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Vol. 46. Issue 2.
Pages 85-91 (February 2010)
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Vol. 46. Issue 2.
Pages 85-91 (February 2010)
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Bronchial Thermoplasty in the Treatment of Asthma
Termoplastia bronquial en el tratamiento del asma
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Alfons Torrego Fernández
Unidad de Broncoscopia, Servicio de Neumología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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Abstract

Despite the numerous guidelines and treatments available for asthma, the disease remains poorly controlled in some patients, who remain symptomatic, are a considerable burden on the health system, and account for most of the hospitalizations due to asthma.

Bronchial thermoplasty is a novel experimental therapeutic option that consists of delivering radiofrequency-generated heat to the airways via a catheter inserted in the bronchial tree through a flexible bronchoscope to reduce smooth muscle quantity and contractility. The first investigations were conducted using an animal model. Subsequently, 2 randomized clinical trials designed to evaluate the safety and efficacy of thermoplasty in patients with moderate to severe asthma with a 1-year follow-up period showed the procedure to be safe, with mostly transient adverse affects and several clinical benefits.

Although results from ongoing clinical trials are still awaited, thermoplasty may become an innovative therapeutic approach to asthma.

Keywords:
Asthma
Bronchial thermoplasty
Radiofrequency
Bronchial smooth muscle
Bronchial hyperresponsiveness
Ablation
Resumen

A pesar de las normativas y tratamientos existentes, una proporción de pacientes con asma permanecen sintomáticos, están mal controlados y son causa de un mayor impacto sanitario e ingresos por asma.

La termoplastia bronquial es una novedosa opción terapéutica en fase experimental, que consiste en la aplicación de calor generado por radiofrecuencia, mediante un catéter que se introduce en el árbol bronquial con broncoscopia flexible, para reducir la cantidad y contractilidad del músculo liso. En una fase inicial se utilizó un modelo experimental animal. Posteriormente, 2 ensayos clínicos aleatorizados han examinado la seguridad y eficacia de la termoplastia en pacientes con asma moderada-grave tras un año de seguimiento. Los resultados muestran que es un procedimiento seguro, con efectos adversos en general transitorios, y que comporta algunos beneficios clínicos. A la espera de nuevos datos que ofrecerán ensayos clínicos en curso, la termoplastia se ha constituido como una posible e innovadora aproximación terapéutica del asma.

Palabras clave:
Asma
Termoplastia bronquial
Radiofrecuencia
Músculo liso bronquial
Hiperreactividad bronquial
Ablación
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Copyright © 2010. Sociedad Española de Neumología y Cirugía Torácica
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