A group of Malaga scientists has achieved a relevant advance to clarify why certain people experience adverse reactions after taking everyday anti-inflammatories such as aspirin or ibuprofen.
The work, focused on the role of genetic factors in this type of responses, has Isabel María Jiménez Sánchez, P-FIS researcher, as lead author, and is coordinated by José Antonio Cornejo García, senior researcher of the Nicolás Monardes Program.
Both are part of the Group of Allergic Diseases to Drugs and Allergens, led by María José Torres Jaén, head of the Clinical Management Unit of Allergology of the Regional University Hospital of Malaga and professor of Medicine at the University of Malaga, and by Cristobalina Mayorga Mayorga, senior researcher of the Nicolás Monardes Program.
Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most widely used drugs worldwide and, at the same time, constitute the main cause of drug hypersensitivity. The most common manifestation is the sudden appearance of skin welts (urticaria) or inflammation, especially in the lips and eyelids (angioedema).
The research is aimed at clarifying why these reactions appear more frequently in people with a previous allergy, which specialists call "atopy". Many of these patients present allergy to environmental components, such as house dust mites. Understanding what genetic factors explain this association will allow progress towards more accurate diagnoses and more individualized treatments in the coming years, Ibima has indicated in a note.
GENETIC LINK
They have detailed that, although it was already known that a very high percentage of those who react to NSAIDs are also allergic to mites, it had not been delved into until now what specific genes supported that relationship. For this, the team examined the DNA of 1,240 people, in search of small genetic variations in genes linked to the immune system.
They thus identified an essential clue: certain variants in two genes associated with dust mite allergy –Il4ra and Fcer1a– notably increase the probability of suffering from urticaria caused by NSAIDs. According to the researchers, this result allows demonstrating for the first time at a molecular level that there is a direct connection between genetic predisposition to common allergy and the risk of suffering hypersensitivity reactions to NSAIDs.
In other words, they have indicated, some people do not present these reactions by chance, but because their immune system is genetically more inclined to respond in this way.
To guarantee the robustness and consistency of the conclusions, the study was carried out in two independent phases. Firstly, patients treated at the Allergy Unit of the Regional University Hospital of Malaga were evaluated and, subsequently, the results were verified in a second group of patients from Hospital Clinic of Barcelona.
This two-stage approach reinforces the robustness of the data. The researchers observed that those carrying these genetic variants not only presented a higher risk of developing urticaria after taking NSAIDs, but also showed higher concentrations of immunoglobulin E (IgE), the key antibody in allergic reactions, as well as specific IgE against mites.
The discovery represents a significant advance towards precision medicine: being able to identify beforehand patients with greater genetic risk will facilitate in the future safer and more adapted decisions before prescribing certain medications.
The study has received funding from the Carlos III Health Institute and from the Spanish Society of Allergology and Clinical Immunology, and has been published and selected as "Editor's choice" in the journal Journal of Allergy and Clinical Immunology.