Bronchial Thermoplasty Management in Severe Asthma

Bronchial thermoplasty was first published in 2007 by Mayse et al. as a treatment for severe asthma. Studies such as AIR2, Seely et al., and others demonstrated improvements in quality of life, symptom reduction, and frequency of exacerbations in asthma patients treated with bronchial thermoplasty. It is crucial for clinicians to recognize this method as a potential treatment for severe asthma. This paper was prepared based on a literature review of journals published in the past five years. Bronchial thermoplasty was considered for patients with severe asthma that is not of the type 2 inflammatory nature. Severe asthma with type 2 inflammation is characterized by blood eosinophil count > 150 μl, FeNO > 20 ppb, sputum eosinophils > 2%, and asthma clinically controlled by allergens. Bronchial thermoplasty involves inserting a basket catheter into the airways, guided by bronchoscopy, to deliver thermal energy that reduces smooth muscle mass, decreases nerve fibers in the submucosa and smooth muscle, and suppresses airway hyperresponsiveness, thus alleviating airway obstruction in severe asthma. In conclusion, bronchial thermoplasty is a treatment for severe asthma that is not of the type 2 inflammatory nature. The mechanism of action of bronchial thermoplasty involves delivering thermal energy to the bronchial walls to widen the airways and suppress airway hyperresponsiveness.