[Bronchial thermoplasty for severe asthma].

Place de thermoplastie bronchique dans la prise en charge de l’asthme sévère.
Asthme sévère Bronchial thermoplasty Bronchoscopie interventionnelle Interventional pulmonology Severe asthma Thermoplastie bronchique

Journal

Revue des maladies respiratoires
ISSN: 1776-2588
Titre abrégé: Rev Mal Respir
Pays: France
ID NLM: 8408032

Informations de publication

Date de publication:
Mar 2021
Historique:
received: 27 08 2020
accepted: 13 10 2020
pubmed: 4 2 2021
medline: 18 9 2021
entrez: 3 2 2021
Statut: ppublish

Résumé

Bronchial thermoplasty has been developed over the past fifteen years and is the first endoscopic technique approved in the management of severe asthma. This procedure uses radiofrequency applied to the airway wall to target bronchial smooth muscle. Patients treated in randomized controlled trials have experienced significant decreases in the use of rescue medications, urgent care visits, and exacerbations rate. The lack of reliable predictive markers of response to this expensive, minimally-invasive technique currently makes it a last-line treatment option. We review the principles and supposed mechanisms of action of this treatment, the results from the main trials and clinical registry data and discuss the place of bronchial thermoplasty in the current management of severe asthma. We also discuss perspectives to better characterize the mechanisms of action and identify the responder phenotype, the main challenge of current studies.

Identifiants

pubmed: 33531186
pii: S0761-8425(21)00003-6
doi: 10.1016/j.rmr.2021.01.002
pii:
doi:

Types de publication

Journal Article Review

Langues

fre

Sous-ensembles de citation

IM

Pagination

289-296

Informations de copyright

Copyright © 2021 SPLF. Published by Elsevier Masson SAS. All rights reserved.

Auteurs

V Héluain (V)

Service de pneumologie, hôpital Larrey, université Paul-Sabatier, CHU Toulouse, Toulouse, France.

L Guilleminault (L)

Service de pneumologie, hôpital Larrey, université Paul-Sabatier, CHU Toulouse, Toulouse, France; Centre de physiopathologie Toulouse Purpan, INSERM U1043, CNRS UMR 5282, université Toulouse III, Toulouse, France; INSERM, F-CRIN, Clinical Research Initiative In Severe Asthma: a Lever for Innovation & Science (CRISALIS), Toulouse, France.

C Hermant (C)

Service de pneumologie, hôpital Larrey, université Paul-Sabatier, CHU Toulouse, Toulouse, France.

G Plat (G)

Service de pneumologie, hôpital Larrey, université Paul-Sabatier, CHU Toulouse, Toulouse, France.

A Didier (A)

Service de pneumologie, hôpital Larrey, université Paul-Sabatier, CHU Toulouse, Toulouse, France; Centre de physiopathologie Toulouse Purpan, INSERM U1043, CNRS UMR 5282, université Toulouse III, Toulouse, France; INSERM, F-CRIN, Clinical Research Initiative In Severe Asthma: a Lever for Innovation & Science (CRISALIS), Toulouse, France.

N Guibert (N)

Service de pneumologie, hôpital Larrey, université Paul-Sabatier, CHU Toulouse, Toulouse, France. Electronic address: guibert.n@chu-toulouse.fr.

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Classifications MeSH