AERD (Aspirin Exacerbated Respiratory Disease)

Chronic rhinosinusitis with nasal polyps (CRSwNP) has multiple endotypes including aspirin exacerbated respiratory disease (AERD) that consists of the triad of sinus polyps, asthma and non-steroidal anti-inflammatory drug induced allergic reactions. AERD is characterized by a hypersensitivity to cyclooxygenase inhibitors (for example aspirin or ibuprofen), and elevated leukotriene E4 (LTE4) levels. AERD can be managed in part by a combination of complete sinus surgery and aspirin desensitization. We identified an intranasal cytokine signature post-aspirin desensitization consistent with immune tolerance. A goal of this research effort is to understand and identify potential mechanisms of immune tolerance that may be associated with successful aspirin desensitization. This work complements the multi-disciplinary clinical efforts of the Penn AERD Center.