Airway smooth muscle and long-term clinical efficacy following bronchial thermoplasty in severe asthma.

The mechanism of action of bronchial thermoplasty (BT) treatment for patients with severe asthma is incompletely understood. This study investigated the 2.5-year impact of BT on airway smooth muscle (ASM) mass and clinical parameters by paired data analysis in 22 patients. Our findings demonstrate the persistence of ASM mass reduction of >50% after 2.5 years. Furthermore, sustained improvement in asthma control, quality of life and exacerbation rates was found, which is in line with previous reports. An association was found between the remaining ASM and both the exacerbation rate (r=0.61, p=0.04 for desmin, r=0.85, p<0.01 for alpha smooth muscle actin (SMA)) and post-bronchodilator forced expiratory volume in 1 s predicted percentage (r=-0.69, p=0.03 for desmin, r=-0.58, p=0.08 for alpha SMA). This study provides new insight into the long-term impact of BT.

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Déclaration de conflit d'intérêts

Competing interests: No conflicts of interest exist for the following authors—PW, AWMG, JNSd'H, NHTtH, JJTHR, TM, EJMW and PS. JTA reports research grants from Boston Scientific during the conduct of the study. PB reports research grants from Boston Scientific, non-financial support from Boston Scientific related to investigator-initiated research grant, research grants from ZonMw and research grants from Dutch Lung Foundation, during the conduct of the study.