RT Journal Article
T1 Progress in understanding hypersensitivity reactions to nonsteroidal anti-inflammatory drugs.
A1 Doña, Inmaculada
A1 Pérez-Sánchez, Natalia
A1 Eguiluz-Gracia, Ibon
A1 Muñoz-Cano, Rosa
A1 Bartra, Joan
A1 Torres, María José
A1 Cornejo-García, José Antonio
K1 NERD
K1 anaphylaxis
K1 clinical immunology
K1 drug allergy
K1 urticaria
AB Nonsteroidal anti-inflammatory drugs (NSAIDs), the medications most commonly used for treating pain and inflammation, are the main triggers of drug hypersensitivity reactions. The latest classification of NSAIDs hypersensitivity by the European Academy of Allergy and Clinical Immunology (EAACI) differentiates between cross-hypersensitivity reactions (CRs), associated with COX-1 inhibition, and selective reactions, associated with immunological mechanisms. Three phenotypes fill into the first group: NSAIDs-exacerbated respiratory disease, NSAIDs-exacerbated cutaneous disease and NSAIDs-induced urticaria/angioedema. Two phenotypes fill into the second one: single-NSAID-induced urticaria/angioedema/anaphylaxis and single-NSAID-induced delayed reactions. Diagnosis of NSAIDs hypersensitivity is hampered by different factors, including the lack of validated in vitro biomarkers and the uselessness of skin tests. The advances achieved over recent years recommend a re-evaluation of the EAACI classification, as it does not consider other phenotypes such as blended reactions (coexistence of cutaneous and respiratory symptoms) or food-dependent NSAID-induced anaphylaxis. In addition, it does not regard the natural evolution of phenotypes and their potential interconversion, the development of tolerance over time or the role of atopy. Here, we address these topics. A state of the art on the underlying mechanisms and on the approaches for biomarkers discovery is also provided, including genetic studies and available information on transcriptomics and metabolomics.
YR 2019
FD 2019-10-28
LK http://hdl.handle.net/10668/14459
UL http://hdl.handle.net/10668/14459
LA en
DS RISalud
RD Apr 8, 2025