The most common connection between asthma and aspirin is the risk of severe allergic reaction. For those with asthma, aspirin allergies or sensitivity to aspirin typically triggers an asthma attack, rather than hives or other common allergy symptoms. According to reports and studies, only a small number of patients with asthma have aspirin sensitivity. Several studies throughout the 20th and 21st centuries explored the causes, frequency, and severity of adverse reactions to aspirin among patients with asthma.
Initial studies in the 1920s suggested that certain individuals with asthma experienced severe asthma attacks when taking aspirin. Further research in the 1960s also suggested a link between asthma and aspirin, especially when patients also presented with nasal polyps. Today, a small percentage of asthma patients have what is known as Samter’s syndrome or the asthma triad. Samter’s syndrome is the combined presence of nasal polyps, asthma, and aspirin sensitivity. Patients with all three factors are at risk for severe, even fatal asthma attacks when aspirin or aspirin-containing medications are ingested.
Experts project a mix of opinions on just how many people are at risk in terms of the combination of asthma and aspirin sensitivity. Some experts suggest that less than five percent of asthma patients have Samter’s syndrome or other forms of aspirin-sensitive asthma. Other experts put the numbers between 10 and 20 percent. Regardless of the specific number of people affected, most medical professionals advise patients with asthma to avoid taking anything containing aspirin or aspirin-like medications. Such medications, known as non-steroidal anti-inflammatory drugs or NSAIDs, include ibuprofen, naproxen, and similar over-the-counter pain relievers with aspirin-like qualities.
In terms of causation, aspirin can cause a severe asthma attack in patients with aspirin-sensitive asthma due to anomalies in how the body handles arachidonic acids. Arachidonic acids are an integral part of the natural inflammatory response encoded into every living being. These chemicals control how and when muscles and blood vessels contract and dilate. Specifically, aspirin blocks the production of prostaglandin, a chemical that helps moderate inflammatory responses. As a result, the body produces too much leukotrienes, causing unregulated rates of inflammation, especially in the bronchial tubes.
Not all patients with asthma and aspirin sensitivities have a severe response. Severe attacks are most commonly seen in patients with Samter’s syndrome. Although, patients may experience severe reactions to aspirin regardless of whether the patient has Samter’s syndrome or not. Most asthma patients do not show signs of aspirin sensitivity until adulthood, with 20 to 30 being the average age for the onset of adverse reactions. Avoidance of aspirin is the most common treatment, although some patients may require a special diet, medication therapies, or surgery to remove polyps.