Nerve ablation after bronchial thermoplasty and sustained improvement in severe asthma

N. FacciolongoA. DiStefanoV. PietriniC. GaleoneF. BellanovaF. MenzellaN. ScichiloneR. PiroG. L. BajocchiB. BalbiL. AgostiniP. P. SalsiD. Formisano and M. Lusuardi
 
BMC Pulmonary Medicine BMC series – open, inclusive and trusted 201818:29

https://doi.org/10.1186/s12890-017-0554-8

Abstract

Background

Bronchial thermoplasty (BT) is a non-pharmacological intervention for severe asthma whose mechanism of action is not completely explained by a reduction of airway smooth muscle (ASM). In this study we analyzed the effect of BT on nerve fibers and inflammatory components in the bronchial mucosa at 1 year.

Methods

Endobronchial biopsies were obtained from 12 subjects (mean age 47 ± 11.3 years, 50% male) with severe asthma. Biopsies were performed at baseline (T0) and after 1 (T1), 2 (T2) and 12 (T12) months post-BT, and studied with immunocytochemistry and microscopy methods. Clinical data including Asthma Quality of Life Questionnaire (AQLQ) and Asthma Control Questionnaire (ACQ) scores, exacerbations, hospitalizations, oral corticosteroids use were also collected at the same time points.

Results

A statistically significant reduction at T1, T2 and T12 of nerve fibers was observed in the submucosa and in ASM compared to T0. Among inflammatory cells, only CD68 showed significant changes at all time points. Improvement of all clinical outcomes was documented and persisted at the end of follow up.

Conclusions

A reduction of nerve fibers in epithelium and in ASM occurs earlier and persists at one year after BT. We propose that nerve ablation may contribute to mediate the beneficial effects of BT in severe asthma.

Download PDF 

 

(You must be logged in to add and reply comments)

Interasma on Twitter

Interasma Top story: FDA to Review BLA for Oral Immunotherapy AR101 for Peanut Allergy - Pulmonology Advisor… https://t.co/JSl0Dhdy2k
3hreplyretweetfavorite
Interasma RT @Aller_MD: “VIDEO: #Dupilumab or cyclosporine for treating atopic dermatitis?” https://t.co/sIseou6JYq https://t.co/4h02wi3UUa
6hreplyretweetfavorite
Interasma RT @Aller_MD: “More than one in five infants with a bronchiolitis hospital admission will have a subsequent respiratory-related hospital ad…
6hreplyretweetfavorite
Interasma RT @Aller_MD: “FDA to Review BLA for Oral Immunotherapy AR101 for Peanut #Allergyhttps://t.co/4UDldOOtRd https://t.co/HNeJTDeR9s
6hreplyretweetfavorite
Interasma RT @Aller_MD: 10 startups tackling the problem of high prescription drug costs. Managing payments, connecting consumers to reimbursement op…
6hreplyretweetfavorite

Editor: Juan C. Ivancevich, MD

Copyright © Interasma 2003-2017  •  Terms of Use  •  Privacy Policy  •  Contact Us  •  Sitemap

Powered by FREI SA

InterAsma