Minaldi Ellen, Cahill Katherine
Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.
Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Internal Medicine, Vanderbilt University Medical Center, 2525 West End Avenue, Suite 450, Nashville, TN, 37203, USA.
Curr Allergy Asthma Rep. 2023 Mar;23(3):181-188. doi: 10.1007/s11882-023-01064-3. Epub 2023 Feb 9.
To provide a review of available literature regarding nonsteroidal anti-inflammatory drug (NSAID) hypersensitivity with an emphasis on more recent findings.
Oral provocation tests with aspirin are important for diagnosis and management in adult and pediatric populations with reported NSAID hypersensitivity. Risk of cross-reactivity to COX-2 inhibitors varies by NSAID hypersensitivity phenotype. COX-2 inhibitors are tolerated in aspirin-exacerbated respiratory disease. Reported NSAID allergy is associated with a higher risk of a substance use disorder. Effective treatment of underlying chronic spontaneous urticaria can allow tolerance of NSAIDs in NSAID-exacerbated cutaneous disease. The pathophysiology, cross-reactivity, and appropriate diagnostic evaluation differ between the 5 distinct NSAID hypersensitivity phenotypes. Further research into the pathophysiology of NSAID hypersensitivity in patients with and without underlying disease is needed.
对有关非甾体抗炎药（NSAID）超敏反应的现有文献进行综述，重点关注最新研究结果。
对于报告有NSAID超敏反应的成人和儿童人群，阿司匹林口服激发试验对诊断和管理很重要。对COX-2抑制剂的交叉反应风险因NSAID超敏反应表型而异。在阿司匹林诱发的呼吸道疾病中，COX-2抑制剂可耐受。报告的NSAID过敏与物质使用障碍的较高风险相关。有效治疗潜在的慢性自发性荨麻疹可使NSAID诱发的皮肤病患者耐受NSAIDs。5种不同的NSAID超敏反应表型在病理生理学、交叉反应和适当的诊断评估方面存在差异。需要对有或无基础疾病患者的NSAID超敏反应病理生理学进行进一步研究。
