Tehran University of Medical Sciences Iranian Journal of Allergy, Asthma and Immunology 1735-1502 21 5 2022 10 26 512 523 Hossein Esmaeilzadeh Department of Allergy and Clinical Immunology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran AND Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Maryam Zare Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Soheila Alyasin Department of Allergy and Clinical Immunology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran AND Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Hesamedin Nabavizadeh Department of Allergy and Clinical Immunology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran AND Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Negar Mortazavi Department of Clinical Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran Zahra Kanannejad Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran 2022 04 11 2022 07 06 Aspirin-exacerbated respiratory disease (AERD) is a chronic inflammatory disease. It is defined by asthma, chronic rhinosinusitis with nasal polyposis, and a hypersensitivity reaction to aspirin or nonsteroidal anti-inflammatory drugs. Aspirin desensitization (AD) has been confirmed as an effective treatment to control AERD inflammation through the modulation of immune responses. We aimed to review AERD with an overview of the epidemiology, pathophysiology, and treatment. We also discussed the effect of AD on immunological markers involved in AERD pathogenesis. A search of electronic databases on AERD was performed. We included five randomized clinical trials (RCTs) on AD. We also searched databases for recent studies that investigated the effect of AD on the immunological mechanisms of AERD. RCTs have demonstrated the therapeutic effectiveness of AD on the patients’ quality of life, asthma symptom score, inhaled and oral steroid use, forced expiratory volume in 1 sec (FEV1), and inflammatory mediators. The clinical benefits of AD can occur though the regulation of innate and adaptive immune responses that are involved in the pathogenesis of AERD. In addition to the valuable effects of AD in RCTs, some side effects such as gastrointestinal bleeding, asthma exacerbation, or rash have been reported that should be considered for reaching an optimal protocol for AD. https://ijaai.tums.ac.ir/index.php/ijaai/article/view/3510 https://ijaai.tums.ac.ir/index.php/ijaai/article/download/3510/1878