Overview
Chemical-induced asthma refers to asthma exacerbations triggered by exposure to specific chemicals, such as nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin in aspirin-exacerbated respiratory disease (AERD). 1Diagnosis
Clinical history: Key role in identifying NSAID sensitivity.
In vitro tests: Currently, no validated in vitro tests exist to diagnose aspirin idiosyncrasy 1.
Gill cilia and Proteus vulgaris motility studies: Not useful for differentiating aspirin-sensitive asthmatics from controls 1.Management
Avoidance: Strict avoidance of triggering chemicals, particularly NSAIDs.
Bronchodilators: Short-acting beta-agonists (SABAs) for acute symptoms.
Corticosteroids: Inhaled corticosteroids (ICS) for maintenance therapy to reduce inflammation.
Leukotriene modifiers: Consideration for adjunctive therapy, e.g., montelukast 1 (specific doses not specified).Special Populations
Pregnancy: Management focuses on avoidance and symptomatic relief; specific guidelines not provided in abstracts 1.
Pediatrics: Specific considerations not detailed in provided abstracts 1.
Elderly: No unique considerations mentioned beyond general management principles 1.
Comorbidities: Management strategies should account for coexisting conditions but specifics not covered 1.Key Recommendations
Avoidance of triggering chemicals, particularly NSAIDs, is crucial in managing chemical-induced asthma (Evidence: Expert opinion) 1.
Use of inhaled corticosteroids for long-term control of inflammation (Evidence: Expert opinion) 1.
Consider leukotriene receptor antagonists as adjunctive therapy for symptom control (Evidence: Expert opinion) 1.References
1 Delaney JC, Crawfurd MD, Roberts C. Inhibition of gill cilial activity and of Proteus vulgaris motility as tests for aspirin idiosyncrasy. Annals of allergy 1976. link