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Journal of Allergy
Volume 2012 (2012), Article ID 273752, 8 pages
http://dx.doi.org/10.1155/2012/273752
Review Article

Rhinosinusitis and Aspirin-Exacerbated Respiratory Disease

1Department of Immunogenetics and Allergy, Instituto Nacional de Enfermedades Respiratorias, 14080 DF, Mexico
2Otolaryngology Department, Instituto Nacional de Enfermedades Respiratorias, 14080 DF, Mexico

Received 15 February 2012; Accepted 11 May 2012

Academic Editor: A. P. Sampson

Copyright © 2012 Maria L. Garcia Cruz et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Rhinosinusitis is a feature of aspirin-exacerbated respiratory disease (AERD), which in the initial phase is manifested as nasal congestion, mostly affecting females at the age of around 30 years on average. Subsequently, nasal inflammation progresses to chronic eosinophilic rhinosinusitis, asthma, nasal polyposis, and intolerance to aspirin and to other NSAIDs. While it has been long established that NSAIDs cause inhibition of cyclooxygenase-1 (COX-1), leading to excessive metabolism of arachidonic acid (AA) to cysteinyl-leukotrienes (cys-LTs), there is now evidence that both cytokines and staphylococcus superantigens amplify the inflammatory process exacerbating the disease. This paper gives a brief overview of the development of chronic rhinosinusitis (CRS) in sensitive patients, and we share our experience in the diagnosis and management of CRS in AERD.