NSAIDs hypersensitivity: questions not resolved
| Autor: | Teresa Bellón, Miguel Blanca, Natalia Blanca-López, Gemma Amo, Maria Luisa Somoza-Alvarez, Gabriela Canto |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Hypersensitivity
Immediate Pharmacogenomic Variants T cell Respiratory Tract Diseases Immunology Disease Immunologic Tests Bioinformatics Immunoglobulin E Drug Hypersensitivity 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine T-Lymphocyte Subsets Prevalence Humans Immunology and Allergy Medicine Angioedema skin and connective tissue diseases biology business.industry Anti-Inflammatory Agents Non-Steroidal Respiratory disease Symptom Flare Up medicine.disease Acquired immune system Pharmacogenomic Testing medicine.anatomical_structure 030228 respiratory system biology.protein medicine.symptom business Prostaglandin metabolism Anaphylaxis |
| Zdroj: | Current Opinion in Allergy & Clinical Immunology. 18:291-301 |
| ISSN: | 1473-6322 1528-4050 |
| DOI: | 10.1097/aci.0000000000000454 |
| Popis: | Purpose of review NSAIDs are the drugs most frequently involved in hypersensitivity reactions (HSR). These are frequently prescribed at all ages. HSR are of great concern and can affect people at any age. These drugs can induce reactions by stimulating the adaptive immune system (IgE or T cell), known as selective responders or more frequently by abnormalities in biochemical pathways related with prostaglandin metabolism. These are known as cross-intolerant. With some exceptions, skin testing and in-vitro studies are of little value in selective responders. Recent findings In the last years, several classifications have been provided based on clinical symptoms, time interval between drug intake and appearance of symptoms, response to other nonchemically related NSAIDs and the underlying disease. Based on this classification, several well differentiated categories within each group of entities cross-intolerant and selective responders are now recognized. The most complex groups for evaluation are cross-intolerant in which three major groups exist: NSAIDs exacerbated respiratory disease, NSAIDs exacerbated cutaneous disease and NSAIDs-induced urticaria/angioedema in the absence of chronic spontaneous urticaria. Within the selective responders, there are two mechanisms involved: drug-specific IgE or T-cell effector responses. New entities have been added to this classification like mixed reactions within the cross-intolerant category, that must manifest as anaphylaxis and multiple immediate selective reactions. Summary The precise evaluation of patients with NSAIDs hypersensitivity following established guidelines will improve not only our understanding but also the management of these entities. As the number of patients affected with NSAIDs is important, further studies are warranted. |
| Databáze: | OpenAIRE |
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