Serum IgG and IgG subclass in aspirin-sensitive asthma / 천식및알레르기

BACKGROUND AND OBJECTIVES: Immunoglobulin G (IgG) subclass deficiency has been reported in patients with bronchial asthma and is associated with recurrent respiratory tract infections. Aspirin-sensitive asthma (ASA) which affects 10% of adult asthmatics, asthma runs a chronic course with frequent asthma exacerbations, often related to respiratory infections. We performed this study to identify the prevalence of IgG subclass deficiency and evaluate the association between recurrent asthma exacerbations and IgG subclass deficiency in ASA. SUBJECTS AND METHODS: We measured serum levels of IgG and IgG subclass in 26 aspirin- sensitive asthmatic patients (15 steroid used and 11 steroid not used) and 55 healthy controls using nephelometry. Reference values of each IgG subclass was defined as cumulative percentile between 2.5% to 97.5% of controls. RESULTS: Total IgG, IgG1, IgG2 and IgG3 of aspirin-sensitvie asthmatics, were significantly lower than for those of controls (p0.05, respectively). CONCLUSION: Lowered levels of IgG, IgG1, IgG2 and IgG3 were noted in ASA sensitive asthma patients, which might be associated with use of steroid. Further studies will be needed to evaluate their clinical significance.

Prevalence of nimesulide sensitivity in subjects diagnosed as having aspirin-sensitive asthma / 천식및알레르기

BACKGROUND AND OBJECTIVE: In patients with aspirin-sensitive asthma, anti-inflammatory treatment is a common problem in clinical practice. Nimesulide has been chosen due to weak inhibitory action on cyclooxygenase in ASA-sensitive asthma patients. In this study, we evaluated the safety of nimesulide in patients with ASA-sensitive asthma. METHODS: We performed lysine-aspirin bronchoprovocation test to confirm ASA-sensitive asthma, and nimesulide oral provocation test (up to 200 mg) to screen nimesulide sensitivity in 17 cases of bronchial asthma patients. RESULTS: Fifteen (88.2%) of 17 subjects showed positive responses to lysine-aspirin bronchoprovocation test. Six (35.3%) patients reacted to nimesulide oral provocation test. Of the six patients who reacted to nimesulide, three experienced bronchospasm, two urticaria, and one anaphylaxis. All positive reactions occurred within the 200 mg dose. One of 6 subjects showed a positive response to nimesulide oral provocation test without ASA-sensitivity. CONCLUSION: The prevalence of nimesulide sensitivity among aspirin-sensitive asthma was 33.3%, which was higher than in the previous reports. Screening oral provocation test is essential before prescribing relative COX-2 inhibitors for ASA-sensitive asthmatic patients. A case of nimesulide-sensitive asthma without ASA-sensitivity was also noted.

Changes of serum neutrophil chemotactic activity(NCA) and myeloperoxidase(MPO) level following lysine-aspirin(L-ASA) bronchoprovocation test in aspirin-sensitive asthmatic patients / 천식및알레르기

BACKGROUND: There have been few reports suggesting involvement of mast cell and neutrophil to induce bronchoconstriction in aspirin-sensitive asthrna. OBJECTIVE: To evaluate mast cell and neutrophil activation in pathogenesis of aspirin-sensitive asthma. MATERIAL AND METHOD: We observed changes of serum NCA and MPO levels during L-ASA bronchoprovocation test in 14 subjects with aspirin-sensitive asthma. RESULTS: Serum NCA was significantly increased at 30 min(p=0.01) after the inhalation of L-ASA and then, no significant changes were noted at 240 min (p=0.14). NCA was significantly higher in subjects with late asthmatic responses than in those without it (p=0.04). Serum MPO level tended to increase at 30 min with no statistical significance (p=0.08), and then it significantly decreased at 240 min (p=0.05). There was no significant correlation between serum NCA and MPO level (r=0.22, p=0.58). CONCLUSION: These results support the view that NCA derived from mast cell may contribute to neutrophil recruitment into the airway in aspirin-sensitive asthmatic patients.

Sodium salicylate sensitivity in an asthmatic patient with aspirin sensitivity

Non-acetylated salicylates have been recommended for use as alternatives to nonsteroidal anti-inflammatory drugs (NSAIDs) in aspirin and/or tartrazine-sensitive patients. We experienced a case of an aspirin-sensitive asthmatic patient who developed a broncho-obstructive reaction after taking 100 mg of sodium salicylate. The result of this study suggests that sodium salicylate may cross-react with aspirin in aspirin-and tartrazine-sensitive patients.