Abstract:
Nonsteroidal anti-inflammatory drug-exacerbated respiratory disease (NSAID-ERD) is a distinct clinical syndrome characterized by nonsteroidal anti-inflammatory drug (NSAID) hypersensitivity, asthma, and nasal polyposis. Its diagnosis is challenging owing to variable presentations and a lack of simple tests, leading to diagnostic delays. Recent research has revealed its genetic predispositions, environmental triggers, and associations with atopy and second-hand tobacco smoke exposure or smoking cessation. Despite its severity, diagnostic awareness remains low, leading to the delay in effective management. Therapeutically, NSAID-ERD necessitates multidisciplinary approaches, often combining surgical interventions with medical management, including aspirin desensitization and biologic agents. However, predictive biomarkers for treatment response remain elusive. Understanding the underlying mechanisms driving NSAID-ERD pathogenesis and identifying reliable biomarkers are crucial for enhancing diagnostic accuracy and refining targeted therapeutic strategies for this debilitating condition. This review aims to provide a thorough understanding of NSAID-ERD, covering its history, clinical features, epidemiology, diagnosis, systemic and molecular biomarkers, available treatment options, and avenues for future research.
摘要:
非甾体抗炎药物加重性呼吸系统疾病(NSAID-ERD)是一种以NSAID超敏反应为特征的独特临床综合征,哮喘,和鼻息肉病.由于不同的表现和缺乏简单的测试,其诊断具有挑战性,导致诊断延迟。最近的研究揭示了它的遗传倾向,环境触发因素,以及与特应性和二手烟草烟雾暴露或戒烟的关联。尽管严重,诊断意识仍然很低,导致有效管理的延误。治疗学上,NSAID-ERD需要多学科方法,通常将手术干预与医疗管理相结合,包括阿司匹林脱敏和生物制剂。然而,治疗反应的预测性生物标志物仍然难以捉摸。了解驱动NSAID-ERD发病机制的潜在机制和确定可靠的生物标志物对于提高诊断准确性和完善针对这种衰弱状况的靶向治疗策略至关重要。这篇综述旨在全面了解NSAID-ERD,涵盖了它的历史,临床特征,流行病学,诊断,系统和分子生物标志物,可用的治疗选择,以及未来研究的途径。