Genetic Mechanisms in Aspirin-induced Asthma

Although cases of violent, acute bronchospasm after aspirin ingestion were reported shortly after introduction of aspirin into therapy, only in more recent years has this type of asthma attracted the growing interest of clinicians, pharmacologists, biochemists, and molecular biologists. It has distinct features that differentiate it clearly from other types of asthma. Its course is characteristic, suggesting a common principle as the driving force. And in the background there is an alteration of arachidonic acid metabolism that contributes to the clinical presentation. Indeed, aspirin-induced asthma appears to be a cysteinyl-leukotriene (Cys-LT)-driven syndrome. Its association with leukotriene-C 4 synthase polymorphism points to a genetic influence. Would patients with this type of asthma benefit most from treatment with antileukotriene drugs, rapidly reaching the market? This question and others related to the genetic features of aspirin-induced asthma are discussed here.