sensitive patients reacted to catechins in red wine, but not to resveratrol. It has been suggested that steel fermented white wines and clear liquors may cause less of a reaction than other alcoholic beverages. Desensitization to aspirin has been found to reduce reactions to alcohol. Dietary salicylates Given that aspirin is a salicylate, specifically acetyl salicylic acid, research has gone into low-salicylate diets such as the Feingold diet to see if they benefit AERD patients. For example, a prospective randomized trial with 30 patients following a low-salicylate diet for six weeks demonstrated a clinically significant decrease in both subjective and objective scoring of severity of disease, but made note of the challenge for patients in following what is a fairly stringent diet. Despite these findings, experts on the disease do not believe that dietary salicylates contribute to AERD symptoms. Dietary salicylates do not significantly inhibit the COX-1 enzyme, which is the cause of AERD reactions. One confounding factor in the study that showed a benefit from avoidance of dietary salicylates is that a low salicylate diet involves eliminating wine and beer. The majority of AERD patients react to wine and beer for reasons that do not involve their salicylate content. There is also a strong placebo effect involved with any dietary intervention. In contrast to aspirin, dietary salicylates are not acetylated and therefore do not block cyclooxygenases and hence, there is no rationale why a low salicylate diet would be beneficial for AERD patients. Alternate and related names Aspirin-induced asthma Aspirin-intolerant asthma NSAID-exacerbated respiratory disease (NERD) Samter's triad (named for Max Samter) Leukotriene associated hypersensitivity Acetylsalicylic acid triad Widal's triad (named for Georges-Fernand Widal) Francis' triad Aspirin triad Aspirin-induced asthma and rhinitis (AIAR) History The first adverse reactions to aspirin were described in 1902 in Germany, only four years after aspirin's commercial introduction. The first published report of an aspirin-induced asthma attack was in 1911. Initial reports on the linkage between asthma, aspirin, and nasal polyposis were made by Georges-Fernand Widal et al. in 1922. Further studies were conducted by Samter and Beers in reports published in 1968, which brought full clinical characterization. The recognition Samter brought to the disease through his studies led to it being called "Samter's triad", although today "aspirin-exacerbated respiratory disease" is preferred to better reflect the progressive nature of the condition even when patients abstain from NSAIDs. See also Salicylate sensitivity Drug intolerance Alcohol-induced respiratory