Bronchial thermoplasty in patients with dynamic hyperinflation: results from the proof-of-concept HEAT trial

Guibert, Nicolas; Guilleminault, L.; Lepage, Benoît; Héluain, Valentin; Fumat, Romane; Dupuis, Marion; Faviez, G.; Plat, Gavin; Hermant, Christophe; Didier, A.

doi:10.1183/13993003.01616-2020

Cited by 4 publications

(3 citation statements)

References 15 publications

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“…However, no significant effect had been observed on small airways evaluated by oscillometry 6 months after the procedure, despite significantly improved clinical markers 116. Interestingly, a proof-of-concept pilot study found that bronchial thermoplasty could nevertheless improve dynamic hyperinflation in selected patients 117. Though, such results need to be confirmed in larger and control clinical studies.…”

Section: Introductionmentioning

confidence: 92%

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Bronchial smooth muscle cell in asthma: where does it fit?

et al. 2022

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Asthma is a frequent respiratory condition whose pathophysiology relies on altered interactions between bronchial epithelium, smooth muscle cells (SMC) and immune responses. Those leads to classical hallmarks of asthma: airway hyper-responsiveness, bronchial remodelling and chronic inflammation. Airway smooth muscle biology and pathophysiological implication in asthma are now better understood. Precise deciphering of intracellular signalling pathways regulating smooth muscle contraction highlighted the critical roles played by small GTPases of Rho superfamily. Beyond contractile considerations, active involvement of airway smooth muscle in bronchial remodelling mechanisms is now established. Not only cytokines and growth factors, such as fibroblats growth factor or transforming growth factor-β, but also extracellular matrix composition have been demonstrated as potent phenotype modifiers for airway SMC. Although basic science knowledge has grown significantly, little of it has translated into improvement in asthma clinical practice. Evaluation of airway smooth muscle function is still limited to its contractile activity. Moreover, it relies on tools, such as spirometry, that give only an overall assessment and not a specific one. Interesting technics such as forced oscillometry or specific imagery (CT and MRI) give new perspectives to evaluate other aspects of airway muscle such as bronchial remodelling. Finally, except for the refinement of conventional bronchodilators, no new drug therapy directly targeting airway smooth muscle proved its efficacy. Bronchial thermoplasty is an innovative and efficient therapeutic strategy but is only restricted to a small proportion of severe asthmatic patients. New diagnostic and therapeutic strategies specifically oriented toward airway smooth muscle are needed to improve global asthma care.

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Section: Introductionmentioning

confidence: 92%

“…116 Interestingly, a proof-of-concept pilot study found that bronchial thermoplasty could nevertheless improve dynamic hyperinflation in selected patients. 117 Though, such results need to be confirmed in larger and control clinical studies.…”

Section: Bronchial Thermoplastymentioning

confidence: 97%

Bronchial smooth muscle cell in asthma: where does it fit?

et al. 2022

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“…• Perform additional economic analyses on a larger scale using real-world data Limited, although increasing, understanding of the role of specific asthma endotypes/phenotypes 55 • Perform additional studies on a larger scale to include extremes of ages, all endotypes/ phenotypes and clinical variants such as cough-variant and exercise-induced asthma 58 Difficulties with insurance coverage even when patients meet the conventional treatment criteria 59 • Relevant professional societies should formulate updated evidence-based clinical practice guidelines to reflect the changing landscape of clinical evidence over the past few years since older guidelines had come out • Engage with insurance companies to educate them about our updated understanding of BT, including its safety, effectiveness and cost-effectiveness Absence of direct comparison with novel biologic therapies 60…”

Section: Current Challenges and Potential Next Stepsmentioning

confidence: 99%

Bronchial thermoplasty: State of the art

2022

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Since the publication of a sham‐controlled, randomized trial (AIR2) and subsequent marketing approval by the US Food and Drug Administration, we have significantly advanced our understanding of bronchial thermoplasty (BT)'s scientific basis, long‐term safety, clinical efficacy and cost‐effectiveness. In particular, the last 2 years have witnessed multiple research publications on several of these counts. In this review, we critically appraise our evolving understanding of BT's biologic underpinnings and clinical impact, offer an evidence‐based patient workflow guide for the busy pulmonologist and highlight both current challenges as well as potential solutions for the researcher and the clinician.

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Novel indocyanine green-loaded photothermal nanoparticles targeting TRPV1 for thermal ablation treatment of severe murine asthma induced by ovalbumin and lipopolysaccharide

Zhang,

et al. 2024

International Journal of Pharmaceutics

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Bronchial thermoplasty in patients with dynamic hyperinflation: results from the proof-of-concept HEAT trial

Cited by 4 publications

References 15 publications

Bronchial smooth muscle cell in asthma: where does it fit?

Bronchial smooth muscle cell in asthma: where does it fit?

Bronchial thermoplasty: State of the art

Novel indocyanine green-loaded photothermal nanoparticles targeting TRPV1 for thermal ablation treatment of severe murine asthma induced by ovalbumin and lipopolysaccharide

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