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Monitoring of the indivdual metabolism during aspirin desensitization
Abstract Background The pathophysiology of AERD is still a matter of debate. Oral Aspirin provocations tests are the diagnostic method of choice so far. However, provocation tests do not analyse the induvial arachidonic acid metabolism. In contrast the functional eicosanoid blood test can identify individuals suffering from AERD even without asthma.
Which test parameters are most suitable to estimate a successful aspirin desensitization and which parameters correlate with clinical symptoms are unknown.
The aim of the study is to identify in vitro parameters which are suitable parameters during therapy and which should help to implement an individual dose depended aspirin desensitization in the future.
Methods 16 patients were analysed within a prospective clinical trial. All patients had undergone sinus surgery due to chronic rhinosinusitis followed by aspirin desensitization.
Functional eicosanoid testing was repeated and in-vitro parameters of the arachidonic acid metabolism such as leukotrienes, prostaglandins and neuropeptide prostaglandin were analysed and correlated to patients’ clinical symptoms, nasal endoscopy and quality of life.
Results The study provides a closer insight into the arachidonic acid metabolisms and its products in relation to the clinical symptoms. Further we identified parameters which are most suitable to estimate a successful aspirin desensitization
Summary In the future the identified in vitro-parameters should help to perform and individual aspirin desensitization with an individual aspirin maintenance dose as low as possible.
Article published online:
10 June 2020
© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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