Cytokine Expression Before and After Aspirin Desensitization Therapy in Aspirin-Exacerbated Respiratory Disease
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Cytokine Expression Before and After Aspirin Desensitization Therapy in Aspirin-Exacerbated Respiratory Disease Ayse Aktas,1,4 Emel Kurt,2 and Zafer Gulbas3
Abstract—Aspirin exacerbated respiratory disease (AERD) is induced by acetylsalicylic acid (ASA) and/or nonsteroidal antiinflammatory drugs (NSAIDs). Effects of desensitization on many mediators have been examined previously, but few studies addressed the influence of desensitization on T lymphocytes and T lymphocyte-derived cytokines. This study was performed to examine peripheral blood lymphocyte (PBL) cytokine expression in aspirin-sensitive patients who have asthma before and after aspirin desensitization. In this study, the release of interleukin-2 (IL-2), interleukin-4 (IL-4), and interferon-gamma (IFN-γ) by CD4+ T lymphocytes prior to aspirin desensitization were also measured at intracellular levels, and expression of these cytokines after 1 month aspirin desensitization was evaluated. Twelve patients with AERD were included in the study. Two different control groups were formed, one consisted of 15 healthy people and second 12 aspirin tolerant asthmatic (ATA) patients using aspirin. A blood sample was collected prior to desensitization, and the tests were repeated by taking a second blood sample 1 month after the 4-day desensitization treatment. The proportion of lymphocytes secreting IFN-γ in the study group was 15.61±4.40 % before desensitization and 15.08±5.89 % after desensitization. The rate of IFN-γ secreting CD4+ T lymphocytes was 20.51±4.41 % in the normal control group and 16.07±5.7 % in the ATA group (p=0.021). The ratio of CD4+ T lymphocyte secreting IFN-γ was reduced in patients with AERD before desensitization compared to normal control group (p=0.040). The levels of IL-2, IL-4, and the subsets of lymphocyte were not different before and after desensitization compared to control groups. KEY WORDS: desensitization; aspirin sensitivity; asthma; cytokines.
INTRODUCTION Aspirin-exacerbated respiratory disease (AERD) also known as aspirin-sensitive asthma, includes rhinitis (with or without polyps), asthma, acetylsalicylic acid (ASA), and/or other nonsteroidal antiinflammatory drugs (NSAIDs) sensitivity [1]. The prevalence of intolerance reactions caused by ASA and other NSAIDs in patients with asthma varies according to the method chosen; based
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Division of Allergy and Immunology, Department of Internal Medicine, Celal Bayar University School of Medicine, Manisa, Turkey 2 Division of Allergy and Immunology, Department of Chest Diseases, Eskisehir Osmangazi University School of Medicine, Eskisehir, Turkey 3 Bone Marrow Transplantation Center, Anadolu Medical Center Hospital, Gebze, Kocaeli, Turkey 4 To whom correspondence should be addressed at Division of Allergy and Immunology, Department of Internal Medicine, Celal Bayar University School of Medicine, Manisa, Turkey. E-mail: [email protected]
upon the self-reported statements of patients, 3 % of adults and 2 % of children experience intolerance reactions, while according to ASA provoca
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