Asthma, Airway Smooth Muscle Cell, and Bronchial Thermoplasty

The chronic inflammation associated with asthma leads to remodeling of the lung resulting in bronchoconstriction from airway hyperresponsiveness and progressive airway narrowing. Although the inflammation related to asthma affects the epithelial lining, basement membrane and vascular supply of the airway, its affect on the airway smooth muscle ultimately leads to both acute bronchoconstriction and progressive airway obstruction. Current therapies, including inhaled corticosteroids and long-acting &bgr2-adrenergic agonists, do not conclusively alter the remodeling of the lung tissue related to asthma. The direct application of thermal energy to the airway, termed bronchial thermoplasty, has been demonstrated to reduce the thickness and responsiveness of airway smooth muscle, as well as reduce the incidence of acute exacerbations related to bronchoconstriction and improve progressive airway obstruction.