Long-Term Effects of Bronchial Thermoplasty on Airway Smooth Muscle and Reticular Basement Membrane Thickness in Severe Asthma

摘要

Bronchial thermoplasty (BT) that has been approved for the management of severe asthma is performed by controlled delivery of radiofrequency energy to bronchial mucosa. It has been proposed that the improvements observed after the use of this technique are the result of a decrease in airway smooth muscle (ASM) mass (1). In dogs, BT reduction of ASM mass inversely correlated with a decreased airway hyperresponsiveness, and these effects persisted during a 3-year period (2). No bronchial histological analyses were performed in the initial clinical trials. At 5-year follow-up, these studies showed a durable efficacy and safety, documented notably with an improvement in asthma control, a sustained decline in exacerbation rates, and the absence of structural abnormalities that could be related to BT on high-resolution computed tomography (3-5).