Effect of low salicylate diet on clinical and inflammatory markers in patients with aspirin exacerbated respiratory disease – a randomized crossover trial
Abstract Background Aspirin-exacerbated respiratory disease (AERD) is characterized by eosinophilic rhinosinusitis, nasal polyposis, and bronchial asthma, along with the onset of respiratory reactions after the ingestion of nonsteroidal anti-inflammatory drugs (NSAIDs) or acetylsalicylic acid (ASA)....
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| Language: | English |
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SAGE Publishing
2021-04-01
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| Series: | Journal of Otolaryngology - Head and Neck Surgery |
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| Online Access: | https://doi.org/10.1186/s40463-021-00502-4 |
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| author | Leigh J. Sowerby Krupal B. Patel Crystal Schmerk Brian W. Rotenberg Taciano Rocha Doron D. Sommer |
| author_facet | Leigh J. Sowerby Krupal B. Patel Crystal Schmerk Brian W. Rotenberg Taciano Rocha Doron D. Sommer |
| author_sort | Leigh J. Sowerby |
| collection | DOAJ |
| description | Abstract Background Aspirin-exacerbated respiratory disease (AERD) is characterized by eosinophilic rhinosinusitis, nasal polyposis, and bronchial asthma, along with the onset of respiratory reactions after the ingestion of nonsteroidal anti-inflammatory drugs (NSAIDs) or acetylsalicylic acid (ASA). In addition to the therapeutic routines and surgical options available, a low dietary intake of food salicylate has been suggested as adjunctive therapy for this condition. This study aimed to assess the influence of a short-term low salicylate diet on inflammatory markers in patients with AERD and whether that would result in symptomatic improvement. Methods Prospective study with randomization to either a high or low salicylate diet for 1 week, followed by cross-over to the other study arm. Participants were asked to record their dietary salicylate for each week of the study. Urinary creatinine, salicylate and leukotriene levels were measured at the time of recruitment, end of week one and end of week two and the SNOT-22 questionnaire was filled out at the same time points. Results A total of seven participants completed the study. There was no statistical difference in the urinary salicylate and leukotriene levels between the two diets; nevertheless, participants on low salicylate diet reported improved SNOT-22 symptoms scores (p = 0.04), mainly in the rhinologic, ear/facial, and sleep dysfunction symptom domains. In addition, these last two domains outcomes were more significant than the minimal clinically important difference. Conclusions A short-term low salicylate diet may not result in biochemical outcomes changes but seems to provide significant symptomatic relief for patients with AERD. Trial registration NCT01778465 ( www.clinicaltrials.gov ) Graphical abstract |
| format | Article |
| id | doaj-art-ded3a5a227f7494b9cf70ce28f310122 |
| institution | Kabale University |
| issn | 1916-0216 |
| language | English |
| publishDate | 2021-04-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Otolaryngology - Head and Neck Surgery |
| spelling | doaj-art-ded3a5a227f7494b9cf70ce28f3101222025-02-03T10:53:56ZengSAGE PublishingJournal of Otolaryngology - Head and Neck Surgery1916-02162021-04-015011810.1186/s40463-021-00502-4Effect of low salicylate diet on clinical and inflammatory markers in patients with aspirin exacerbated respiratory disease – a randomized crossover trialLeigh J. Sowerby0Krupal B. Patel1Crystal Schmerk2Brian W. Rotenberg3Taciano Rocha4Doron D. Sommer5Department of Otolaryngology – Head & Neck Surgery, Schulich Medicine & Dentistry, Western University, London Health Sciences Centre, St. Joseph’s HospitalDepartment of Otolaryngology – Head & Neck Surgery, Schulich Medicine & Dentistry, Western University, London Health Sciences Centre, St. Joseph’s HospitalDepartment of Medicine, Western UniversityDepartment of Otolaryngology – Head & Neck Surgery, Schulich Medicine & Dentistry, Western University, London Health Sciences Centre, St. Joseph’s HospitalDepartment of Otolaryngology – Head & Neck Surgery, Schulich Medicine & Dentistry, Western University, London Health Sciences Centre, St. Joseph’s HospitalDivision of Otolaryngology – Department of Surgery, McMaster UniversityAbstract Background Aspirin-exacerbated respiratory disease (AERD) is characterized by eosinophilic rhinosinusitis, nasal polyposis, and bronchial asthma, along with the onset of respiratory reactions after the ingestion of nonsteroidal anti-inflammatory drugs (NSAIDs) or acetylsalicylic acid (ASA). In addition to the therapeutic routines and surgical options available, a low dietary intake of food salicylate has been suggested as adjunctive therapy for this condition. This study aimed to assess the influence of a short-term low salicylate diet on inflammatory markers in patients with AERD and whether that would result in symptomatic improvement. Methods Prospective study with randomization to either a high or low salicylate diet for 1 week, followed by cross-over to the other study arm. Participants were asked to record their dietary salicylate for each week of the study. Urinary creatinine, salicylate and leukotriene levels were measured at the time of recruitment, end of week one and end of week two and the SNOT-22 questionnaire was filled out at the same time points. Results A total of seven participants completed the study. There was no statistical difference in the urinary salicylate and leukotriene levels between the two diets; nevertheless, participants on low salicylate diet reported improved SNOT-22 symptoms scores (p = 0.04), mainly in the rhinologic, ear/facial, and sleep dysfunction symptom domains. In addition, these last two domains outcomes were more significant than the minimal clinically important difference. Conclusions A short-term low salicylate diet may not result in biochemical outcomes changes but seems to provide significant symptomatic relief for patients with AERD. Trial registration NCT01778465 ( www.clinicaltrials.gov ) Graphical abstracthttps://doi.org/10.1186/s40463-021-00502-4Chronic rhinosinusitisAsthmaAspirin sensitivityImmune system diseasesNasal polyps |
| spellingShingle | Leigh J. Sowerby Krupal B. Patel Crystal Schmerk Brian W. Rotenberg Taciano Rocha Doron D. Sommer Effect of low salicylate diet on clinical and inflammatory markers in patients with aspirin exacerbated respiratory disease – a randomized crossover trial Journal of Otolaryngology - Head and Neck Surgery Chronic rhinosinusitis Asthma Aspirin sensitivity Immune system diseases Nasal polyps |
| title | Effect of low salicylate diet on clinical and inflammatory markers in patients with aspirin exacerbated respiratory disease – a randomized crossover trial |
| title_full | Effect of low salicylate diet on clinical and inflammatory markers in patients with aspirin exacerbated respiratory disease – a randomized crossover trial |
| title_fullStr | Effect of low salicylate diet on clinical and inflammatory markers in patients with aspirin exacerbated respiratory disease – a randomized crossover trial |
| title_full_unstemmed | Effect of low salicylate diet on clinical and inflammatory markers in patients with aspirin exacerbated respiratory disease – a randomized crossover trial |
| title_short | Effect of low salicylate diet on clinical and inflammatory markers in patients with aspirin exacerbated respiratory disease – a randomized crossover trial |
| title_sort | effect of low salicylate diet on clinical and inflammatory markers in patients with aspirin exacerbated respiratory disease a randomized crossover trial |
| topic | Chronic rhinosinusitis Asthma Aspirin sensitivity Immune system diseases Nasal polyps |
| url | https://doi.org/10.1186/s40463-021-00502-4 |
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