Aspirin-induced asthma

The typical clinical presentation of AIA is that of a middle-aged asthmatic with recurrent nasal polyps and secondary chronic sinusitis. Nevertheless, only one-third of patients with this presentation have a positive aspirin-challenge test (2). Their prognosis is no different than that in aspirin-tolerant asthma. Mechanistically, the COX response to ASA is altered in AIA through an unknown mechanism, leading to an etiologic role for PepLTs and opportunities for therapeutic interventions with LT blockade and aspirin desensitization. These therapeutic interventions provide varying but incomplete degrees of protection in this interesting syndrome.