductionmentioning

confidence: 99%

“…12 Studies indicate that during inflammation, lung epithelial cells also express high levels of cyclooxygenase (COX)-2 proteins, leading to increased injury in the lungs. 12 Furthermore, inflammatory lung epithelial cells also express adhesion molecules, including intercellular adhesion molecule 1 (ICAM-1) and vascular cell adhesion molecule 1 (VCAM-1), to adsorb more leukocytes and infiltrate into the lungs. 12 Furthermore, inflammatory lung epithelial cells also express adhesion molecules, including intercellular adhesion molecule 1 (ICAM-1) and vascular cell adhesion molecule 1 (VCAM-1), to adsorb more leukocytes and infiltrate into the lungs.…”

Section: Introductionmentioning

confidence: 99%

Phloretin inhibits interleukin-1β-induced COX-2 and ICAM-1 expression through inhibition of MAPK, Akt, and NF-κB signaling in human lung epithelial cells

Huang

et al. 2015

Food Funct.

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Phloretin, a flavonoid isolated from the apple tree, is reported to have anti-inflammatory, anti-oxidant, and anti-adiposity effects. In this study, we evaluated the suppressive effects of phloretin on intercellular adhesion molecule 1 (ICAM-1) and cyclooxygenase (COX)-2 expression in IL-1β-stimulated human lung epithelial A549 cells. The cells were pretreated with various concentrations of phloretin (3-100 μM), followed by induced inflammation by IL-1β. Phloretin inhibited levels of prostaglandin E2, decreased COX-2 expression, and suppressed IL-8, monocyte chemotactic protein 1, and IL-6 production. It also decreased ICAM-1 gene and protein expression and suppressed monocyte adhesion to inflammatory A549 cells. Phloretin also significantly inhibited Akt and mitogen-activated protein kinase (MAPK) phosphorylation and decreased nuclear transcription factor kappa-B (NF-κB) subunit p65 protein translocation into the nucleus. In addition, ICAM-1 and COX-2 expression was suppressed by pretreatment with both MAPK inhibitors and phloretin in inflammatory A549 cells. However, phlorizin, a derivative of phloretin, did not suppress the inflammatory response in IL-1β-stimulated A549 cells. These results suggest that phloretin might have an anti-inflammatory effect by inhibiting proinflammatory cytokine, COX-2, and ICAM-1 expression via blocked NF-κB and MAPK signaling pathways.

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“…The pseudo Samter's group included asthma patients with NSAID-induced urticaria/angio-oedema (n = 83, 25.1%) and the AERD group included asthma patients with NSAID-induced anaphylaxis, rhinitis/asthma, or a combination of reactions. 6 The control group included 338 randomly selected NSAID-tolerant asthma patients that presented during the same time period. Demographic and clinical data were obtained from patient files.…”

Section: Methodsmentioning

confidence: 99%

“…An earlier study conducted at our centre that investigated the relationship between NSAID hypersensitivity, and chronic urticaria, rhinitis/rhinosinusitis, and asthma, and identified the NSAID reaction patterns in asthmatics 6 reported that AERD patients are a heterogeneous group, and proposed a new classification system (Kalyoncu classification). According to Kalyoncu classification, NSAID-induced urticaria/angio-oedema in asthma patients is defined as pseudo Samter's syndrome.…”

Section: Introductionmentioning

confidence: 99%

Comorbid diseases in aspirin-exacerbated respiratory disease, and asthma

Erdoğan

Karakaya

Kalyoncu

2015

Allergologia et Immunopathologia

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Non-steroidal anti-inflammatory drug hypersensitivity in adults and the factors associated with asthma

Cited by 23 publications

References 28 publications

Hypersensitivity Reactions to Nonsteroidal Anti-Inflammatory Drugs among Adults: Clinical Features and Risk Factors for Diagnosis Confirmation

Hypersensitivity Reactions to Nonsteroidal Anti-Inflammatory Drugs among Adults: Clinical Features and Risk Factors for Diagnosis Confirmation

Phloretin inhibits interleukin-1β-induced COX-2 and ICAM-1 expression through inhibition of MAPK, Akt, and NF-κB signaling in human lung epithelial cells

Comorbid diseases in aspirin-exacerbated respiratory disease, and asthma

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