{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T07:27:38Z","timestamp":1780385258370,"version":"3.54.1"},"reference-count":36,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2012,5,1]],"date-time":"2012-05-01T00:00:00Z","timestamp":1335830400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Rhinol\ufffdAllergy"],"published-print":{"date-parts":[[2012,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">Current guidelines recommend a greater use of aspirin challenge testing in the diagnosis of aspirin-intolerant rhinosinusitis and asthma, a disorder with high burden of illness and resistance to treatment. The indications for these tests and their clinical significance remain unclear. This study was designed to characterize the phenotype of patients with chronic rhinosinusitis with nasal polyposis (CRSwNP) with or without asthma undergoing a nasal lysine\u2013aspirin (L-ASA) challenge to evaluate which factors strongly predict a positive test.<\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">Seveny-five patients with CRSwNP underwent nasal challenge with 16 mg (total) of L-ASA after 30 minutes of acclimatization and diluent challenge. A positive challenge was defined as a 25% drop in total nasal volume measured by acoustic rhinometry.<\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">Twenty-three (31%) participants gave a history of aspirin intolerance and 38 (51%) had a positive nasal L-ASA challenge. Upper airway measures (CT scan score, olfaction, polyp grading, peak nasal inspiratory flow, nasal symptoms<\/jats:italic>\n                      , etc.)\n                      <jats:italic toggle=\"yes\">\n                        and lower airway measures (0methacholine provocative concentration required to produce a 20% drop in forced expiratory volume in 1 second, effective special airway resistance, and spirometry) were not significantly worse in patients with a positive aspirin challenge. Test sensitivity was 48%, specificity was 52%, positive predictive value was 29%, and negative predictive value was 68%. A regression analysis identified forced expiratory flow at 25\u201375% (FEF\n                        <jats:sub>25\u201375<\/jats:sub>\n                        ), history of aspirin intolerance, and duration of rhinosinusitis as significant predictors of a positive aspirin challenge.\n                      <\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">\n                        A positive response to nasal L-ASA challenge is not associated with a more severe phenotype of CRSwNP with or without asthma. A history of aspirin intolerance, duration of rhinosinusitis, and FEF\n                        <jats:sub>25\u201375<\/jats:sub>\n                        predict a greater response to aspirin.\n                      <\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2500\/ajra.2012.26.3767","type":"journal-article","created":{"date-parts":[[2012,7,6]],"date-time":"2012-07-06T16:42:18Z","timestamp":1341592938000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Is a Positive Nasal Lysine\u2013Aspirin Challenge Test Associated with a More Severe Phenotype of Chronic Rhinosinusitis and Asthma?"],"prefix":"10.1177","volume":"26","author":[{"given":"Sriram","family":"Vaidyanathan","sequence":"first","affiliation":[{"name":"Asthma and Allergy Research Group, Center for Cardiovascular and Lung Biology, Division of Medical Sciences, Ninewells Hospital and University of Dundee, Dundee, Scotland, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter A.","family":"Williamson","sequence":"additional","affiliation":[{"name":"Asthma and Allergy Research Group, Center for Cardiovascular and Lung Biology, Division of Medical Sciences, Ninewells Hospital and University of Dundee, Dundee, Scotland, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian J.","family":"Lipworth","sequence":"additional","affiliation":[{"name":"Asthma and Allergy Research Group, Center for Cardiovascular and Lung Biology, Division of Medical Sciences, Ninewells Hospital and University of Dundee, Dundee, Scotland, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2012,5]]},"reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2009.01964.x"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)62084-4"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)60615-1"},{"key":"e_1_3_1_5_2","first-page":"297","article-title":"First complete description of the aspirin idiosyncrasy-asthma-nasal polyposis syndrome (plus urticaria)\u20141922 (with a note on aspirin desensitization).","volume":"24","author":"Widal F.","year":"1987","unstructured":"WidalF., AbramiP., and LermoyezJ.. 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