Aspirin-Exacerbated Respiratory Disease and the Unified Airway

Walters, Benjamin K; Hagan, John B.; Divekar, Rohit; Willson, Thomas D.; Stokken, Janalee K.; Pinheiro‐Neto, Carlos D.; O’Brien, Erin; Choby, Garret

doi:10.1016/j.otc.2022.09.008

Cited by 5 publications

(2 citation statements)

References 111 publications

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“…This condition is known as aspirin-exacerbated respiratory disease (AERD). It is estimated that approximately 10% of patients with nasal polyps and 9% of patients with CRS have AERD, although the true prevalence of this disease remains unknown [15]. Medical treatment options for patients with chronic nasosinusal polyposis (CRSwNP) remain limited.…”

Section: Introductionmentioning

confidence: 99%

Real-Life Effects of Omalizumab on Chronic Rhinosinusitis with Nasal Polyposis

Lombardo,

Piazzetta,

Lobello

et al. 2023

JPM

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Chronic rhinosinusitis with nasal polyposis (CRSwNP) is an inflammatory disease of the nasal and sinus mucosa. This inflammatory process is supported by a multitude of cytokines, including IL-4, IL-5, and IL-13 produced by Th2 cells, as well as by IgE produced by B lymphocytes in response to a stimulus. Omalizumab is an anti-IgE monoclonal antibody with well-recognized roles in allergic asthma and chronic spontaneous urticaria. The aim of this study was to evaluate the clinical efficacy of omalizumab in a cohort of 13 patients suffering from chronic rhinosinusitis with CRSwNP. The inclusion criteria considered were as follows: 18 years of age, with a diagnosis of chronic rhinosinusitis with severe nasal polyposis expressed by an NPS greater than or equal to 5 and/or a SNOT-22 greater than or equal to 50. In addition, in the enrolled patients, the classic treatment with corticosteroids had to have been suspended due to recurrence after surgery or lack of response. Our results highlighted that omalizumab treatment for 16 weeks improved the parameters analyzed: SNOT-22, NPS, NRS, and NCS. The clinical efficacy of omalizumab was further strengthened by a significant improvement in respiratory function as well as reductions in the nasal polyps’ size and in the associated symptoms.

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Section: Introductionmentioning

confidence: 99%

Real-Life Effects of Omalizumab on Chronic Rhinosinusitis with Nasal Polyposis

Lombardo,

Piazzetta,

Lobello

et al. 2023

JPM

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“…Aspirin-exacerbated respiratory disease (AERD) is an inflammatory condition that consists of eosinophilic asthma, chronic rhinosinusitis with nasal polyps (CRSwNP) and respiratory reactions to cyclooxygenase-1 (COX-1) inhibitors. The reported prevalence of AERD in CRSwNP patients ranges between 8.7% and 26% [1][2][3][4][5]. Compared with asthmatics, AERD patients may be predominantly characterized by severe asthma according to the American Thoracic Society/European Respiratory Society definition (which includes patients with refractory asthma and those in whom treatment of comorbidities, such as severe sinus disease remains incomplete [2,6,7]) and by aggressive CRSwNP in terms of a higher probability of recurrence after surgery [2,3,8].…”

Section: Introductionmentioning

confidence: 99%

Blood Basophils Relevance in Chronic Rhinosinusitis with Aspirin-Exacerbated Respiratory Disease

Brescia,

Fabbris,

Calvanese

et al. 2023

Diagnostics

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Aspirin-exacerbated respiratory disease (AERD) is characterized by eosinophilic asthma, chronic rhinosinusitis with nasal polyps (CRSwNP) and intolerance to cyclooxygenase-1 inhibitors. Interest is emerging in studying the role of circulating inflammatory cells in CRSwNP pathogenesis and its course, as well as their potential use for a patient-tailored approach. By releasing IL-4, basophils play a crucial role in activating the Th2-mediated response. The main aim of this study was to, first, investigate the level of the pre-operative blood basophils’ values, blood basophil/lymphocyte ratio (bBLR) and blood eosinophil-to-basophil ratio (bEBR) as predictors of recurrent polyps after endoscopic sinus surgery (ESS) in AERD patients. The secondary aim was to compare the blood basophil-related variables of the AERD series (study group) with those of a control group of 95 consecutive cases of histologically non-eosinophilic CRSwNP. The AERD group showed a higher recurrence rate than the control group (p < 0.0001). The pre-operative blood basophil count and pre-operative bEBR were higher in AERD patients than in the control group (p = 0.0364 and p = 0.0006, respectively). The results of this study support the hypothesis that polyps removal may contribute to reducing the inflammation and activation of basophils.

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Sleep dysfunction in aspirin exacerbated respiratory disease: A prospective cohort study

Cvancara,

Aboueisha,

Sharma

et al. 2024

World j. otorhinolaryngol.-head neck surg.

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ObjectiveStudies have described sleep dysfunction (SD) in patients with chronic rhinosinusitis (CRS). However, there is a paucity of literature describing sleep dysfunction in the context of aspirin‐exacerbated respiratory disease (AERD). The purpose of this study was to evaluate the prevalence and severity of SD in patients with AERD relative to CRS.MethodsThis study is a prospective cohort study. Patients diagnosed with CRS without polyposis (CRSsNP, n = 206), CRS with nasal polyposis (CRSwNP, n = 38), and AERD (n = 28) were recruited prospectively in academic center rhinology clinic. SD was assessed using the Neuro‐QOL Short Form v1.0‐Sleep Disturbance (sleep‐QOL), for which severe SD is defined as a score >2.0 standard deviations from the normalized mean. Demographic and patient‐reported outcome measures (including SNOT‐22 and PHQ‐2) were collected to adjust for sleep confounders. Comparisons were made between groups using univariate and multivariate analyses.ResultsThe prevalence of severe SD was significantly higher in AERD (57.1%) than in CRSsNP (32.5%) or CRSwNP (34.2%), p = 0.038. After adjusting for sleep confounders, the risk of sleep dysfunction remained higher among patients with AERD (odds ratio [OR] = 2.72 vs. CRSsNP, 95% confidence interval [CI] = 1.18–6.27, p = 0.02; OR = 3.06 vs. CRSwNP, 95% CI = 1.06–8.82, p = 0.04). SNOT‐22 total score and the sleep subdomain showed no correlation with sleep‐QOL score.ConclusionsThe frequency and severity of SD are greater in AERD patients than in patients with CRS with or without nasal polyposis, independent of confounders of sleep quality. While the putative link between AERD and SD remains elusive, this study suggests that SD in AERD may be greater than previously recognized.

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Aspirin-Exacerbated Respiratory Disease and the Unified Airway

Cited by 5 publications

References 111 publications

Real-Life Effects of Omalizumab on Chronic Rhinosinusitis with Nasal Polyposis

Real-Life Effects of Omalizumab on Chronic Rhinosinusitis with Nasal Polyposis

Blood Basophils Relevance in Chronic Rhinosinusitis with Aspirin-Exacerbated Respiratory Disease

Sleep dysfunction in aspirin exacerbated respiratory disease: A prospective cohort study

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