Researchers have discovered that most adults with asthma who are sensitive to Aspirin also get mild to severe respiratory symptoms when drinking alcohol.

Dr. Tanya Laidlaw, of the allergic disease research center at Boston’s Brigham and Women’s Hospital, explained that Aspirin Exacerbated Respiratory Disease, or AERD, is a condition that involves three things: asthma, nasal polyps and a sensitivity to Aspirin (and other non-steroidal anti-inflammatory drugs or NSAIDS). AERD affects 10 to 20 percent of those with adult asthma.

She says her research team has now found that “three-quarters of all AERD patients do have respiratory reactions when they drink alcohol. For many of them, it’s within several sips of a single glass.”

Seventy-four percent were found to react to alcohol with an upper respiratory reaction, such as a runny nose or congestion, compared to 34 percent of a group with asthma who tolerate Aspirin.

Lower respiratory reactions, such as sometimes severe wheezing and shortness of breath, occurred in 51 percent of AERD patients after drinking alcohol, compared to 24 percent of the Aspirin-tolerant asthmatics.

What Causes Your Reaction to Alcohol?

The alcohol association arose initially from patients themselves. Laidlaw says patients at the AERD clinic at Brigham and Women’s Hospital were often mentioning symptoms like wheezing and coughing, signs of an asthma attack, when they drank alcohol. “They began asking: ‘Did we know why it was that when they had a glass of wine or a couple of beers, they would also have a very similar and often very severe respiratory reaction to the alcohol,’” she told a news conference.

She and her colleagues didn’t know, but were intrigued and decided this warranted study. The Brigham and Women’s center collaborated with the Scripps respiratory clinic in San Diego to send out a survey study to four groups: diagnosed AERD patients, patients who had asthma but are aspirin tolerant, patients with chronic sinusitis who don’t have asthma and to healthy patients with no asthma or sinus issues.

Among the patients reacting to alcohol, red wine emerged as the most likely to provoke symptoms (29 percent of patients), followed by beer (9 percent) and white wine or liquor (6 percent). However, for half of the patients, any kind of alcohol triggered symptoms.

This study of AERD patients and alcohol is continuing. So far, 132 patients have been recruited into the study, but researchers hope to expand this number to 320 before they finish.

Laidlaw notes that many AERD patients have had to stop drinking alcohol. The next step will be to examine what the mechanisms through which alcohol triggers such symptoms. Laidlaw says the relationship should also be useful in the diagnosis of AERD, which is not always obvious, as the sensitivity to Aspirin can be mild and is often overlooked.

See more news from the AAAAI 2013 conference here.

Read more about wine reactions here.

Allergy. A small number of people are allergic to pure ethanol, but the bigger culprits behind true allergic responses are base ingredients, including barley, hops, yeast and grapes. Agents that are derived from foods such as egg and seafood are often used to clarify wine, but in such minuscule quantities that many question whether they pose a serious risk. Symptoms of true allergic reactions can include congestion, runny nose, swelling, hives, asthma, and in rare cases, anaphylaxis.

Allergy-like reactions. A person who reacts to alcohol may have classic allergy symptoms, but it may not be a “true” allergy. For example, reactions to sulfites in wine are not considered true allergic responses because the underlying physiological mechanism is different – and yet the sulfite-sensitive may experience asthma and even anaphylaxis. Glycoproteins are suspected of producing either allergy or allergy-like reactions.

Intolerance. Substances commonly found in wine including histamine (more often in reds than whites) can lead to sneezing, flushing, headache, diarrhea, skin itch and shortness of breath. Other amines such as tyramine and tryptamine, may play a role in alcohol intolerance; and salicylate, a chemical found in grapes, yeast, wine, beer and many foods, can lead to hives and eczema.

Asian Flush. Many people of Asian descent experience flushing, rapid heart rate, and reduced blood pressure because of a genetic incapacity to properly metabolizing alcohol. So-called “Asian Flush” is thought to be caused by the deficiency of enzymes called aldehyde dehydrogenases (ALDH).

Migraine. Red and white wines have been implicated in these headaches.

Sources: The Auckland Allergy Clinic and The Australasian Society of Clinical Immunology and Allergy.

See: Scientist Discovers Big Clue in Wine Reactions

First published in Allergic Living magazine.
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© Copyright AGW Publishing Inc.

Reprinted from Allergic Living magazine, 2011

The baseball game hadn’t even started when Kishari Sing began to feel that something was seriously wrong. She knew that, like her father, she reacted badly to alcohol; even a small taste of Irish Cream in high school had made her wheeze. Still, in the parking lot outside the San Diego stadium, her college friends tried to convince Sing that she could build up a tolerance to alcohol, and specifically to their drink of choice – a cheap boxed rosé. She drank one glass and remembers little after that.

“It completely whacked me out. I was sick the entire time,” recounts Sing, now a marketing executive in Los Angeles with a well-known blog called The Food Allergy Queen.

“There’s a picture of me at the game, and there’s this row of fraternity guys cheering – but I’m all red and puffy and trying to sleep on someone’s shoulder. I was completely incapacitated.”

Fortunately, the reaction to the cheap vino didn’t progress any further – but it was serious enough to keep Sing away from wine for good. “It made me so ill,” she says. “So it really wasn’t worth it.”

Sing is not alone. In fact, roughly 8 percent of people worldwide suffer from allergic-type responses to wine, and even relatively small amounts of the age-old drink can lead to symptoms including redness, itching, swelling, runny nose, headaches and asthma flare-ups.

Some people have true allergic reactions to wine ingredients – in rare cases to the point of anaphylactic shock.

But a new study out of Denmark may be the first step in turning those avoiders into connoisseurs who can sip hardy cabernets and oaky chardonnays with impunity. Until now, sulfites – which are used as a preservative in many wines and also can occur naturally  – have borne the brunt of the blame for the allergy-related reactions.

Yet only a fraction of people who are sensitive to wine are sensitive to the common preservative. Yeast, tannins and grapes in the vintages are also known to set off allergy symptoms, while histamines and salicylates are linked to intolerance.

Next: A surprising new allergy culprit