Russian Journal of AllergyRussian Journal of AllergyРоссийский Аллергологический Журнал1810-88302686-682XPublishing House ABV Press138410.36691/RJA1384ReviewsНаучные обзорыResearch ArticleNon-steroidal anti-inflammatory drugs (NSAIDs) – exacerbated respiratory disease: epidemiology, pathogenesis, clinical findings and managementНПВП-индуцированные респираторные заболевания: эпидемиология, патогенез, клиническая картина и тактика ведения пациентовhttps://orcid.org/0000-0002-4164-4094PavlovaKsenia S.ПавловаКсения Сергеевна
Russian Federation

Senior Research Assistant of Bronchial Asthma, NRC Institute of Immunology FMBA of Russia, MD, PhD

старший научный сотрудник отделения бронхиальной астмы, ФГБУ «ГНЦ Институт иммунологии» ФМБА России, кандидат медицинских наук

ksenimedical@gmail.comhttps://orcid.org/0000-0003-1965-8446DynevaMiramgul E.ДыневаМирамгуль Есенгельдыевна
Russian Federation

post-graduate student, NRC Institute of Immunology FMBA of Russia

аспирант отделения бронхиальной астмы, ФГБУ «ГНЦ Институт иммунологии» ФМБА России

amanturliva.miramgul@mail.ruhttps://orcid.org/0000-0003-3250-0694KurbachevaOksana M.КурбачёваОксана Михайловна
Russian Federation

Head of the Asthma department, NRC Institute of Immunology FMBA of Russia, PhD, professor

зав. отделением бронхиальной астмы, ФГБУ «ГНЦ Институт иммунологии» ФМБА России, доктор медицинских наук, профессор

kurbacheva@gmail.comNRC Institute of Immunology FMBA of RussiaГНЦ Институт иммунологии ФМБА России2910202017315332707202019082020Copyright ©; 2020, Pharmarus Print MediaCopyright ©; 2020, Фармарус Принт Медиа2020Pharmarus Print MediaФармарус Принт Медиаhttps://rusalljournal.ru/raj/article/view/1384

Non­-steroidal anti­-inflammatory drugs (NSAIDs) ­– exacerbated respiratory disease (N­-ERD) are characterized by non­-allergic hypersensitivity (intolerance) to NSAIDs and aspirin in patients with asthma and/or eosinophilic chronic rhinosinusitis with nasal polyps (CRSwNP). Asthma in N­-ERD patients is usually characterized by eosinophilic inflammation, tends to become severe and intractable, and needs chronic oral corticosteroid therapy. For some patients recurrent CSwNP is more significant problem due to nasal congestion, anosmia, and multiple repeated surgeries. Intolerance to aspirin and other NSAIDs limits the choice of pain relievers and antipyretics. Accidental use of these medications can lead to dangerous consequences, including anaphylaxis. This review presents the current understanding of the N­-ERD pathogenesis and perspective trends in therapy.

Респираторные заболевания, индуцированные приемом нестероидных противовоспалительных препаратов (НПВП-индуцированные РЗ), характеризуются неаллергической гиперчувствительностью (непереносимостью) к НПВП и аспирину у пациентов с бронхиальной астмой и/или эозинофильным полипозным риносинуситом (ПРС). Астма в группе пациентов с НПВП-индуцированными РЗ, как правило, характеризуется эозинофильным воспалением, тяжелым течением, торпидным к стандартной терапии, приводящим к назначению системных глюкокортикостероидов на постоянной основе. Рецидивирующий ПРС для некоторых пациентов представляет собой наиболее значимую проблему, поскольку сопряжен с отсутствием носового дыхания и обоняния и необходимостью многократных повторных оперативных вмешательств. Непереносимость аспирина и других НПВП является отдельной проблемой, резко снижающей выбор препаратов, которые можно использовать у данной группы пациентов в качестве обезболивающих и жаропонижающих. Случайное применение этих препаратов может приводить к жизнеугрожающим реакциям, включая анафилактический шок. В данном обзоре представлены современные представления о патогенезе НПВП-индуцированных РЗ и перспективные направления в терапии.

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