AERD is a common respiratory condition in people with asthma who have sensitivity to aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs).

Aspirin is usually taken as a handy aid for relieving aches and pains and also as a way to help prevent heart attacks. But, in some cases, its use can be the primary cause of certain diseases.

One such disease, aspirin-exacerbated respiratory disease (AERD), is a common respiratory condition that occurs in people with asthma who have sensitivity to aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs). AERD affects 5 to 10 percent of adults with asthma, around 30 percent of people with severe asthma, and approximately 40 percent of people with asthma plus nasal polyps. New research at Brigham and Women’s Hospital, however, has provided insight into how the disease reveals itself and has helped suggest new treatment options.

One of the characteristics of AERD is the overproduction of cysteinyl leukotrienes – one of many chemical “referees” that control the body’s inflammatory response. Overproduction of these regulators leads to narrowing of airway passages in the lungs and other respiratory symptoms. Also, the respiratory system’s negative reaction to aspirin prevents another type of inflammatory response referee, known as prostaglandin E2, from being produced and working properly.

“Our study strongly suggests that the body’s inability to make normal amounts of prostaglandin E2 is a likely cause of AERD,” says Joshua Boyce, MD, Director of the Inflammation and Allergic Diseases Section in the Department of Rheumatology, Immunology and Allergy, and senior study author.

Knowing that insufficient quantities of prostaglandins play a role in causing AERD, researchers deliberately established normal levels of prostaglandins in pre-clinical studies. This served to reduce adverse respiratory reactions to aspirin by about 90 percent. The researchers also demonstrated that using drugs that targeted certain cells and cell receptors involved in the overproduction of chemical referees effectively reduced AERD symptoms.

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– Chris P., MMQ

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