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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Why Does Taking Aspirin Cause Wheezing?

Hi, I was just wondering if someone would be able to explain the mechanism of action behind why taking aspirin can cause wheezing? Is this related to the fact that asthmatics are unable to take aspirin as an NSAID as it potentiates leukotrienes and hence bronchospasm?
Wed, 31 May 2023
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General & Family Physician 's  Response
Hi,

Yes, you are correct that taking aspirin can cause wheezing in some individuals, especially those with asthma. This phenomenon is known as aspirin-exacerbated respiratory disease (AERD), also called aspirin-induced asthma. The exact mechanism of how aspirin causes wheezing is not fully understood, but it is believed to involve the cyclooxygenase (COX) pathway and the arachidonic acid (AA) pathway. Aspirin is an NSAID that inhibits COX, an enzyme that produces prostaglandins from AA.

Prostaglandins are mediators of pain and inflammation. In individuals with AERD, the inhibition of COX by aspirin leads to the shunting of AA towards the lipoxygenase pathway, which results in the production of leukotrienes. Leukotrienes are potent inflammatory mediators that can cause bronchospasm, mucus secretion, and swelling of the airway walls. In individuals with asthma, the production of leukotrienes is already increased, and the addition of aspirin can further exacerbate bronchospasm and wheezing.

It is important to note that not all individuals with asthma are sensitive to aspirin, and the severity of AERD can vary among individuals. If you experience wheezing or other respiratory symptoms after taking aspirin, you should avoid taking it and discuss this with your doctor. They may be able to provide alternative pain relief options or prescribe medication to manage your asthma symptoms.

If you require a personalized response, kindly use the Ask A Doctor service and post a follow-up. Take care. Hope I have answered your question.

Regards,
Dr. Priyanka, General & Family Physician
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Internal Medicine Specialist Dr. Dr diwashish biswas's  Response
Hi,

Aspirin is a type of nonsteroidal anti-inflammatory drug (NSAID) that works by blocking the action of an enzyme called cyclooxygenase (COX). COX is involved in the production of prostaglandins, which are chemical messengers that regulate inflammation, pain, and fever.

In some individuals, particularly those with a history of asthma or nasal polyps, taking aspirin can lead to a rare condition called aspirin-exacerbated respiratory disease (AERD), also known as aspirin-induced asthma. This condition is characterized by wheezing, shortness of breath, nasal congestion, and sometimes even anaphylaxis.

The exact mechanism behind AERD is not fully understood, but it is thought to involve the abnormal metabolism of arachidonic acid, which is a precursor to leukotrienes. Leukotrienes are chemical messengers that also regulate inflammation and are involved in the pathophysiology of asthma. In individuals with AERD, aspirin and other NSAIDs can trigger the overproduction of leukotrienes, leading to bronchospasm and other respiratory symptoms.

In summary, taking aspirin can cause wheezing in some individuals, particularly those with a history of asthma or nasal polyps, due to a rare condition called aspirin-exacerbated respiratory disease (AERD). The mechanism behind AERD is thought to involve the abnormal metabolism of arachidonic acid, which leads to the overproduction of leukotrienes and subsequent bronchospasm.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Diwashish Biswas, Internal Medicine Specialist
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Why Does Taking Aspirin Cause Wheezing?

Hi, Yes, you are correct that taking aspirin can cause wheezing in some individuals, especially those with asthma. This phenomenon is known as aspirin-exacerbated respiratory disease (AERD), also called aspirin-induced asthma. The exact mechanism of how aspirin causes wheezing is not fully understood, but it is believed to involve the cyclooxygenase (COX) pathway and the arachidonic acid (AA) pathway. Aspirin is an NSAID that inhibits COX, an enzyme that produces prostaglandins from AA. Prostaglandins are mediators of pain and inflammation. In individuals with AERD, the inhibition of COX by aspirin leads to the shunting of AA towards the lipoxygenase pathway, which results in the production of leukotrienes. Leukotrienes are potent inflammatory mediators that can cause bronchospasm, mucus secretion, and swelling of the airway walls. In individuals with asthma, the production of leukotrienes is already increased, and the addition of aspirin can further exacerbate bronchospasm and wheezing. It is important to note that not all individuals with asthma are sensitive to aspirin, and the severity of AERD can vary among individuals. If you experience wheezing or other respiratory symptoms after taking aspirin, you should avoid taking it and discuss this with your doctor. They may be able to provide alternative pain relief options or prescribe medication to manage your asthma symptoms. If you require a personalized response, kindly use the Ask A Doctor service and post a follow-up. Take care. Hope I have answered your question. Regards, Dr. Priyanka, General & Family Physician