Sputum biomarkers during aspirin desensitization in nonsteroidal anti-inflammatory drugs exacerbated respiratory disease

Tyrak, Katarzyna Ewa; Kupryś‐Lipińska, Izabela; Czarnobilska, Ewa; Jakieła, Bogdan; Pajdzik, Kinga; Ćmiel, Adam; Plutecka, Hanna; Koziej, Mateusz; Gawrońska, Aleksandra; Konduracka, Ewa; Kuna, Piotr; Sanak, Marek; Mastalerz, Lucyna

doi:10.1016/j.rmed.2019.04.021

Cited by 10 publications

(23 citation statements)

References 47 publications

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“…Although the role of serum IgE is not well established in the natural progression of AERD, previous studies have reported high levels of IgE in patients with AERD in the absence of atopy and also as a response to staphylococcal superantigens . Interestingly, aspirin responders in this study—as well as in another study on aspirin treatment responders where IgE levels were reported—appeared to have lower IgE levels than aspirin nonresponders . Nonresponders were more likely to be African American.…”

Section: Discussioncontrasting

confidence: 56%

“…27 Interestingly, aspirin responders in this study-as well as in another study on aspirin treatment responders where IgE levels were reported-appeared to have lower IgE levels than aspirin nonresponders. 10 Nonresponders were more likely to be African American. Several studies showed that African Americans tend to have higher IgE levels than Caucasians.…”

Section: Discussionmentioning

confidence: 98%

“…In addition, aspirin seems to benefit some patients, even if surgery timing was not accounted for or if ESS was performed >12 months before start of aspirin treatment. 6,9,10 The goal of this study was to further elucidate the role of ESS in AERD treatment and to characterize AERD those patients who are less likely to respond to aspirin treatment without preceding ESS.…”

mentioning

confidence: 99%

“…Although ESS enhances aspirin treatment response in patients with AERD when performed 3‐6 weeks before initiation of aspirin desensitization and treatment, there is insufficient research on aspirin desensitization outcomes with and without antecedent ESS. In addition, aspirin seems to benefit some patients, even if surgery timing was not accounted for or if ESS was performed >12 months before start of aspirin treatment …”

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confidence: 99%

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Endoscopic sinus surgery improves aspirin treatment response in aspirin‐exacerbated respiratory disease patients

Shah

Abuzeid

Ponduri

et al. 2019

Int Forum Allergy Rhinol

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Background Aspirin desensitization and treatment benefits most patients with aspirin‐exacerbated respiratory disease (AERD), although some patients fail therapy. Our objective was to assess whether recent endoscopic sinus surgery (ESS) improved aspirin treatment outcomes in AERD patients who initially failed aspirin therapy. Methods Outcomes of aspirin desensitization and treatment in AERD patients prospectively enrolled were assessed preoperatively and at 4, 12, and 24 weeks after ESS by determining changes in Asthma Control Test (ACT) and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) scores and respiratory function. Biomarkers, including fractional excretion of nitric oxide (FeNO), spirometry, nasal inspiratory peak flow (NPF), immunoglobulin E (IgE), and eosinophil count, were measured. Results Nineteen patients who benefited (responders) and 21 patients who failed (nonresponders) preoperative aspirin treatment with a distant history of ESS (mean, 48 months) were identified. Nonresponders were more likely to be African American (71%, p < 0.01) and have higher baseline IgE levels (252 kU/L vs 87 kU/L in responders, p < 0.01). 24 of the 40 patients (nine responders and 15 non‐responders) required subsequent ESS and underwent another aspirin desensitization 3‐4 weeks after ESS. All 24 patients tolerated a second round of aspirin desensitization and treatment. The primary aspirin therapy was associated with a significant increase in IgE in nonresponders, but there was no significant increase in IgE after the second aspirin desensitization and treatment. Conclusion Antecedent ESS enhances aspirin treatment responses in AERD patients and may convert patients who failed aspirin treatment before surgery to a more responsive phenotype after ESS. Patients with higher baseline serum IgE levels may benefit from ESS performed shortly before aspirin desensitization and therapy.

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Section: Discussioncontrasting

confidence: 56%

Section: Discussionmentioning

confidence: 98%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Endoscopic sinus surgery improves aspirin treatment response in aspirin‐exacerbated respiratory disease patients

Shah

Abuzeid

Ponduri

et al. 2019

Int Forum Allergy Rhinol

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“…With longer-term high-dose aspirin therapy, one proposed mechanism of clinical benefit is a reduction in PGD2 activity. 45,46 However, high-dose aspirin therapy does not appear to rectify the overall dysregulation in eicosanoid synthesis and MC homeostasis characteristic of AERD. The clinical benefit of daily high-dose aspirin in AERD appears to be independent of a reduction in MC activation and CysLT production.…”

Section: Therapeutic Implications MC Response During Long-term Aspirimentioning

confidence: 99%

<p>The Role of Mast Cells in Aspirin-Exacerbated Respiratory Disease (AERD) Pathogenesis: Implications for Future Therapeutics</p>

Kuruvilla

Vanijcharoenkarn

Levy

2020

JAA

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Mast cells (MC) have recently been demonstrated to play an integral role in the pathogenesis of aspirin-exacerbated respiratory disease (AERD). When activated, MCs release pre-formed granules of many pro-inflammatory mediators, including histamine, serotonin, and various chemokines and cytokines including tumor necrosis factor (TNF)-α, interferon ɣ (IFN ɣ), macrophage inhibitory factor, transforming growth factor, interleukin (IL) 1, 3-6, 9, 10, 13 and 16. These mediators promote inflammation in AERD by recruiting or activating a network of cells involved in acute and chronic inflammatory pathways, such as endothelial, epithelial, stromal, and other immune cells. Several studies have implicated multifactorial pathways for MC activation in AERD beyond classical IgE mediated mechanisms. The elucidation of these complex networks therefore represents important targets for innovative patient therapeutics. This review summarizes classic and alternative pathways of MC activation in AERD with a special focus in relation to new and emerging treatment strategies.

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Machine learning in the diagnosis of asthma phenotypes during coronavirus disease 2019 pandemic

Gawlewicz‐Mroczka

Pytlewski

Celejewska‐Wójcik

et al. 2022

Clinical & Translational All

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Background During the coronavirus disease 2019 (COVID‐19) pandemic, it has become a pressing need to be able to diagnose aspirin hypersensitivity in patients with asthma without the need to use oral aspirin challenge (OAC) testing. OAC is time consuming and is associated with the risk of severe hypersensitive reactions. In this study, we sought to investigate whether machine learning (ML) based on some clinical and laboratory procedures performed during the pandemic might be used for discriminating between patients with aspirin hypersensitivity and those with aspirin‐tolerant asthma. Methods We used a prospective database of 135 patients with non‐steroidal anti‐inflammatory drug (NSAID)–exacerbated respiratory disease (NERD) and 81 NSAID‐tolerant (NTA) patients with asthma who underwent OAC. Clinical characteristics, inflammatory phenotypes based on sputum cells, as well as eicosanoid levels in induced sputum supernatant and urine were extracted for the purpose of applying ML techniques. Results The overall best ML model, neural network (NN), trained on a set of best features, achieved a sensitivity of 95% and a specificity of 76% for diagnosing NERD. The 3 promising models (i.e., multiple logistic regression, support vector machine, and NN) trained on a set of easy‐to‐obtain features including only clinical characteristics and laboratory data achieved a sensitivity of 97% and a specificity of 67%. Conclusions ML techniques are becoming a promising tool for discriminating between patients with NERD and NTA. The models are easy to use, safe, and achieve very good results, which is particularly important during the COVID‐19 pandemic.

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Sputum biomarkers during aspirin desensitization in nonsteroidal anti-inflammatory drugs exacerbated respiratory disease

Cited by 10 publications

References 47 publications

Endoscopic sinus surgery improves aspirin treatment response in aspirin‐exacerbated respiratory disease patients

Endoscopic sinus surgery improves aspirin treatment response in aspirin‐exacerbated respiratory disease patients

<p>The Role of Mast Cells in Aspirin-Exacerbated Respiratory Disease (AERD) Pathogenesis: Implications for Future Therapeutics</p>

Machine learning in the diagnosis of asthma phenotypes during coronavirus disease 2019 pandemic

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