CRTH2 and Leukotriene Antagonists
A subset of AERD patients may express a discrete T2 subendotype with increased production of prostaglandin D2 (PGD2) and cysteinyl leukotrienes compared to aspirin-tolerant T2 CRSwNP101. PGD2 activates the chemoattractant receptor-homologous molecule expressed on Th2 cells (CRTH2), which is important for eosinophil, basophil and lymphocyte recruitment and activation 164. It is thus possible that CRTH2 and leukotriene antagonists could play a more significant role in managing patients with AERD compared to CRSwNP.