Dx. Zhu et al., DRUG ALLERGY - IDENTIFICATION AND CHARACTERIZATION OF IGE-REACTIVITIES TO ASPIRIN AND RELATED-COMPOUNDS, Journal of investigational allergology & clinical immunology, 7(3), 1997, pp. 160-168
Twenty-seven patients with aspirin (ASA) sensitivity were studied. 14
patients had naso-ocular-bronchial reactions after taking ASA while ot
hers had cutaneous and gastrointestinal reactions. The oral challenges
with salicylic acid (SA), O-methylsalicylic acid (OMSA), ASA, and the
determination of IgE antibodies specific to salicyloyl, O-methylsalic
yloyl, acetylsalicyloyl using correspondent disks by RAST, RAST inhibi
tion and RAST cross inhibition assays were performed. The findings sug
gest that OMSA seems to be the main offender responsible for cutaneous
and gastrointestinal reactions, whereas ASA is responsible for naso-o
cular-bronchial reactions. The clinical cross reactions between ASA an
d ASA-like drugs (nonsteroidal anti-inflammatory drugs and pyrazolone
drugs) are probably due to ''inborn errors of metabolism'. The results
indicate that genetic factors, mast-cell heterogeneity, and the inter
individual variability in drug metabolism, combined with immunological
background should be considered as underlying mechanisms.