Palikhe N S, Kim S-H, Park H-S
Department of Allergy & Rheumatology, Ajou University School of Medicine, Suwon, Korea.
J Clin Pharm Ther. 2008 Oct;33(5):465-72. doi: 10.1111/j.1365-2710.2008.00961.x.
Although acetylsalicylic acid is prescribed for a broad range of diseases, it can induce a wide array of clinically recognized hypersensitivity reactions, including aspirin-intolerant asthma (AIA) with rhinitis and aspirin-intolerant urticaria (AIU) with anaphylaxis. Altered eicosanoid metabolism is the generally accepted mechanism of aspirin intolerance; the overproduction of cysteinyl leucotrienes has been suggested to play a causative role in both AIA and AIU. Genetic markers suggested for AIA include HLA-DPBI0301, leucotriene C4 synthase (LTC4S), ALOX5, CYSLT, PGE2, TBXA2R and TBX21. Similarly, HLA-DB10609, ALOX5, FCER1A and HNMT have been identified as possible genetic markers for AIU. An additional low-risk genetic marker for AIA is MS4A2, which encodes the beta-chain of FCER1. Other single and sets of two or more interacting genetic markers are currently being investigated. Analyses of the genetic backgrounds of patients with AIA and AIU will promote the development of early diagnostic and therapeutic interventions, which may reduce the incidence of AIA and AIU.
尽管乙酰水杨酸被用于治疗多种疾病，但它可引发一系列临床上公认的超敏反应，包括伴有鼻炎的阿司匹林不耐受性哮喘（AIA）以及伴有过敏反应的阿司匹林不耐受性荨麻疹（AIU）。类花生酸代谢改变是普遍认可的阿司匹林不耐受机制；半胱氨酰白三烯的过度产生被认为在AIA和AIU中均起致病作用。提示与AIA相关的遗传标记包括HLA-DPBI0301、白三烯C4合酶（LTC4S）、ALOX5、CYSLT、PGE2、TBXA2R和TBX21。同样，HLA-DB10609、ALOX5、FCER1A和HNMT已被确定为AIU的可能遗传标记。AIA的另一个低风险遗传标记是MS4A2，它编码FCER1的β链。目前正在研究其他单个以及两个或更多相互作用的遗传标记。对AIA和AIU患者的遗传背景进行分析将促进早期诊断和治疗干预措施的发展，这可能会降低AIA和AIU的发病率。
