Reacciones alérgicas inmediatas y selectivas a AINES.Nuevos fenotipos

Abstract

Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most commonly used drugs and widely prescribed for treating pain and inflammatory conditions. Hypersensitivity drug reactions (HDRs) are classified as a type B reaction, or not predictable, which are triggered by the release of anti-inflammatory mediators eliciting a variety of clinical entities ranging from urticaria and angioedema to anaphylactic shock and bronchial asthma. Recent data shows that NSAIDs are the most frequent triggers of hypersensitivity drug reactions (HDR), which may be induced by both specific immunological mechanisms mediated by IgE antibodies or T cells (allergic or selective reactions SR) and mechanisms not based on immunological recognition related to the inhibition of the cyclooxygenase (COX)-1 enzyme and subsequent release of inflammatory mediators from arachidonic acid pathway (cross-hypersensitivity reactions [CRs]). Currently, CRs mediated clinical entities are the best studied models. However, SR are also play a fundamental role in HDRs to NSAIDs, being the main trigger of drug-induced anaphylaxis and it has recently been reported that in some countries they represent the most frequent type of NSAID hypersensitivity.