Why Do I Have This Disease?

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The cause of Aspirin Exacerbated Respiratory Disease remains unknown. It does not appear to be a genetic or inherited disorder. Studies have found that only a small percentage of patients report a family history of NSAID sensitivity, which does not suggest a strong genetic component of the disease. It has been theorized that AERD may develop following exposure to a viral infection or environmental toxin, but the mechanism by which this may happen remains unclear. AERD is not considered an autoimmune disorder, but has instead been referred to as a "chronic immune dysregulation."

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While the cause of AERD remains unknown, researchers have made many important findings about how the disease causes inflammation. AERD causes abnormal activation of mast cells and eosinophils, which release inflammatory substances like leukotrienes and prostaglandins that produce allergy-like effects. These symptoms are chronic, but when an AERD patient takes an NSAID medication, a more dramatic surge in the production of these inflammatory substances takes place. This is because AERD patients have an impaired cyclooxygenase enzyme (COX) pathway. Aspirin and NSAIDs block the COX-1 enzyme, which results in the acute reactions we experience when we ingest them. It's important to remember that even in the absence of exposure to NSAIDs, AERD patients will have chronic airway inflammation.

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