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EL PAPEL DE LOS MODIFICADORES DE LEUCOTRIENOS EN EL TRATAMIENTO DEL ASMA INDUCIDA POR ASPIRINA
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EL PAPEL DE LOS MODIFICADORES DE LEUCOTRIENOS EN EL TRATAMIENTO DEL ASMA INDUCIDA POR ASPIRINA

(especial para SIIC © Derechos reservados)
Los modificadores de leucotrienos, independientemente de la gravedad de la enfermedad, podrían mejorar los síntomas en pacientes con asma inducida por aspirina, pero no son un tratamiento efectivo para evitar la sensibilidad a la aspirina y a los antiinflamatorios no esteroides. A tal efecto se debe utilizar un plan de desensibilización en centros especializados. Los inhibidores selectivos de la COX-2 parecen ser una opción interesante para el tratamiento de estos pacientes.
obase.jpg Autor:
Yasushi Obase
Columnista Experto de SIIC
Artículos publicados por Yasushi Obase
Coautores
Hiroto Matsusex* Terufumi Shimoda** Shigeru Kohno*** 
MD, PhD, Hiroto Nagasaki University School of Medicine*
MD, PhD, Clinical Research Center, National Minami Fukuoka Hospital**
MD, PhD, Nagasaki University School of Medicine***
Recepción del artículo
25 de Junio, 2003
Aprobación
29 de Agosto, 2003
Primera edición
6 de Octubre, 2003
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
Las aspirinas y los antiinflamatorios no esteroides (AINE) causan exacerbaciones de asma en aproximadamente el 10% de los asmáticos adultos. Para diagnosticar el asma inducida por aspirina (AIA) se puede llevar a cabo una prueba de provocación, que se efectúa solamente en instalaciones con médicos especializados. Las diferencias exactas en la patogenia del AIA y de las otras formas de asma no han sido todavía totalmente aclaradas. La interacción de la aspirina y los AINE con el metabolismo del ácido araquidónico en los pulmones se relaciona con el mecanismo del AIA; la inhibición de la ciclooxigenasa se acompaña de sobreproducción de cisteinil leucotrienos, que junto al freno impuesto por el efecto broncodilatador de la prostaglandina E2 puede causar crisis asmáticas en los pacientes con AIA. Ya que los leucotrienos (LT) juegan un importante papel en el AIA, los modificadores de leucotrienos pueden ser la medicación adecuada para el control a largo plazo de pacientes con AIA. Se ha confirmado un efecto aditivo de los modificadores de leucotrienos en pacientes con AIA previamente tratados con corticosteroides inhalatorios. Sin embargo, esto no significa que los AINE y la aspirina puedan ser utilizados con seguridad en los pacientes con AIA tratados con modificadores de leucotrienos. Cuando los pacientes con AIA necesitan de estas drogas por su efecto analgésico, el médico debería utilizar un inhibidor selectivo de la COX-2. A pesar de ello, los efectos de la inhibición de la COX-2 a largo plazo no han sido aún totalmente aclarados. Para clarificar cómo se adquiere y cómo se activa la reacción de intolerancia en algunos individuos, se requiere más investigación sobre los mecanismos celulares y moleculares.

Palabras clave
Asma inducida por aspirina, leucotrienos, prueba de provocación, ciclooxigenasa


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Abstract
Aspirin (ASA) and non-steroidal anti-inflammatory drugs (NSAIDs) cause asthma exacerbations in around 10% of adults with asthma. To diagnose AIA, a challenge test is performed only in facilities with experienced physicians. The exact differences of pathogenesis between AIA and other type of asthma are not fully revealed yet. The interference of ASA/NSAIDs with arachidonic acid metabolism in the lungs are involved with mechanism of AIA; inhibition of cyclooxygenase is accompanied by overproduction of cysteinyl leukotrienes (cys-LTs), together with the "brake" imposed by the bronchodilator prostaglandin E2 may cause asthma attack in AIA patients. Since LT plays an important role in AIA, LT modifiers may be the preferred medication for long-term control of patients with AIA. Add-on efficacy of LT modifiers has been confirmed in AIA patients already treated with inhaled corticosteroid. However, these do not mean that ASA/NSAIDs can be safely taken by AIA patients on LT modifiers. When AIA patients require ASA/NSAIDs for analgesic effect, the physician should use a COX-2 selective inhibitor. However, the effects of long-term inhibition of COX-2 are not yet fully clarified. To clarify how the intolerance reaction is acquired and triggered in some individuals, more research on cellular and molecular mechanisms is required.

Key words
Asma inducida por aspirina, leucotrienos, prueba de provocación, ciclooxigenasa


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Especialidades
Principal: Alergia
Relacionadas: Farmacología, Inmunología, Medicina Interna, Neumonología



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Bibliografía del artículo
  1. Widal F, Abrami P, Lermoyez J: First complete description of the aspirin idiosyncrasy-asthma-nasal polyposis syndrome (plus urticaria)--1922 (with a note on aspirin desensitization). By F. Widal, P. Abrami, J. Lermoyez. J Asthma 1987;24:297-300.
  2. Samter M, Beers RF Jr: Intolerance to aspirin. Clinical studies and consideration of its pathogenesis. Ann Intern Med 1968;68:975-983.
  3. Szczeklik A, Stevenson DD: Aspirin-induced asthma: advances in pathogenesis and management. J Allergy Clin Immunol 1999;104:5-13.
  4. Kalyoncu AF, Karakaya G, Sahin AA, Baris YI: Occurrence of allergic conditions in asthmatics with analgesic intolerance. Allergy 1999;54:428-435.
  5. Hedman J, Kaprio J, Poussa T, Nieminen MM: Prevalence of asthma, aspirin intolerance, nasal polyposis and chronic obstructive pulmonary disease in a population-based study. Int J Epidemiol 1999;28:717-722.
  6. McDonald JR, Mathison DA, Stevenson DD: Aspirin intolerance in asthma. Detection by oral challenge. J Allergy Clin Immunol 1972;50:198-207.
  7. Szczeklik A, Nizankowska E, Duplaga M: Natural history of aspirin-induced asthma. AIANE Investigators. European Network on Aspirin-Induced Asthma. Eur Respir J 2000;16:432-436.
  8. Marquette CH, Saulnier F, Leroy O, Wallaert B, Chopin C, Demarcq JM, Durocher A, Tonnel AB: Long-term prognosis of near-fatal asthma. A 6-year follow-up study of 145 asthmatic patients who underwent mechanical ventilation for a near-fatal attack of asthma. Am Rev Respir Dis 1992;146:76-81.
  9. Matsuse H, Shimoda T, Matsuo N, Fukushima C, Takao A, Sakai H, Asai S, Kohno S: Aspirin-induced asthma as a risk factor for asthma mortality. J Asthma 1997;34:413-417.
  10. Bochenek G, Niz Ankowska E, Szczeklik A: Testing for aspirin hypersensitivity. Allergy 2002;57:562-565.
  11. Melillo G, Balzano G, Bianco S, Dahlen B, Godard P, Kowalsky ML, Picado C, Stevenson DD, Suetsugu S: Report of the INTERASMA Working Group on Standardization of Inhalation Provocation Tests in Aspirin-induced Asthma. Oral and inhalation provocation tests for the diagnosis of aspirin-induced asthma. Allergy 2001;56:899-911.
  12. Kawagishi Y, Mita H, Taniguchi M, Maruyama M, Oosaki R, Higashi N, Kashii T, Kobayashi M, Akiyama K: Leukotriene C4 synthase promoter polymorphism in Japanese patients with aspirin-induced asthma. J Allergy Clin Immunol 2002;109:936-942.
  13. Obase Y, Shimoda T, Tomari SY, Mitsuta K, Kawano T, Matsuse H, Kohno S: Effects of pranlukast on chemical mediators in induced sputum on provocation tests in atopic and aspirin-intolerant asthmatic patients. Chest 2002;121:143-150.
  14. Quiralte J, Blanco C, Castillo R, Delgado J, Carrillo T: Intolerance to nonsteroidal antiinflammatory drugs: results of controlled drug challenges in 98 patients. J Allergy Clin Immunol 1996;98:678-685.
  15. Bianco S, Robuschi M, Petrigni G: Aspirin-induced tolerance in aspirin induced asthma detected by a new challenge (IRCS) Med Sci 1977;5:129.
  16. Nizankowska E, Bestynska Krypel A, Cmiel A, Szczeklik A: Oral and bronchial provocation tests with aspirin for diagnosis of aspirin-induced asthma. Eur Respir J 2000;15:863-869.
  17. Phillips GD, Foord R, Holgate ST: Inhaled lysine-aspirin as a bronchoprovocation procedure in aspirin-sensitive asthma: its repeatability, absence of a late-phase reaction, and the role of histamine. J Allergy Clin Immunol 1989;84:232-241.
  18. Casadevall J, Ventura PJ, Mullol J, Picado C: Intranasal challenge with aspirin in the diagnosis of aspirin intolerant asthma: evaluation of nasal response by acoustic rhinometry. Thorax 2000;55:921-924.
  19. Vane SJ: Aspirin and other anti-inflammatory drugs. Thorax 55 Suppl 2000;2:S3-9.
  20. Hawkey CJ: COX-2 inhibitors. Lancet 1999;353:307-314.
  21. Christie PE, Tagari P, Ford Hutchinson AW, Charlesson S, Chee P, Arm JP, Lee TH: Urinary leukotriene E4 concentrations increase after aspirin challenge in aspirin-sensitive asthmatic subjects. Am Rev Respir Dis 1991;143:1025-1029.
  22. Funk CD: Prostaglandins and leukotrienes: advances in eicosanoid biology. Science 2001;294:1871-1875.
  23. Jawien J: A new insight into aspirin-induced asthma. Eur J Clin Invest 2002;32:134-138.
  24. Holgate ST, Burns GB, Robinson C, Church MK: Anaphylactic- and calcium-dependent generation of prostaglandin D2 (PGD2), thromboxane B2, and other cyclooxygenase products of arachidonic acid by dispersed human lung cells and relationship to histamine release. J Immunol 1984;133:2138-2144.
  25. Szczeklik A, Mastalerz L, Nizankowska E, Cmiel A: Protective and bronchodilator effects of prostaglandin E and salbutamol in aspirin-induced asthma. Am J Respir Crit Care Med 1996;153:567-571.
  26. Sestini P, Armetti L, Gambaro G, Pieroni MG, Refini RM, Sala A, Vaghi A, Folco GC, Bianco S, Robuschi M: Inhaled PGE2 prevents aspirin-induced bronchoconstriction and urinary LTE4 excretion in aspirin-sensitive asthma. Am J Respir Crit Care Med 1996;153:572-575.
  27. Kuehl FA Jr, Dougherty HW, Ham EA: Interactions between prostaglandins and leukotrienes. Biochem Pharmacol 1984;33:1-5.
  28. Christman BW, Christman JW, Dworski R, Blair IA, Prakash C: Prostaglandin E2 limits arachidonic acid availability and inhibits leukotriene B4 synthesis in rat alveolar macrophages by a nonphospholipase A2 mechanism. J Immunol 1993;151:2096-2104.
  29. Schafer D, Schmid M, Gode UC, Baenkler HW: Dynamics of eicosanoids in peripheral blood cells during bronchial provocation in aspirin-intolerant asthmatics. Eur Respir J 1999;13:638-646.
  30. Kowalski ML, Pawliczak R, Wozniak J, Siuda K, Poniatowska M, Iwaszkiewicz J, Kornatowski T, Kaliner MA: Differential metabolism of arachidonic acid in nasal polyp epithelial cells cultured from aspirin-sensitive and aspirin-tolerant patients. Am J Respir Crit Care Med 2000;161:391-398.
  31. Kellaway CH, Trethewie WR: The liberation of a slow reacting smoth muscle-stimulating substance in anaphylaxis Q I Exp Physiol 1940;30:121-145.
  32. Murphy RC, Hammarstrom S, Samuelsson B: Leukotriene C: a slow-reacting substance from murine mastocytoma cells. Proc Natl Acad Sci U S A 1979;76:4275-4279.
  33. Radmark O, Malmsten C, Samuelsson B: Leukotriene A4: enzymatic conversion to leukotriene C4. Biochem Biophys Res Commun 1980;96:1679-1687.
  34. Szczeklik A: Prostaglandin E2 and aspirin-induced asthma. Lancet 1995;345:1056.
  35. Picado C: Aspirin-intolerant asthma: role of cyclo-oxygenase enzymes. Allergy 57 Suppl 2002;72:58-60.
  36. Vane JR: Inhibition of prostaglandin synthesis as a mechanism of action for aspirin-like drugs. Nat New Biol 1971;231:232-235.
  37. National Institute of Health, National Heart, Lung, and Blood Institute: Global Initiative For Asthma. Global Strategy For Asthma Management And Prevention: a practical guide for public health officials and health care professionals. NIH Publication 2002;:No.02-3659.
  38. Bethesda MD: Guidlines for the diagnosis, management of asthma Expert Panel Report II. Revised in 2002. National Institutes of Health 1997; NIH pubicaiton ;:no.97-4051.
  39. Demoly P, Jaffuel D, Mathieu M, Sahla H, Godard P, Michel FB, Bousquet J: Glucocorticoid insensitive asthma: a one year clinical follow up pilot study. Thorax 1998;53:1063-1065.
  40. Greening AP, Ind PW, Northfield M, Shaw G: Added salmeterol versus higher-dose corticosteroid in asthma patients with symptoms on existing inhaled corticosteroid. Allen & Hanburys Limited UK Study Group. Lancet 1994;344:219-224.
  41. Drazen JM, Israel E, O\'Byrne PM: Treatment of asthma with drugs modifying the leukotriene pathway. N Engl J Med 1999;340:197-206.
  42. Lipworth BJ: Leukotriene-receptor antagonists. Lancet 1999;353:57-62.
  43. Dahlen B, Margolskee DJ, Zetterstrom O, Dahlen SE: Effect of the leukotriene receptor antagonist MK-0679 on baseline pulmonary function in aspirin sensitive asthmatic subjects. Thorax 1993;48:1205-1210.
  44. Israel E, Fischer AR, Rosenberg MA, Lilly CM, Callery JC, Shapiro J, Cohn J, Rubin P, Drazen JM: The pivotal role of 5-lipoxygenase products in the reaction of aspirin-sensitive asthmatics to aspirin. Am Rev Respir Dis 1993;148:1447-1451.
  45. Babu KS, Salvi SS: Aspirin and asthma. Chest 2000;118:1470-1476.
  46. Obase Y, Shimoda T, Tomari S, Mitsuta K, Fukushima C, Kawano T, Matsuse H, Kohno S: Effects of pranlukast on aspirin-induced bronchoconstriction: differences in chemical mediators between aspirin-intolerant and tolerant asthmatic patients. Ann Allergy Asthma Immunol 2001;87:74-79.
  47. Sebaldt RJ, Sheller JR, Oates JA, Roberts LJ 2nd, FitzGerald GA: Inhibition of eicosanoid biosynthesis by glucocorticoids in humans. Proc Natl Acad Sci U S A 1990;87:6974-6978.
  48. Tomari S, Matsuse H, Machida I, Kondo Y, Kawano T, Obase Y, Fukushima C, Shimoda T, Kohno S: Pranlukast, a cysteinyl leukotoriene receptor 1 antagonist, atenuates allergen specific TNF-alpha production and NF-kappaB nuclear translocation in peripheral blood monocytes from atopic asthmatics Clin Exp Allergy In press;:.
  49. O\'Shaughnessy KM, Wellings R, Gillies B, Fuller RW: Differential effects of fluticasone propionate on allergen-evoked bronchoconstriction and increased urinary leukotriene E4 excretion. Am Rev Respir Dis 1993;147:1472-1476.
  50. Antczak A, Montuschi P, Kharitonov S, Gorski P, Barnes PJ: Increased exhaled cysteinyl-leukotrienes and 8-isoprostane in aspirin-induced asthma. Am J Respir Crit Care Med 2002;166:301-306.
  51. Aksoy MO, Li X, Borenstein M, Yi Y, Kelsen SG: Effects of topical corticosteroids on inflammatory mediator-induced eicosanoid release by human airway epithelial cells. J Allergy Clin Immunol 1999;103:1081-1091.
  52. Dahlen SE, Malmstrom K, Nizankowska E, Dahlen B, Kuna P, Kowalski M, Lumry WR, Picado C, Stevenson DD, Bousquet J, Pauwels R, Holgate ST, Shahane A, Zhang J, Reiss TF, Szczeklik A: Improvement of aspirin-intolerant asthma by montelukast, a leukotriene antagonist: a randomized, double-blind, placebo-controlled trial. Am J Respir Crit Care Med 2002;165:9-14.
  53. Ragab S, Parikh A, Darby YC, Scadding GK: An open audit of montelukast, a leukotriene receptor antagonist, in nasal polyposis associated with asthma. Clin Exp Allergy 2001;31:1385-1391.
  54. Asano K, Shiomi T, Hasegawa N, Nakamura H, Kudo H, Matsuzaki T, Hakuno H, Fukunaga K, Suzuki Y, Kanazawa M, Yamaguchi K: Leukotriene C4 synthase gene A(-444)C polymorphism and clinical response to a CYS-LT(1) antagonist, pranlukast, in Japanese patients with moderate asthma. Pharmacogenetics 2002;12:565-570.
  55. Wechsler ME, Garpestad E, Flier SR, Kocher O, Weiland DA, Polito AJ, Klinek MM, Bigby TD, Wong GA, Helmers RA, Drazen JM: Pulmonary infiltrates, eosinophilia, and cardiomyopathy following corticosteroid withdrawal in patients with asthma receiving zafirlukast. JAMA 1998;279:455-457.
  56. Churg J, Churg A: Zafirlukast and Churg-Strauss syndrome. JAMA 1998;279:1949-1950.
  57. Green RL, Vayonis AG: Churg-Strauss syndrome after zafirlukast in two patients not receiving systemic steroid treatment. Lancet 1999;353:725-726.
  58. Settipane RA, Schrank PJ, Simon RA, Mathison DA, Christiansen SC, Stevenson DD: Prevalence of cross-sensitivity with acetaminophen in aspirin-sensitive asthmatic subjects. J Allergy Clin Immunol 1995;96:480-485.
  59. Bianco S, Robuschi M, Petrigni G, Scuri M, Pieroni MG, Refini RM, Vaghi A, Sestini PS: Efficacy and tolerability of nimesulide in asthmatic patients intolerant to aspirin. Drugs 46 Suppl 1993;1:115-120.
  60. Kosnik M, Music E, Matjaz F, Suskovic S: Relative safety of meloxicam in NSAID-intolerant patients. Allergy 1998;53:1231-1233.
  61. Martin Garcia C, Hinojosa M, Berges P, Camacho E, Garcia Rodriguez R, Alfaya T, Iscar A: Safety of a cyclooxygenase-2 inhibitor in patients with aspirin-sensitive asthma. Chest 2002;121:1812-1817.
  62. Dahlen B, Szczeklik A, Murray JJ: Celecoxib in patients with asthma and aspirin intolerance. The Celecoxib in Aspirin-Intolerant Asthma Study Group. N Engl J Med 2001;344:142.
  63. Woessner KM, Simon RA, Stevenson DD: The safety of celecoxib in patients with aspirin-sensitive asthma. Arthritis Rheum 2002;46:2201-2206.
  64. Szczeklik A, Nizankowska E, Bochenek G, Nagraba K, Mejza F, Swierczynska M: Safety of a specific COX-2 inhibitor in aspirin-induced asthma. Clin Exp Allergy 2001;31:219-225.
  65. Walenga RW, Kester M, Coroneos E, Butcher S, Dwivedi R, Statt C: Constitutive expression of prostaglandin endoperoxide G/H synthetase (PGHS)-2 but not PGHS-1 in human tracheal epithelial cells in vitro. Prostaglandins 1996;52:341-359.
  66. Tocco G, Freire Moar J, Schreiber SS, Sakhi SH, Aisen PS, Pasinetti GM: Maturational regulation and regional induction of cyclooxygenase-2 in rat brain: implications for Alzheimer\'s disease. Exp Neurol 1997;144:339-349.
  67. Zimmermann KC, Sarbia M, Schror K, Weber AA: Constitutive cyclooxygenase-2 expression in healthy human and rabbit gastric mucosa. Mol Pharmacol 1998;54:536-540.
  68. Petkova DK, Pang L, Range SP, Holland E, Knox AJ: Immunocytochemical localization of cyclo-oxygenase isoforms in cultured human airway structural cells. Clin Exp Allergy 1999;29:965-972.
  69. Langenbach R, Morham SG, Tiano HF, Loftin CD, Ghanayem BI, Chulada PC, Mahler JF, Lee CA, Goulding EH, Kluckman KD, et al.: Prostaglandin synthase 1 gene disruption in mice reduces arachidonic acid-induced inflammation and indomethacin-induced gastric ulceration. Cell 1995;83:483-492.
  70. Berges Gimeno MP, Simon RA, Stevenson DD: Long-term treatment with aspirin desensitization in asthmatic patients with aspirin-exacerbated respiratory disease. J Allergy Clin Immunol 2003;111:180-186.
  71. Chiu JT: Improvement in aspirin-sensitive asthmatic subjects after rapid aspirin desensitization and aspirin maintenance (ADAM) treatment. J Allergy Clin Immunol 1983;71:560-567.
  72. Sweet JM, Stevenson DD, Simon RA, Mathison DA: Long-term effects of aspirin desensitization--treatment for aspirin-sensitive rhinosinusitis-asthma. J Allergy Clin Immunol 1990;85:59-65.
  73. Stevenson DD, Hankammer MA, Mathison DA, Christiansen SC, Simon RA: Aspirin desensitization treatment of aspirin-sensitive patients with rhinosinusitis-asthma: long-term outcomes. J Allergy Clin Immunol 1996;98:751-758.
  74. Schaefer OP, Gore JM: Aspirin sensitivity: the role for aspirin challenge and desensitization in postmyocardial infarction patients. Cardiology 1999;91:8-13.
  75. Pleskow WW, Stevenson DD, Mathison DA, Simon RA, Schatz M, Zeiger RS: Aspirin desensitization in aspirin-sensitive asthmatic patients: clinical manifestations and characterization of the refractory period. J Allergy Clin Immunol 1982;69:11-19.
  76. Nasser SM, Patel M, Bell GS, Lee TH: The effect of aspirin desensitization on urinary leukotriene E4 concentrations in aspirin-sensitive asthma. Am J Respir Crit Care Med 1995;151:1326-1330.

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