Table 1.
Pathogenic mechanisms and clinical manifestations of NSAID hypersensitivity
| Type of reaction | Time of onseta | Clinical manifestation | Mechanism |
|---|---|---|---|
| Cross reactive | Acute | NERD | COX-1 inhibition |
| Oxidative stress | |||
| NECD | COX-1 inhibition | ||
| NIUA | COX-1 inhibition | ||
| Platelet activation | |||
| Selective | Acute | SNIUAA | IgE-mediated |
| Delayed | NIDHR | T cell-mediated |
NSAID, nonsteroidal anti-inf lammatory drug; NERD, NSAID-exacerbated respiratory disease; COX-1, cyclooxygenase 1; NECD, NSAID-exacerbated cutaneous disease; NIUA, NSAID-induced urticaria/angioedema; SNIUAA, single-NSAID-induced urticaria/anaphylaxis; IgE, immunoglobulin E; NIDHR, NSAID-induced delayed hypersensitivity reaction.
a
Acute onset, clinical symptoms occur immediately or a few hours after drug administration; delayed onset, clinical symptoms occur 24 hours or more after drug administration.