Arachidonic acid metabolism in nasal tissue and peripheral blood cells in aspirin intolerant asthmatics

Aspirin intolerance (AI) is characterized by polypous rhinosinusitis, bronc hial asthma and adverse reactions to aspirin. The common intolerance to all cyclo-oxygenase inhibitors allows us to focus study of the pathogenesis of AI on the metabolism of arachidonic acid (AA). We studied the metabolism o f AA in nine aspirin intolerant asthmatics (AIA) and eight healthy voluntee rs (controls) by measuring prostaglandin E-2 (PGE(2)) and peptido-leukotrie nes (pLT = LTC4/D-4/E-4) in nasal tissue and peripheral blood cells (PBCs) using a specific immunoassay. In all patients with AI the tests were perfor med before and after bronchial provocation with lysine-ASA. In the control group the tests were done before and after 500 mg ASA p.o. The release of p LT in nasal polyps of AIA was found to be significantly higher than in norm al mucosa of AIAs and controls. In every tissue a significant increase of p LT after aspirin challenge was observed. Nasal polyps of AIA show a signifi cantly lower release of PGE(2) than normal mucosa of AIAs and controls. Per ipheral blood cells of AIA show a significantly higher release of pLT and a significantly lower release of PGE(2) than PBCs of controls. Therefore cli nical manifestations of AI may be based on an alteration of AA metabolism i n AIA.