Polarization Sensitive Optical Coherence Tomography for Bronchoscopic Airway Smooth Muscle Detection in Bronchial Thermoplasty-Treated Patients With Asthma

Vaselli, Margherita; Wijsman, Pieta; Willemse, Joy; Goorsenberg, Annika W.M.; Feroldi, Fabio; d'Hooghe, Julia N S; Annema, Jouke T.; Boer, Johannes F. de; Bonta, Peter I.

doi:10.1016/j.chest.2021.03.042

Cited by 20 publications

(21 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recently, the randomized controlled TASMA study [ 94 ] reported a significant decrease of ASM mass in asthmatic patients undergoing bronchial biopsy before and after BT when compared with a randomized non-BT-treated control group, even though it failed to show a correlation of this finding with clinical outcomes. The same effect of ASM mass and extracellular matrix reduction following a BT procedure, representing changes in the remodeling of asthmatic airways, has consistently been shown with the less invasive Optical Coherence Tomography bronchoscopic imaging technique not requiring biopsy [ 95 ]. Moreover, an international, multicentre study of asthmatic patients who were previously enrolled in the AIR [ 91 ], RISA [ 92 ] and AIR2 [ 93 ] studies has shown that the beneficial effects of BT, in terms of a reduction in exacerbation rate and an improvement in quality of life, are sustained for 10 years or more, with an acceptable safety profile [ 96 ].…”

Section: Non-pharmacological Strategiesmentioning

confidence: 78%

Paucigranulocytic Asthma: Potential Pathogenetic Mechanisms, Clinical Features and Therapeutic Management

Papaioannou

Fouka

Ntontsi

et al. 2022

JPM

View full text Add to dashboard Cite

Asthma is a heterogeneous disease usually characterized by chronic airway inflammation, in which several phenotypes have been described, related to the age of onset, symptoms, inflammatory characteristics and treatment response. The identification of the inflammatory phenotype in asthma is very useful, since it allows for both the recognition of the asthmatic triggering factor as well as the optimization of treatment The paucigranulocytic phenotype of asthma (PGA) is characterized by sputum eosinophil levels <1–3% and sputum neutrophil levels < 60%. The precise characteristics and the pathobiology of PGA are not fully understood, and, in some cases, it seems to represent a previous eosinophilic phenotype with a good response to anti-inflammatory treatment. However, many patients with PGA remain uncontrolled and experience asthmatic symptoms and exacerbations, irrespective of the low grade of airway inflammation. This observation leads to the hypothesis that PGA might also be either a special phenotype driven by different kinds of cells, such as macrophages or mast cells, or a non-inflammatory phenotype with a low grade of eosinophilic inflammation. In this review, we aim to describe the special characteristics of PGA and the potential therapeutic interventions that could be offered to these patients.

show abstract

Section: Non-pharmacological Strategiesmentioning

confidence: 78%

Paucigranulocytic Asthma: Potential Pathogenetic Mechanisms, Clinical Features and Therapeutic Management

Papaioannou

Fouka

Ntontsi

et al. 2022

JPM

View full text Add to dashboard Cite

show abstract

“…This might, for example, include differences in the thickness of this layer and hence susceptibility to radiofrequency treatment. Optical coherence tomography, deployed down the bronchoscope, offers a potential method of evaluating ASM thickness in vivo and may potentially solve the riddle of nonresponse in bronchial thermoplasty [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

Plethysmography-derived gas trapping lacks utility in predicting response to bronchial thermoplasty

2022

View full text Add to dashboard Cite

There is a paucity of literature on measurable baseline parameters predicting response and guiding selection for bronchial thermoplasty (BT). This study examines whether baseline gas trapping, as assessed by plethysmography is associated with a response to BT at 12 months.Forty three consecutive patients with severe asthma (57.6±13.3 years) were evaluated at baseline and 12 months post BT. Data collected at both time points included spirometry, body plethysmography, and four clinical outcome measures, namely Asthma Control Questionnaire score (ACQ), annual exacerbation frequency, maintenance oral corticosteroid requirement and short acting beta agonist use).At baseline, participants had severe airflow obstruction (FEV1 49.1±15.8%) with marked gas trapping (RV 150.3±40.8%, RV/TLC 51.3±10.5%), poor symptom control (ACQ 3.3±1.0) and frequent exacerbations (4 (8)). Twelve months after BT, significant improvements were observed in all four clinical outcome measures. However, baseline RV and RV/TLC were not significantly associated with changes in ACQ nor any other clinical outcome measure, and changes in RV and RV/TLC did not significantly correlate with a change in any clinical outcome measure.Plethysmography derived gas trapping does not demonstrate utility in predicting response and guiding selection for BT. An improvement in gas trapping was not associated with positive clinical outcomes, suggesting this may not the dominant mode of action of BT in generating clinical improvement.

show abstract

“…Previous studies have demonstrated several changes immediately following BT including bronchial wall and peribronchial oedema as well as epithelial sloughing. [30][31][32] Some of these changes were noted in airways distal to the ones directly treated as well as in the untreated RML, again suggesting that the effects of BT are not limited to directly targeted airways.…”

Section: Novel Insights Using Optical Coherence Tomographymentioning

confidence: 93%

Bronchial thermoplasty: State of the art

2022

View full text Add to dashboard Cite

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.

show abstract

Polarization Sensitive Optical Coherence Tomography for Bronchoscopic Airway Smooth Muscle Detection in Bronchial Thermoplasty-Treated Patients With Asthma

Cited by 20 publications

References 11 publications

Paucigranulocytic Asthma: Potential Pathogenetic Mechanisms, Clinical Features and Therapeutic Management

Paucigranulocytic Asthma: Potential Pathogenetic Mechanisms, Clinical Features and Therapeutic Management

Plethysmography-derived gas trapping lacks utility in predicting response to bronchial thermoplasty

Bronchial thermoplasty: State of the art

Contact Info

Product

Resources

About