LIPOXYGENASE INHIBITOR-PROVOKED ACUTE ASTHMA IN A PATIENT WITH ASTHMARELIEVED BY ASPIRIN

Background: A very small number of patients with asthma show symptomat ic improvement after administration of aspirin and other cyclooxygenas e inhibitors. The clinical features of such patients with so-called as pirin-relieved asthma are similar to those with aspirin-induced asthma , but the pathogenesis is unclear. Methods: We encountered one confirm ed aspirin-relieved asthma patient and investigated the effects of cyc looxygenase and lipoxygenase inhibitors on his condition. Results: Our patient showed a marked improvement of the forced expiratory volume i n one second (FEV,) after administration of aspirin and three other cy clooxygenase inhibitors (indomethacin, mefenamic acid, and ketoprofen) . A 5-lipoxygenase inhibitor (AA861, Takeda, Japan), however, evoked a cute asthma, and repeated administration of this drug resulted in some desensitization, but not complete tolerance. Conclusions: These resul ts suggest an altered balance of arachidonic acid metabolism may play a critical role in the pathophysiology of aspirin-relieved asthma.