Mechanistic and clinical updates in AERD: 2021-2022

Whitney W. Stevens; Katherine N. Cahill

doi:10.1016/j.jaci.2023.03.015

Mechanistic and clinical updates in AERD: 2021-2022

Whitney W. Stevens, Katherine N. Cahill^*

^*Corresponding author for this work

Medicine, Allergy Division

Research output: Contribution to journal › Article › peer-review

10 Scopus citations

Abstract

Aspirin-exacerbated respiratory disease (AERD) is a unique and often clinically severe disease affecting a subgroup of adults with asthma and chronic rhinosinusitis with nasal polyposis. Works published in 2021-2022 confirmed the critical role of lipid mediator dysregulation and mast cell activation and expanded our understanding of basophils, macrophages, fibrin dysregulation, and the 15-lipoxygenase pathway in disease pathogenesis. Translational studies established inflammatory heterogeneity in the upper and lower airway at baseline and during aspirin-induced respiratory reactions. Clinical cohorts provided insights into the mechanistic actions of frequently utilized biologic therapies in AERD. These advances are already changing clinical care delivery and affecting patient outcomes. Despite this, further work is needed to improve clinical tools to reliably diagnose AERD and identify factors that could prevent development of the disease altogether. Additionally, the impact of inflammatory heterogeneity on clinical trajectories and the utility and safety of combination biologic and daily aspirin therapies remains unanswered.

Original language	English (US)
Pages (from-to)	1448-1456
Number of pages	9
Journal	Journal of Allergy and Clinical Immunology
Volume	151
Issue number	6
DOIs	https://doi.org/10.1016/j.jaci.2023.03.015
State	Published - Jun 2023

Funding

Supported by grants U01 AI155299, R01 HL122554, and UG1 HL139119 (to K.N.C.); grants K23AI141694 and P01AI145818 (to W.W.S.); and the Walder Foundation/ Doris Duke Charitable Foundation (to W.W.S.). Supported by grants U01 AI155299, R01 HL122554, and UG1 HL139119 (to K.N.C.); grants K23AI141694 and P01AI145818 (to W.W.S.); and the Walder Foundation/Doris Duke Charitable Foundation (to W.W.S.).Disclosure of potential conflict of interest: K. N. Cahill serves on scientific advisory boards for GSK, AstraZeneca, and Regeneron; serves as a consultant for Third Harmonic Bio, Ribon Therapeutics, and Verantos; receives royalties from UpToDate and ClinicalKey; and receives research support from NovoNordisk outside the submitted work. W. W. Stevens served on scientific advisory boards for GSK and Regeneron.

Keywords

15-lipoxygenase
Nasal polyps
asthma
basophil
biologics
chronic rhinosinusitis
macrophage
mast cell
mechanisms
type 2 inflammation

ASJC Scopus subject areas

Immunology and Allergy
Immunology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jaci.2023.03.015

Cite this

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title = "Mechanistic and clinical updates in AERD: 2021-2022",

abstract = "Aspirin-exacerbated respiratory disease (AERD) is a unique and often clinically severe disease affecting a subgroup of adults with asthma and chronic rhinosinusitis with nasal polyposis. Works published in 2021-2022 confirmed the critical role of lipid mediator dysregulation and mast cell activation and expanded our understanding of basophils, macrophages, fibrin dysregulation, and the 15-lipoxygenase pathway in disease pathogenesis. Translational studies established inflammatory heterogeneity in the upper and lower airway at baseline and during aspirin-induced respiratory reactions. Clinical cohorts provided insights into the mechanistic actions of frequently utilized biologic therapies in AERD. These advances are already changing clinical care delivery and affecting patient outcomes. Despite this, further work is needed to improve clinical tools to reliably diagnose AERD and identify factors that could prevent development of the disease altogether. Additionally, the impact of inflammatory heterogeneity on clinical trajectories and the utility and safety of combination biologic and daily aspirin therapies remains unanswered.",

keywords = "15-lipoxygenase, Nasal polyps, asthma, basophil, biologics, chronic rhinosinusitis, macrophage, mast cell, mechanisms, type 2 inflammation",

author = "Stevens, {Whitney W.} and Cahill, {Katherine N.}",

note = "Publisher Copyright: {\textcopyright} 2023 American Academy of Allergy, Asthma & Immunology",

year = "2023",

month = jun,

doi = "10.1016/j.jaci.2023.03.015",

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AU - Cahill, Katherine N.

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N2 - Aspirin-exacerbated respiratory disease (AERD) is a unique and often clinically severe disease affecting a subgroup of adults with asthma and chronic rhinosinusitis with nasal polyposis. Works published in 2021-2022 confirmed the critical role of lipid mediator dysregulation and mast cell activation and expanded our understanding of basophils, macrophages, fibrin dysregulation, and the 15-lipoxygenase pathway in disease pathogenesis. Translational studies established inflammatory heterogeneity in the upper and lower airway at baseline and during aspirin-induced respiratory reactions. Clinical cohorts provided insights into the mechanistic actions of frequently utilized biologic therapies in AERD. These advances are already changing clinical care delivery and affecting patient outcomes. Despite this, further work is needed to improve clinical tools to reliably diagnose AERD and identify factors that could prevent development of the disease altogether. Additionally, the impact of inflammatory heterogeneity on clinical trajectories and the utility and safety of combination biologic and daily aspirin therapies remains unanswered.

AB - Aspirin-exacerbated respiratory disease (AERD) is a unique and often clinically severe disease affecting a subgroup of adults with asthma and chronic rhinosinusitis with nasal polyposis. Works published in 2021-2022 confirmed the critical role of lipid mediator dysregulation and mast cell activation and expanded our understanding of basophils, macrophages, fibrin dysregulation, and the 15-lipoxygenase pathway in disease pathogenesis. Translational studies established inflammatory heterogeneity in the upper and lower airway at baseline and during aspirin-induced respiratory reactions. Clinical cohorts provided insights into the mechanistic actions of frequently utilized biologic therapies in AERD. These advances are already changing clinical care delivery and affecting patient outcomes. Despite this, further work is needed to improve clinical tools to reliably diagnose AERD and identify factors that could prevent development of the disease altogether. Additionally, the impact of inflammatory heterogeneity on clinical trajectories and the utility and safety of combination biologic and daily aspirin therapies remains unanswered.

KW - 15-lipoxygenase

KW - Nasal polyps

KW - asthma

KW - basophil

KW - biologics

KW - chronic rhinosinusitis

KW - macrophage

KW - mast cell

KW - mechanisms

KW - type 2 inflammation

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ER -

Mechanistic and clinical updates in AERD: 2021-2022

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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