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

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: RSVP to the Back-to-School Twitter Party https://t.co/kfgS8pRncS, see more https://t.co/CpGiFuOOYd
10hreplyretweetfavorite
Interasma Top story: Three Common Comorbidities With Asthma https://t.co/UfB8hfM3H4, see more https://t.co/CpGiFuOOYd
12hreplyretweetfavorite
Interasma RT @ARIAGuideline: This article summarizes a EUFOREA symposium, presented during the European Rhinology Research Forum in Brussels (9-10 No…
18hreplyretweetfavorite
Interasma RT @ARIAGuideline: Rhinology future trends: 2017 EUFOREA debate on allergic rhinitis. https://t.co/ZMAchhHdBx
18hreplyretweetfavorite

Editor: Juan C. Ivancevich, MD

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

Powered by FREI SA

InterAsma