Aspirin-exacerbated respiratory disease (AERD) is a chronic inflammatory disease. It is defined by asthma, chronic rhinosinusitis with nasal polyposis, and a hypersensitivity reaction to aspirin or nonsteroidal anti-inflammatory drugs. Aspirin desensitization (AD) has been confirmed as an effective treatment to control AERD inflammation through the modulation of immune responses. We aimed to review AERD with an overview of the epidemiology, pathophysiology, and treatment. We also discussed the effect of AD on immunological markers involved in AERD pathogenesis. A search of electronic databases on AERD was performed. We included five randomized clinical trials (RCTs) on AD. We also searched databases for recent studies that investigated the effect of AD on the immunological mechanisms of AERD. RCTs have demonstrated the therapeutic effectiveness of AD on the patients’,quality of life, asthma symptom score, inhaled and oral steroid use, forced expiratory volume in 1 sec (FEV1), and inflammatory mediators. The clinical benefits of AD can occur though the regulation of innate and adaptive immune responses that are involved in the pathogenesis of AERD. In addition to the valuable effects of AD in RCTs, some side effects such as gastrointestinal bleeding, asthma exacerbation, or rash have been reported that should be considered for reaching an optimal protocol for AD.

Aspirin is considered a cornerstone medication among patients with established coronary artery disease (CAD). There is a lack of evidence regarding aspirin reloading in CAD patients who are already receiving aspirin therapy. We performed this systematic review to address this gap of knowledge. A systematic review on PubMed, Embase, and the Cochrane Library was conducted from inception until July 15, 2024. Two authors independently performed study selection, data extraction, and risk of bias assessment. Means differences (MD) were used in a meta-analysis of related outcomes from the studies. Our review included four studies enrolling 1187 individuals with CAD and chronic aspirin use before admission. The results of this systematic review found that aspirin reloading is significantly associated with a reduction of thromboxane B2 (MD, -17.46; 95% CI, -19.61 to -15.32; P<0.00001; I2=0%). Additionally, our findings revealed the beneficial effects of aspirin loading on thromboxane B2 -related platelet reactivity and myocardial injury indexes. No significant adverse outcomes, such as bleeding and increased mortality, were observed among the study groups. In conclusion, aspirin reloading can improve cardiovascular outcomes with a good safety profile among CAD individuals. However, further randomized clinical trials (RCTs) are still needed to provide robust evidence.

This study aimed to investigate the efficacy and the underlining mechanism of aspirin desensitization among patients with Aspirin Exacerbated Respiratory Disease (AERD). Thirty- eight patients, who had undergone an aspirin challenge test and were diagnosed as having AERD, were engaged in a double- blind randomized clinical trial. They were divided into two groups- an active group of patients who went through aspirin desensitization, and the control group, receiving placebo. Clinical symptoms and the quality of life of the patients- in addition to the levels of interleukin 4 and 5 (IL4), (IL5)-were documented at the beginning of the study and again after six months of aspirin desensitization. The quality of life of the patients was significantly higher in the active group after six months (P=0.001). Medication requirements and symptom score were manifested to be significantly lower in the active group after six months than at the beginning of the study (P=0.005, 0.017 respectively). Forced expiratory volume in the second one (FEV1) was, also, significantly higher in the active group after six months of the study (P=0.032). IL5 was found to be significantly lower in the active group after six months (P=0.019). However, no significant difference was observed in the levels of IL4 between the two groups (P=0.152). The study revealed that aspirin desensitization can improve the quality of life of patients with AERD, lessen their symptoms and medication requirements, lower their levels of IL5, and improve some pulmonary function tests such as FEV1.

Aspirin (acetylsalicylic acid; ASA) is one of the most commonly used drugs, Studies have showed that low dose ASA can reduce cardiovascular events by irreversibly binding to cyclooxygenase and inhibiting platelet aggregation. However, ASA has not prevented all patients from cardiovascular events [1]. Ackerman and Newman were the first to describe the phenomenon of Aspirin resistance (AR) in 1990, named "incomplete antiplatelet effect of aspirin". Afterwards, in the last two decades, several studies have demonstrated that some people do not respond to low dose aspirin as an anti-platelet [2].

the coronavirus disease, which started in Wuhan, China in 2019, has raised many concerns about the mortality of infected patients. Besides, patients require intensive care (critically ill), and different intubation rates increase this concern [1]. . . .

Background: Using aspirin, heparin, or both in women with unexplained recurrent miscarriage could be useful, because this problem might be initiated by thrombosis in decidual vessels.Objective: To investigate the association between thrombophilia and unexplained recurrent miscarriage and to evaluate the efficacy of anticoagulant treatment.Materials and Methods: In this quasi experimental, we enrolled 520 women, who had a history of recurrent miscarriage. Two hundred fifty two women with unexplained recurrent miscarriage were assigned to receive aspirin (80 mg daily) for two month before pregnancy and after confirmation of a viable pregnancy until 36 weeks of gestation or receive aspirin, as the same, plus heparin (5000 unit twice a day) subcutaneously after confirmation of viable pregnancy until 4 weeks after delivery. Type of medication was chosen for each woman according to number of abortion and age.Results: Live-birth rates did not different significantly among the two study groups. The proportions of women who gave birth to a live normal infant were 74.5% in the group receiving aspirin plus heparin (combination-therapy group) and 79.8% in the aspirin group.Conclusion: Live-birth rates did not different significantly among the two study groups. So, using aspirin or aspirin plus heparin did not change pregnancy rate in these patients. Using aspirin is easier than injecting heparin which should be chosen case by case.