Clinical and pathologic perspectives on aspirin sensitivity and asthma

J Allergy Clin Immunol. 2006 Oct;118(4):773-86; quiz 787-8. doi: 10.1016/j.jaci.2006.07.024. Epub 2006 Sep 1.


Aspirin and other nonsteroidal anti-inflammatory drugs that inhibit COX-1 induce unique nonallergic reactions, consisting of attacks of rhinitis and asthma. These hypersensitivity reactions occur in a subset of asthmatic subjects, thus identifying them as having this exclusive clinical presentation. We refer to these patients as having aspirin-exacerbated respiratory disease, a disease process that produces devastating eosinophilic inflammation of both the upper and lower respiratory tracts. This review focuses on a description of patients with aspirin-exacerbated respiratory disease, methods available to diagnose their condition, the unique ability of all nonsteroidal anti-inflammatory drugs that inhibit COX-1 to cross-react with aspirin, an update on pathogenesis, and current thoughts about treatment.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Anti-Inflammatory Agents, Non-Steroidal / immunology
  • Aspirin / adverse effects*
  • Aspirin / immunology
  • Asthma / immunology*
  • Cross Reactions
  • Cyclooxygenase Inhibitors / immunology
  • Drug Hypersensitivity / immunology*
  • Humans


  • Anti-Inflammatory Agents, Non-Steroidal
  • Cyclooxygenase Inhibitors
  • Aspirin