Desensitization aspirin

Aspirin desensitization is useful in diseases where low-level antiplatelet action is needed and in the care of patients with aspirin sensitivity and intractable nasal polyps. Lysine aspirin availability in Europe allows desensitization by inhalation at... 

Pleskow WW, Stevenson DD, Mathison DA, Simon RA, Schatz M, Zeiger RS. Aspirin desensitization in aspirin-sensitive asthmatic patients clinical manifestations and characterization of the refractory period. J Allergy Clin Immunol 1982 69(1 Pt 1) 11-19. 

Chiu, J. T., 1983, Improvement in aspirin-sensitive asthmatic subjects after rapid aspirin desensitization and aspirin maintainance (ADAM) treatment, J. Allergy Clin. Immunol. 71 560. 

Berges-Gimeno MP, Simon RA, Stevenson DD. Longterm treatment with aspirin desensitization in asthmatic patients with aspirin-exacerbated respiratory disease. J Allergy Chn Immunol. 2003 11 180-6. 

In general, treatment of the asthma underlying NSAlDs sensitivity should follow standard asthma guidelines. This type of asthma is often severe and frequently high doses of inhaled corticosteroids and daily doses of oral corticosteroids are necessary. A special treatment option is a chronic desensitization to aspirin [8]. Desensitization and aspirin maintenance is routinely used in some centers for treatment of chronic rhinusinusitis with nasal polyposis. It is the only available procedure which allows AIA patients with ischemic heart disease to use aspirin. During the state of desensitization to aspirin, not only aspirin but almost all strong NSAIDs are tolerated, so desensitization and NSAID maintenance could be used for treatment of rheumatic disease or chronic pain syndromes. 

Cayenne pepper s active constituent, capsaicin, produces a hot sensation and is used to treat pain caused by herpes, shingles, arthritis, rheumatism, and other neuralgias by desensitizing the neurons that transmit pain. Capsaicin is used to treat overactive bladders by desensitizing the neurons that trigger excess activity. Cayenne may stimulate the release of opiate-like endorphins and contain aspirin-like salicylates. 

Asthma induced by aspirin is often severe and resistant to treatment. Avoidance of aspirin and substances to which there is cross-sensitivity is the only satisfactory solution. Desensitization is not usually successful and repeated treatments are needed to maintain any effect (84,85). 

Patients with aspirin sensitivity can be desensitized. The ease of desensitization correlates with the sensitivity of the patient. Highly sensitive patients who react initially to less than 100 mg aspirin require multiple rechallenges to produce desensitization. Desensitization usually persists for 2 to 5 days following discontinuance, with full sensitivity reestablished within 7 days. Cross-desensitization has been established between aspirin and aU NSAIDs tested to date. Because patients may experience life-threatening reactions, desensitization should be attempted only in a controlled environment by personnel with expertise in handling these patients. In addition, there have been reports of patients who have failed to maintain a desensitized state despite continued aspirin administration. The chronic asthma symptoms have improved markedly in a number of aspirin-sensitive asthmatics who have undergone desensitization. ... 

In aspirin-sensitive rhinosinusitis, the number of cells expressing the lenkotriene receptor CysLTiR (Sect. 3.2.5.2.2) is significantly higher in aspirin-sensitive than in aspirin-tolerant patients, and desensitization is associated with a decrease in the numbers of cells expressing CysLTiR. 

Table 9.3 Oral desensitization protocol for patients with aspirin-induced asthma (aspirin-exacerbated respiratory disease)...

Following successful desensitization, daily aspirin tablet treatment is maintained... 

Table 9.4 Oral desensitization protocols for patients with aspirin/NSAlD-induced cutaneous reactions...

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