The Journal of Allergy and Clinical Immunology
Volume 121, Issue 2 , Pages 348-354, February 2008

Systemic responses after bronchial aspirin challenge in sensitive patients with asthma

  • Joanna S. Makowska, MD, PhD

      Affiliations

    • Department of Immunology, Rheumatology and Allergy, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
    • ,
  • Janina Grzegorczyk, PhD

      Affiliations

    • Department of Immunological Diagnostics, Faculty of Pharmacy, Medical University of Lodz, Lodz, Poland
    • ,
  • Barbara Bienkiewicz, MD, PhD

      Affiliations

    • Department of Immunology, Rheumatology and Allergy, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
    • ,
  • Maria Wozniak, MD, PhD

      Affiliations

    • Allergy Clinic, Plock, Poland
    • ,
  • Marek L. Kowalski, MD, PhD

      Affiliations

    • Department of Immunology, Rheumatology and Allergy, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
    • Corresponding Author InformationReprint requests: Marek L. Kowalski, MD, PhD, Department of Immunology, Rheumatology and Allergy, Chair of Immunology, Medical University of Lodz, 251 Pomorska Str, 92-215 Lodz, Poland.

Received 28 March 2007; received in revised form 16 September 2007; accepted 26 September 2007. published online 18 December 2007.

Background

In aspirin-sensitive patients with asthma, bronchial obstruction induced by oral aspirin may be associated with extrabronchial symptoms, suggesting the systemic character of the response.

Objective

Go assess potential systemic effects of local aspirin challenge, hemopoietic progenitors were measured in the peripheral blood of challenged patients.

Methods

In 19 patients with a history of aspirin-induced asthma, placebo-controlled bronchial challenges with lysine-aspirin were performed. Peripheral blood was collected before and then 1 hour and 20 hours after challenge (placebo or aspirin). Using the flow-cytometric method, the numbers of leukocyte (CD34+ cells) and eosinophil (CD34+CD125+ cells) progenitors were determined.

Results

The challenge was positive in 13 patients; 6 patients had isolated local bronchial reaction, and 7 patients developed systemic symptoms (bronchial and extrabronchial). In patients with positive challenge (n = 13), leukocyte progenitors increased significantly at 1 hour and 20 hours after challenge (mean, 0.04% at baseline, 0.066% at 1 hour after challenge, and 0.073% at 20 hours; P < .05). Eosinophil progenitors raised significantly from mean 0.017% before challenge to 0.04% (P < .05) at 20 hours after the challenge. At 20 hours after the challenge, the increase in leukocyte and eosinophil progenitors was observed only in patients with systemic reactions. Positive aspirin challenge was associated with a significant increase in eotaxin 2 serum concentration.

Conclusion

This study demonstrated that bronchial challenge with aspirin may involve systemic reactions and is associated with mobilization of leukocyte and eosinophil progenitor cells from the bone marrow.

Key words: Aspirin hypersensitivity, bronchial asthma, AERD, progenitor cells, CD34, aspirin bronchial challenge

Abbreviations used: EP, Eosinophil progenitor, LP, Lymphocyte progenitor, NSAID, Nonsteroidal anti-inflammatory drug

 

 Supported by research grant #3PO5A12325 from the National Research Committee.

 Disclosure of potential conflict of interest: The authors have declared that they have no conflict of interest.

PII: S0091-6749(07)01833-7

doi:10.1016/j.jaci.2007.09.039

The Journal of Allergy and Clinical Immunology
Volume 121, Issue 2 , Pages 348-354, February 2008