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BMC Pulm Med. 2018 Feb 8;18(1):29. doi: 10.1186/s12890-017-0554-8.

Nerve ablation after bronchial thermoplasty and sustained improvement in severe asthma.

Author information

1
Department of Medical Specialties, Pulmonology Unit, Arcispedale Santa Maria Nuova - IRCCS, Azienda USL di Reggio Emilia, Reggio Emilia, Italy. nicola.facciolongo@ausl.re.it.
2
Pulmunology Unit and Laboratory of Citoimmunopatology, Istituti Clinici Scientifici Maugeri SpA, SB, IRCCS, Veruno (NO), Italy.
3
Department of Neurosciences, Laboratory of Neuropathology, University of Parma, Parma, Italy.
4
Department of Medical Specialties, Pulmonology Unit, Arcispedale Santa Maria Nuova - IRCCS, Azienda USL di Reggio Emilia, Reggio Emilia, Italy.
5
Departement of Biomedicine and Medical Specialties, Pulmonology Unit, University of Palermo, Palermo, Italy.
6
Rheumatology Unit, Department of Internal Medicine, Azienda Ospedaliera ASMN, Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy.
7
Anesthesiology and Critical Care Unit, Arcispedale Santa Maria Nuova -IRCCS, Azienda USL di Reggio Emilia, Reggio Emilia, Italy.
8
Research and Statistics, Arcispedale Santa Maria Nuova -IRCCS, Azienda USL di Reggio Emilia, Reggio Emilia, Italy.
9
Pulmonary Rehabilitation, S. Sebastiano Hospital, Correggio (RE), Azienda USL di Reggio Emilia, Reggio Emilia, Italy.

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.

TRIAL REGISTRATION:

Registered on April 2, 2013 at ClinicalTrials.gov Identifier: NCT01839591 .

KEYWORDS:

Bronchial biopsies; Bronchial thermoplasty; Bronchoscopy; Nerve fibers; Severe asthma

PMID:
29422039
PMCID:
PMC5806286
DOI:
10.1186/s12890-017-0554-8
[Indexed for MEDLINE]
Free PMC Article

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