Lipoxygenase inhibitor-provoked acute asthma in a patient with asthma relieved by aspirin
Imokawa, S.; Sato, A.; Taniguchi, M.; Toyoshima, M.; Hayakawa, H.; Chida, K.
Annals of Allergy Asthma and Immunology Official Publication of the American College of Allergy Asthma and Immunology 75(2): 112-114
1995
ISSN/ISBN: 1081-1206 PMID: 7648373 Document Number: 449542
A very small number of patients with asthma show symptomatic improvement after administration of aspirin and other cyclooxygenase inhibitors. The clinical features of such patients with so-called aspirin-relieved asthma are similar to those with aspirin-induced asthma, but the pathogenesis is unclear. We encountered one confirmed aspirin-relieved asthma patient and investigated the effects of cyclooxygenase and lipoxygenase inhibitors on his condition. Our patient showed a marked improvement of the forced expiratory volume in one second (FEV1) after administration of aspirin and three other cyclooxygenase inhibitors (indomethacin, mefenamic acid, and ketoprofen). A 5-lipoxygenase inhibitor (AA861, Takeda, Japan), however, evoked acute asthma, and repeated administration of this drug resulted in some desensitization, but not complete tolerance. These results suggest an altered balance of arachidonic acid metabolism may play a critical role in the pathophysiology of aspirin-relieved asthma.