Abstract
Five patients with asthma and severe aspirin hypersensitivity were challenged on separate days with increasing doses of aspirin given by mouth, starting with 5 mg, until a reduction in FEV1 greater than 15% was obtained. Sodium cromoglycate in doses of 20-40 mg inhibited the bronchoconstrictive reaction not only when inhaled before the challenge but also after it, at a time when progressive reduction in FEV1 values was taking place. According to these results, it seems reasonable to postulate sequential mast cell degranulation and liberation of mediators of anaphylaxis as the mechanism through which aspirin induces bronchoconstriction in aspirin-sensitive asthmatics. The differences between bronchial provocation tests and oral challenge with aspirin are stressed.
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Selected References
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- Beaven M. A. Histamine (first of two parts). N Engl J Med. 1976 Jan 1;294(1):30–36. doi: 10.1056/NEJM197601012940108. [DOI] [PubMed] [Google Scholar]
- Cox J. S., Altounyan R. E. Nature and modes of action of disodium cromoglycate (Lomudal). Respiration. 1970;27(Suppl):292–309. doi: 10.1159/000192762. [DOI] [PubMed] [Google Scholar]
- Cox J. S. Disodium cromoglycate. Mode of action and its possible relevance to the clinical use of the drug. Br J Dis Chest. 1971 Oct;65(4):189–204. doi: 10.1016/0007-0971(71)90028-3. [DOI] [PubMed] [Google Scholar]
- Davies S. E. Effect of disodium cromoglycate on exercise-induced asthma. Br Med J. 1968 Sep 7;3(5618):593–594. doi: 10.1136/bmj.3.5618.593. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Delaney J. C., Kay A. B. Complement components and IgE in patients with asthma and aspirin idiosyncrasy. Thorax. 1976 Aug;31(4):425–427. doi: 10.1136/thx.31.4.425. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Foreman J. C., Garland L. G. Cromoglycate and other antiallergic drugs: a possible mechanism of action. Br Med J. 1976 Apr 3;1(6013):820–821. doi: 10.1136/bmj.1.6013.820. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Girard J. P., Hildebrandt F., Favre H. Hypersensitivity to aspirin: clinical and immunological studies. Helv Med Acta. 1969 Nov;35(2):86–95. [PubMed] [Google Scholar]
- Kaliner M., Austen K. F. Immunologic release of chemical mediators from human tissues. Annu Rev Pharmacol. 1975;15:177–189. doi: 10.1146/annurev.pa.15.040175.001141. [DOI] [PubMed] [Google Scholar]
- Kang B., Townley R. G., Lee C. K., Miller Kolotkin B. Bronchial reactivity to histamine before and after sodium cromoglycate in bronchial asthma. Br Med J. 1976 Apr 10;1(6014):867–870. doi: 10.1136/bmj.1.6014.867. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kolotkin B. M., Lee C. K., Townley R. G. Duration and specificity of sodium cromolyn on allergen inhalation challenges in asthmatics. J Allergy Clin Immunol. 1974 May;53(5):288–297. doi: 10.1016/0091-6749(74)90108-0. [DOI] [PubMed] [Google Scholar]
- Lavin N., Rachelefsky G. S., Kaplan S. A. An action of disodium cromoglycate: inhibition of cyclic 3',5'-AMP phosphodiesterase. J Allergy Clin Immunol. 1976 Jan;57(1):80–88. doi: 10.1016/0091-6749(76)90081-6. [DOI] [PubMed] [Google Scholar]
- Levy G. Pharmacokinetics of salicylate elimination in man. J Pharm Sci. 1965 Jul;54(7):959–967. doi: 10.1002/jps.2600540703. [DOI] [PubMed] [Google Scholar]
- McDonald J. R., Mathison D. A., Stevenson D. D. Aspirin intolerance in asthma. Detection by oral challenge. J Allergy Clin Immunol. 1972 Oct;50(4):198–207. doi: 10.1016/0091-6749(72)90014-0. [DOI] [PubMed] [Google Scholar]
- Patel K. R. Atropine, sodium cromoglycate, and thymoxamine in PGF2 alpha-induced bronchoconstriction in extrinsic asthma. Br Med J. 1975 May 17;2(5967):360–362. doi: 10.1136/bmj.2.5967.360. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pepys J., Hutchcroft B. J. Bronchial provocation tests in etiologic diagnosis and analysis of asthma. Am Rev Respir Dis. 1975 Dec;112(6):829–859. doi: 10.1164/arrd.1975.112.6.829. [DOI] [PubMed] [Google Scholar]
- Roncoroni A. J., Goldman E., Puy R. J., Mancino M. Bronchoconstriction induced by repeated forced vital capacity manoeuvres. Acta Allergol. 1975 Dec;30(6):375–389. doi: 10.1111/j.1398-9995.1975.tb01673.x. [DOI] [PubMed] [Google Scholar]
- Rowland M., Riegelman S., Harris P. A., Sholkoff S. D. Absorption kinetics of aspirin in man following oral administration of an aqueous solution. J Pharm Sci. 1972 Mar;61(3):379–385. doi: 10.1002/jps.2600610312. [DOI] [PubMed] [Google Scholar]
- Samter M., Beers R. F., Jr Concerning the nature of intolerance to aspirin. J Allergy. 1967 Nov;40(5):281–293. doi: 10.1016/0021-8707(67)90076-7. [DOI] [PubMed] [Google Scholar]
- Samter M., Beers R. F., Jr Intolerance to aspirin. Clinical studies and consideration of its pathogenesis. Ann Intern Med. 1968 May;68(5):975–983. doi: 10.7326/0003-4819-68-5-975. [DOI] [PubMed] [Google Scholar]
- Settipane G. A., Chafee F. H., Klein D. E. Aspirin intolerance. II. A prospective study in an atopic and normal population. J Allergy Clin Immunol. 1974 Apr;53(4):200–204. doi: 10.1016/0091-6749(74)90081-5. [DOI] [PubMed] [Google Scholar]
- Smith A. P. Response of aspirin-allergic patients to challenge by some analgesics in common use. Br Med J. 1971 May 29;2(5760):494–496. doi: 10.1136/bmj.2.5760.494. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Szczeklik A., Gryglewski R. J., Czerniawska-Mysik G. Relationship of inhibition of prostaglandin biosynthesis by analgesics to asthma attacks in aspirin-sensitive patients. Br Med J. 1975 Jan 11;1(5949):67–69. doi: 10.1136/bmj.1.5949.67. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Yurchak A. M., Wicher K., Arbesman C. E. Immunologic studies on aspirin. Clinical studies with aspiryl-protein conjugates. J Allergy. 1970 Oct;46(4):245–253. doi: 10.1016/0021-8707(70)90028-6. [DOI] [PubMed] [Google Scholar]
