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Effects of Bronchial Thermoplasty on Pathological Changes in Airways of Patients with Severe Asthma
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A5824 - Effects of Bronchial Thermoplasty on Pathological Changes in Airways of Patients with Severe Asthma
Author Block: T. Ichikawa1, A. L. Panariti2, S. Audusseau2, A. K. Mogas2, R. Olivenstein2, J. Chakir3, C. Baglole2, D. H. Eidelman2, M. Ichinose1, Q. Hamid2; 1Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan, 2Meakins-Christie Laboratories, McGill University Health Center, Montreal, QC, Canada, 3Medecine, Institut universiatire de cardiologie et de pneumologie de Québe, Quebec, QC, Canada.
Rationale: Bronchial thermoplasty (BT) is a novel technique to treat the patients with severe asthma. Radiofrequecy is provided to airway walls during bronchoscopy in order to reduce the amount of airway smooth muscle. Several clinical studies have reported that the symptoms of the patients are improved after BT. However, it has not been fully elucidated yet how BT affects the airway architecture and inflammatory mediators in the airways.
Methods: We investigated the pathological effects of BT on the airways of patients with severe asthma including changes in the airway nerves and airway blood vessels, and changes in the production of interleukin-17A (IL-17A) and transforming growth factor-β1 (TGF-β1) by immunohistochemistry. Fourteen patients with severe asthma were recruited in this study according to the criteria of ATS severe asthma definition. The study subjects undertook bronchial biopsy during the bronchoscopy at baseline and 6 weeks after the initial BT treatment. The obtained samples were processed as pathological slides and stained with antibodies for α-SMA, PGP 9.5 (a marker for nerve), von Willebrand factor (vWF, a marker for blood vessels), IL-17A and TGF-β1.
Results: The expression of α-SMA and PGP 9.5 were significantly reduced after BT. There were no significant differences in the numbers of blood vessels between at baseline and after BT. In addition, BT did not affect the production of IL-17A or TGF-β1 in the airways. The changes in the expression of α-SMA and PGP 9.5 had no significant correlation with the improvement in pulmonary function.
Conclusions: This study suggests that BT reduces airway smooth muscle mass and nerves in patients with severe asthma without any effect on the numbers of blood vessels and inflammatory mediator positive cells.
Author Block: T. Ichikawa1, A. L. Panariti2, S. Audusseau2, A. K. Mogas2, R. Olivenstein2, J. Chakir3, C. Baglole2, D. H. Eidelman2, M. Ichinose1, Q. Hamid2; 1Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan, 2Meakins-Christie Laboratories, McGill University Health Center, Montreal, QC, Canada, 3Medecine, Institut universiatire de cardiologie et de pneumologie de Québe, Quebec, QC, Canada.
Rationale: Bronchial thermoplasty (BT) is a novel technique to treat the patients with severe asthma. Radiofrequecy is provided to airway walls during bronchoscopy in order to reduce the amount of airway smooth muscle. Several clinical studies have reported that the symptoms of the patients are improved after BT. However, it has not been fully elucidated yet how BT affects the airway architecture and inflammatory mediators in the airways.
Methods: We investigated the pathological effects of BT on the airways of patients with severe asthma including changes in the airway nerves and airway blood vessels, and changes in the production of interleukin-17A (IL-17A) and transforming growth factor-β1 (TGF-β1) by immunohistochemistry. Fourteen patients with severe asthma were recruited in this study according to the criteria of ATS severe asthma definition. The study subjects undertook bronchial biopsy during the bronchoscopy at baseline and 6 weeks after the initial BT treatment. The obtained samples were processed as pathological slides and stained with antibodies for α-SMA, PGP 9.5 (a marker for nerve), von Willebrand factor (vWF, a marker for blood vessels), IL-17A and TGF-β1.
Results: The expression of α-SMA and PGP 9.5 were significantly reduced after BT. There were no significant differences in the numbers of blood vessels between at baseline and after BT. In addition, BT did not affect the production of IL-17A or TGF-β1 in the airways. The changes in the expression of α-SMA and PGP 9.5 had no significant correlation with the improvement in pulmonary function.
Conclusions: This study suggests that BT reduces airway smooth muscle mass and nerves in patients with severe asthma without any effect on the numbers of blood vessels and inflammatory mediator positive cells.
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