- مبلغ: ۸۶,۰۰۰ تومان
- مبلغ: ۹۱,۰۰۰ تومان
Asthma is a common chronic disease with several variant phenotypes and endotypes. NSAID-exacerbated respiratory disease (NERD) is one such endotype characterized by asthma, chronic rhinosinusitis (CRS) with nasal polyps, and hypersensitivity to aspirin/cyclooxygenase-1 inhibitors. NERD is more associated with severe asthma than other asthma phenotypes. Regarding diagnosis, aspirin challenge tests via the oral or bronchial route are a standard diagnostic method; reliable in vitro diagnostic tests are not available. Recent studies have reported various biomarkers of phenotype, diagnosis, and prognosis. In this review, we summarized the known potential biomarkers of NERD that are distinct from those of aspirin-tolerant asthma. We also provided an overview of the different NERD subgroups.
The most useful biomarker of NERD is urinary LTE4. Urinary LTE4 level can be used for distinguishing the phenotype (including subtypes) and for predicting the response to desensitization and prognosis. Sputum/blood eosinophil counts are also biomarkers that can be used to identify the endotype of NERD and to monitor the course of treatment. Serum periostin levels and HLA-DPB1 (∗0301 and genetic polymorphisms) are suggested as useful biomarkers for predicting NERD phenotypes.