Emerging understanding of the mechanism of action of Bronchial Thermoplasty in asthma
J N S d'Hooghe, N H T Ten Hacken, E J M Weersink, P J Sterk, J T Annema, P I Bonta, J N S d'Hooghe, N H T Ten Hacken, E J M Weersink, P J Sterk, J T Annema, P I Bonta
Abstract
Bronchial Thermoplasty (BT) is an endoscopic treatment for moderate-to-severe asthma patients who are uncontrolled despite optimal medical therapy. Effectiveness of BT has been demonstrated in several randomized clinical trials. However, the asthma phenotype that benefits most of this treatment is unclear, partly because the mechanism of action is incompletely understood. BT was designed to reduce the amount of airway smooth muscle (ASM), but additional direct and indirect effects on airway pathophysiology are expected. This review will provide an overview of the different components of airway pathophysiology including remodeling, with the ASM as the key player. Current concepts in the understanding of BT clinical effectiveness with a focus on its impact on airway remodeling will be reviewed.
Trial registration: ClinicalTrials.gov NCT02225392.
Keywords: Airway innervation; Airway remodeling; Airway smooth muscle; Asthma; Bronchial Thermoplasty; Inflammation.
Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.
Source: PubMed