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  Authority of Polish Society of Allergology

vol 17. no 2. June 2012  

 Review articles
Allergy and hypersensitivity to nonsteroidal anti-inflammatory drugs
Grażyna Bochenek

Nonsteroidal anti-inflammatory drugs (NSAIDs) are currently the second
most frequent source of hypersensitivity reactions to drugs, preceded
only by antibiotics. The term hypersensitivity describes objectively reproducible
symptoms initiated by exposure to a specific stimulus at
a dose tolerated by normal persons. Allergy is a hypersensitivity reaction
initiated by specific immunologic mechanisms. The background of the
reactions to NSAIDs in majority of cases is nonallergic. The reactions are
related to inhibition of cyclooxygenase enzyme. Such mechanism of
reaction is responsible for: 1) asthma/rhinitis exacerbated by NSAIDs in
patients with asthma, nasal polyposis and chronic rhinosinusitis (aspirin-
induced asthma), 2) urticaria/angioedema exacerbated by NSAIDs in
patients with chronic spontaneous urticaria (aspirin-induced urticaria), 3)
urticaria/angioedema/anaphylaxis induced by multiple NSAIDs in subjects
without chronic urticaria. Urticaria/angioedema/anaphylaxis induced by
a single NSAID or a group of closely chemically related compounds (pyrazolones)
has allergic IgE-related background. Likewise, cutaneous and
systemic reactions developing after exposure to NSAIDs seem to involve
immunological mechanisms of delayed type associated with cytotoxic
T cells

keywords: alergia, nadwrażliwość, niesterydowe leki przeciwzapalne, allergy, hypersensitivity, nonsteroidal anti-inflammatory drugs, aspirin-induced asthma, aspirin-induced urticaria

pages: from 57 to 65

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