Omalizumab,as a biological agent targeting IgE,is a recombinant humanized monoclonal antibody and the first targeted drug approved for treating moderate-to-severe bronchial asthma.By reviewing one case of aspirin-induced asthma complicated with nasosinusitis and otitis media,we discussed the value of omalizumab in the treatment of asthma and its complications,aiming to provide a reference for clinical practice.
奥马珠单抗是一种重组人源化单克隆抗体,为抗IgE靶向生物制剂,是全球首个获批治疗中至重度支气管哮喘的靶向治疗药物。本文对1例阿司匹林哮喘伴分泌性中耳炎及鼻窦炎患者进行回顾性分析,探讨奥马珠单抗在治疗哮喘及其合并症中的价值,为临床实践提供依据。.

This review of aspirin-exacerbated respiratory disease (AERD) describes the clinical characteristics and pathophysiology of disease, highlighting its similarities and unique differences in comparison to classic IgE mediated hypersensitivity as well as AERD as a chronic disease. There is a specific focus on the comparison of mediator production over time and the use of desensitization in each diagnosis that serves to aid the clinician in differentiating aspirin reactions in AERD from those related to true immediate hypersensitivity.

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OBJECTIVE: Samter\'s triad is the combination of asthma, aspirin sensitization, and nasal polyposis. Few data are available on the use of omalizumab in this disease. The study aimed to describe the impact of omalizumab on clinical and functional parameters and the quality of life of a series of patients with Samter\'s triad. Moreover, we aimed to provide a review of the literature on this topic.
METHODS: We retrospectively described four patients with Samter\'s triad undergoing omalizumab therapy. Clinical, functional, and immunological data of these patients were collected at baseline and follow-up.
RESULTS: Reduction of asthma exacerbations and salbutamol rescue therapy were observed in all patients after anti-IgE treatment together with an improvement in the quality of life. A significant improvement in FEV1, FVC, and FEF25-75 was observed. No major side-effects were observed. A total of 14 studies regarding omalizumab in aspirin-exacerbated respiratory diseases were included in the review, comprising 78 patients. All studies reported a good efficacy in improving asthma control; restoration of aspirin tolerance was repeatedly reported.
CONCLUSIONS: The results of our case series and review of the literature suggest that omalizumab effectively improves asthma control, lung function tests, and quality of life in patients with Samter\'s triad.

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Aspirin-exacerbated respiratory disease comprises a series of signs and symptoms mainly involving the upper and lower posterior airway after the consumption of cyclooxygenase enzyme inhibitors. Adverse reactions that occur are not considered to be an allergy and are common to all non-steroidal anti-inflammatory drugs, and cross-reactivity between these agents is therefore common. The description of 3 clinical cases serves to review key aspects of this condition, such as epidemiology, pathophysiology, clinical manifestations, diagnosis and management. Adequate diagnosis and education on the use or elimination of all different NSAIDs is essential, as well as availability of different analgesic options, verified with challenge tests. Aspirin-exacerbated respiratory disease management includes surgical procedures for nasal polyp control, pharmacological treatment for asthma control and desensitization with aspirin in selected individuals.
La enfermedad respiratoria exacerbada por aspirina comprende un conjunto de signos y síntomas que involucran principalmente la vía aérea superior e inferior posterior al consumo de inhibidores de la enzima ciclooxigenasa. Las reacciones adversas que se presentan no se consideran una alergia y son comunes a todos los antiinflamatorios no esteroideos, por lo que la reactividad cruzada entre estos es común. La descripción de tres casos clínicos con diferentes situaciones sirve para revisar aspectos clave de la enfermedad como la epidemiologia, fisiopatología, manifestaciones clínicas, diagnóstico y manejo. El adecuado diagnóstico y educación en el uso o eliminación de los diferentes AINE es fundamental, al igual que la disposición de opciones analgésicas alternativas, comprobadas mediante pruebas de provocación. El manejo de la enfermedad respiratoria exacerbada por aspirina incluye procedimientos quirúrgicos para el control de los pólipos nasales, tratamiento farmacológico para el control del asma y desensibilización con aspirina en individuos seleccionados.

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Kounis syndrome is defined as an acute coronary syndrome triggered by allergic or hypersensitivity reactions resulting in mast cell and platelet activation. Numerous causes have been described, including various drugs, medical conditions, and environmental exposures. Samter\'s triad consists of nasal polyps, asthma, and aspirin (or nonsteroidal anti-inflammatory drug) sensitivity. We describe a case of Kounis type I in a young woman with Samter\'s triad who presented with cardiac arrest on 3 occasions. Ergonovine provocation testing established the diagnosis of coronary vasospasm. The patient has derived significant benefit from calcium channel blockers.

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