Kenta Yamamura1, Johsuke Hara2, Noriyuki Ohkura2, Miki Abo2, Takashi Sone3, Hideharu Kimura1, Kazuo Kasahara1. 1. Department of Respiratory Medicine, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University. 2. Department of Respiratory Medicine, Kanazawa University Hospital. 3. Regional Respiratory Symptomatology, Kanazawa University Graduate School of Medical Science, Takara-machi, Kanazawa, Ishikawa, Japan.
Abstract
BACKGROUND: Bronchial thermoplasty (BT) is a novel bronchoscopic therapy for severe uncontrolled asthma unresponsive to standard pharmacological treatments, including inhaled corticosteroids and long-acting beta-2 agonists. Although several studies have shown that BT improves asthma control, the optimal predictors of BT response remain unknown. PATIENTS AND METHODS: We reviewed 10 consecutive asthma patients treated with BT at Kanazawa University Hospital between January 2016 and March 2018 and attempted to identify factors that correlated with a positive BT response. RESULTS: All patients had the most severe persistent asthma according to the 2017 Japanese guidelines for adult asthma and were uncontrolled despite adequate treatments including high-dose inhaled corticosteroids and long-acting beta-2 agonists. Six patients had significant improvement in asthma control evaluated with the Asthma Control Questionnaire-6. Eight patients showed a significant improvement in asthma-specific health-related quality of life evaluated with the Asthma Quality of Life Questionnaire. The number of severe asthma exacerbations decreased in 6 patients. The maintenance dose of oral corticosteroids decreased in 1 patient. There were no severe adverse events related to the procedure. Six patients showed a positive BT response, and all 4 patients with increased cough receptor sensitivity to capsaicin responded to BT. No other factors, including age, smoking status, body mass index, age of asthma onset, disease duration, blood eosinophil count, total serum immunoglobulin E, prebronchodilator forced expiratory volume in 1 second, reversibility to beta-2 agonist, or fractional exhaled nitric oxide, were associated with a positive BT response. CONCLUSION: Increased cough receptor sensitivity to capsaicin may predict a positive BT response.
BACKGROUND: Bronchial thermoplasty (BT) is a novel bronchoscopic therapy for severe uncontrolled asthma unresponsive to standard pharmacological treatments, including inhaled corticosteroids and long-acting beta-2 agonists. Although several studies have shown that BT improves asthma control, the optimal predictors of BT response remain unknown. PATIENTS AND METHODS: We reviewed 10 consecutive asthmapatients treated with BT at Kanazawa University Hospital between January 2016 and March 2018 and attempted to identify factors that correlated with a positive BT response. RESULTS: All patients had the most severe persistent asthma according to the 2017 Japanese guidelines for adult asthma and were uncontrolled despite adequate treatments including high-dose inhaled corticosteroids and long-acting beta-2 agonists. Six patients had significant improvement in asthma control evaluated with the Asthma Control Questionnaire-6. Eight patients showed a significant improvement in asthma-specific health-related quality of life evaluated with the Asthma Quality of Life Questionnaire. The number of severe asthma exacerbations decreased in 6 patients. The maintenance dose of oral corticosteroids decreased in 1 patient. There were no severe adverse events related to the procedure. Six patients showed a positive BT response, and all 4 patients with increased cough receptor sensitivity to capsaicin responded to BT. No other factors, including age, smoking status, body mass index, age of asthma onset, disease duration, blood eosinophil count, total serum immunoglobulin E, prebronchodilator forced expiratory volume in 1 second, reversibility to beta-2 agonist, or fractional exhaled nitric oxide, were associated with a positive BT response. CONCLUSION: Increased cough receptor sensitivity to capsaicin may predict a positive BT response.
Authors: Clare O Shapiro; Becky J Proskocil; Laura J Oppegard; Emily D Blum; Nicole L Kappel; Christopher H Chang; Allison D Fryer; David B Jacoby; Richard W Costello; Matthew G Drake Journal: Am J Respir Crit Care Med Date: 2021-02-01 Impact factor: 21.405
Authors: Mihai-Daniel Dumitrache; Ana Stefania Jieanu; Cristian Scheau; Ioana Anca Badarau; George Denis Alexandru Popescu; Ana Caruntu; Daniel Octavian Costache; Raluca Simona Costache; Carolina Constantin; Monica Neagu; Constantin Caruntu Journal: Exp Ther Med Date: 2021-06-29 Impact factor: 2.447