Bronchial Cryo-Denervation for Severe Asthma: A Pilot Study.

Wang, Kun; Gao, Shaoyong; Sun, Jiaxing; Liao, Ximing; Zhang, Xin; Chen, Rongzhang; Tang, Rongjuan; Wang, Yuanyuan; Shang, Yan; Xu, Wujian; Li, Qiang

Wang, Kun; Gao, Shaoyong; Sun, Jiaxing; Liao, Ximing; Zhang, Xin; Chen, Rongzhang; Tang, Rongjuan; Wang, Yuanyuan; Shang, Yan; Xu, Wujian; Li, Qiang.

Afiliación

Wang K; Department of Pulmonary and Critical Care Medicine, Shanghai East Hospital, Tongji University, Shanghai, China, dr_wangk@tongji.edu.cn.
Gao S; Department of Pulmonary and Critical Care Medicine, Shanghai East Hospital, Tongji University, Shanghai, China.
Sun J; Department of Pulmonary and Critical Care Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China.
Liao X; Department of Pulmonary and Critical Care Medicine, Shanghai East Hospital, Tongji University, Shanghai, China.
Zhang X; Department of Pulmonary and Critical Care Medicine, People's Liberation Army Joint Logistic Support Force 920th Hospital, Kunming, China.
Chen R; Department of Pulmonary and Critical Care Medicine, Shanghai East Hospital, Tongji University, Shanghai, China.
Tang R; Department of Pulmonary and Critical Care Medicine, Shanghai East Hospital, Tongji University, Shanghai, China.
Wang Y; Department of Pulmonary and Critical Care Medicine, Shanghai East Hospital, Tongji University, Shanghai, China.
Shang Y; Department of General Practice, Shanghai Changhai Hospital, The First Affiliated Hospital of Second Military Medical University, Shanghai, China.
Xu W; Department of Pulmonary and Critical Care Medicine, Shanghai East Hospital, Tongji University, Shanghai, China.
Li Q; Department of Pulmonary and Critical Care Medicine, Shanghai East Hospital, Tongji University, Shanghai, China.

Respiration ; 103(3): 155-165, 2024.

Article en En | MEDLINE | ID: mdl-38382489

ABSTRACT

ABSTRACT

INTRODUCTION:

Targeting the parasympathetic nervous system innervating the airway with pharmacologic products has been proved to improve the clinical outcomes of severe asthma. Bronchial cryo-denervation (BCD) is a novel non-pharmacologic treatment for severe asthma using an endobronchial cryo-balloon administered via bronchoscopy to denervate parasympathetic pulmonary nerves. Preclinical studies have demonstrated that BCD significantly disrupted vagal innervation in the lung.

METHODS:

A total of 15 patients with severe asthma were enrolled in this prospective, single-center pilot study. Patients underwent bifurcated BCD treatment at a 30-day interval after baseline assessment. Follow-up through 12 months included assessment of adverse events, technical feasibility, and changes in pulmonary function; asthma control questionnaire-7 (ACQ-7); and asthma control test (ACT).

RESULTS:

BCD was performed on all 15 severe asthma patients, with technical feasibility of 96.7%. There were no device-related and 2 procedure-related serious adverse events through 12 months, which resolved without sequelae. The most frequent nonserious procedure-related adverse event was increased cough in 60% (9 of 15) patients. Pulmonary function remained unchanged, and significant improvements from baseline ACQ-7 (mean, -1.19, p = 0.0032) and ACT (mean, 3.18, p = 0.0011) scores were observed since the first month's follow-up after a single lung airway treatment, with similar trends till the end of the 12-month follow-up.