Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY.
National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC.
J Allergy Clin Immunol Pract. 2017 Jul-Aug;5(4):998-1007.e2. doi: 10.1016/j.jaip.2016.11.021. Epub 2017 Jan 31.
Aspirin desensitization followed by daily aspirin provides therapeutic benefits to patients with aspirin-exacerbated respiratory disease (AERD). It is not well understood how eicosanoid levels change during aspirin treatment.
To investigate associations between clinical outcomes of aspirin treatment and plasma eicosanoid levels in patients with AERD.
Thirty-nine patients with AERD were offered aspirin treatment (650 mg twice daily) for 4 weeks. Respiratory parameters and plasma levels of multiple eicosanoids were recorded at baseline and after 4 weeks of aspirin therapy using the Asthma Control Test and Rhinoconjunctivitis Quality of Life Questionnaire. Respiratory function was evaluated using the FEV and nasal inspiratory peak flow.
After aspirin treatment, respiratory symptoms improved in 16 patients, worsened in 12 patients, and did not change in 4 patients. Seven patients were unable to complete the desensitization protocol. Patients with symptom improvement had higher baseline plasma 15-hydroxyeicosatetraenoic acid (15-HETE) levels than did patients with symptom worsening: 7006 pg/mL (interquartile range, 6056-8688 pg/mL) versus 4800 pg/mL (interquartile range, 4238-5575 pg/mL), P = .0005. Baseline 15-HETE plasma levels positively correlated with the change in Asthma Control Test score (r = 0.61; P = .001) and in FEV after 4 weeks of aspirin treatment (r = 0.49; P = .01). It inversely correlated with Rhinoconjunctivitis Quality of Life Questionnaire score (r = -0.58; P = .002). Black and Latino patients were more likely to have symptom worsening on aspirin or fail to complete the initial desensitization than white, non-Latino patients (P = .02).
In patients with AERD, low baseline 15-HETE plasma levels and black or Latino ethnicity are associated with worsening of respiratory symptoms during aspirin treatment.
阿司匹林脱敏后每天服用阿司匹林可为阿司匹林加重的呼吸道疾病（AERD）患者提供治疗益处。目前尚不清楚在阿司匹林治疗期间类二十烷酸水平如何变化。
研究 AERD 患者阿司匹林治疗的临床结果与血浆类二十烷酸水平之间的关系。
39 名 AERD 患者接受阿司匹林治疗（每天两次 650mg）4 周。使用哮喘控制测试和鼻结膜炎生活质量问卷，在基线和阿司匹林治疗 4 周后记录呼吸参数和多种类二十烷酸的血浆水平。使用 FEV 和鼻吸气峰流速评估呼吸功能。
在阿司匹林治疗后，16 名患者的呼吸道症状改善，12 名患者的症状恶化，4 名患者的症状无变化。7 名患者无法完成脱敏方案。症状改善的患者的基线血浆 15-羟基二十碳四烯酸（15-HETE）水平高于症状恶化的患者：7006pg/ml（四分位距，6056-8688pg/ml）与 4800pg/ml（四分位距，4238-5575pg/ml）相比，P=0.0005。基线 15-HETE 血浆水平与哮喘控制测试评分的变化呈正相关（r=0.61；P=0.001）和阿司匹林治疗 4 周后的 FEV 呈正相关（r=0.49；P=0.01）。它与鼻结膜炎生活质量问卷评分呈负相关（r=-0.58；P=0.002）。与白人、非拉丁裔患者相比，黑人和拉丁裔患者更有可能在阿司匹林治疗期间出现症状恶化或无法完成初始脱敏（P=0.02）。
在 AERD 患者中，低基线 15-HETE 血浆水平和黑人和拉丁裔种族与阿司匹林治疗期间呼吸道症状恶化相关。
