Calming Nervous Airways: Targeted Lung Denervation for Chronic Obstructive Pulmonary Disease

摘要

In this issue of the , Slebos and colleagues (pp. ) test the novel therapeutic concept that denervation of cholinergic nerves surrounding the main bronchi is safe and can improve clinical outcomes in patients with chronic obstructive pulmonary disease (COPD) ( ). Of course, the idea of targeting the parasympathetic nervous system innervating the airways is not new, as clinicians have routinely prescribed inhaled muscarinic antagonists to treat COPD since 1986, when the U.S. Food and Drug Administration approved ipratropium bromide ( ). The novelty of the Slebos study is that rather than use a pharmacologic product, the investigators have employed radiofrequency ablation therapy administered via bronchoscopy to denervate the major airways of their vagal afferents and parasympathetic efferents, with the hope that this would disrupt airway bronchoconstriction and mucous hypersecretion associated with parasympathetic activity ( ).