Bronchial Thermoplasty in the Treatment of Asthma A Literature Review
DOI:
https://doi.org/10.12775/JEHS.2025.80.60137Keywords
bronchial thermoplasty, asthma, treatmentAbstract
Introduction and purpose
Asthma is a chronic inflammatory disorder affecting people worldwide. Although standard pharmacological management is adequate for most asthma patients, bronchial thermoplasty may serve as a therapeutic alternative in individuals with severe, uncontrolled asthma. The aim of this review is to summarize the knowledge of the effects of bronchial thermoplasty on symptom control, quality of life, and airway remodeling, as well as the use and effectiveness of this procedure in treating asthma.
Description of the state of knowledge
Bronchial thermoplasty (BT) is an endoscopic treatment method that can be used in patients with severe asthma, whose condition has not been adequately controlled with recommended pharmacological treatment. This procedure involves the application of radiofrequency energy to modify the airways’ structure and decrease airway smooth muscle mass. It is regarded as a safe and effective treatment option for long-term asthma management.
Conclusion
After bronchial thermoplasty, improved symptom control and a reduction in the frequency of exacerbations were observed, resulting from a decrease in airway smooth muscle mass and an expansion of airway volume. However, this therapeutic strategy is recommended for individuals for whom other treatments have proven ineffective.
References
1. Foo CT, Donovan GM, Thien F, Langton D, Noble PB. Bronchial Thermoplasty Improves Ventilation Heterogeneity Measured by Functional Respiratory Imaging in Severe Asthma. J Asthma Allergy. 2024;17:399-409. Published 2024 Apr 22. doi:10.2147/JAA.S454951
2. Astma (Asthma). Medycyna Praktyczna (Practical Medicine). https://www.mp.pl/interna/chapter/B16.II.3.7 (accessed January 3, 2025)
3. Ichikawa T, Panariti A, Audusseau S, et al. Effect of bronchial thermoplasty on structural changes and inflammatory mediators in the airways of subjects with severe asthma. Respir Med. 2019;150:165-172. doi:10.1016/j.rmed.2019.03.005
4. Madan K, Suri TM, Mittal S, et al. A multicenter study on the safety and efficacy of bronchial thermoplasty in adults with severe asthma. Lung India. 2021;38(6):524-528. doi:10.4103/lungindia.lungindia_741_20
5. Abe S, Yasuda M, Tobino K, et al. Usefulness of Computed Tomography for Evaluating the Effects of Bronchial Thermoplasty in Japanese Patients with Severe Asthma. J Asthma Allergy. 2024;17:325-337. Published 2024 Apr 6. doi:10.2147/JAA.S452865
6. Burn J, Sims AJ, Patrick H, Heaney LG, Niven RM. Efficacy and safety of bronchial thermoplasty in clinical practice: a prospective, longitudinal, cohort study using evidence from the UK Severe Asthma Registry. BMJ Open. 2019;9(6):e026742. Published 2019 Jun 19. doi:10.1136/bmjopen-2018-026742
7. Donovan GM, Noble PB, Langton D. Therapeutic response to bronchial thermoplasty: toward feasibility of patient selection based on modeling predictions. J Appl Physiol (1985). 2022;133(6):1341-1348. doi:10.1152/japplphysiol.00493.2022
8. Inoue T, Isogai S, Yamamoto N, et al. Safety and efficacy of bronchial thermoplasty in refractory asthma with severe obstructive respiratory dysfunction. Ther Adv Respir Dis. 2024;18:17534666241254980. doi:10.1177/17534666241254980
9. American Thoracic Society. Asthma Control Questionnaire. https://www.thoracic.org/members/assemblies/assemblies/srn/questionaires/acq.php (accessed January 5, 2025)
10. American Thoracic Society. Asthma Control Test. https://www.thoracic.org/members/assemblies/assemblies/srn/questionaires/act.php (accessed January 5, 2025)
11. American Thoracic Society. Asthma Quality of Life Questionnaire. https://www.thoracic.org/members/assemblies/assemblies/srn/questionaires/aqlq.php (accessed January 5, 2025)
12. Torrego A, Herth FJ, Munoz-Fernandez AM, et al. Bronchial Thermoplasty Global Registry (BTGR): 2-year results. BMJ Open. 2021;11(12):e053854. Published 2021 Dec 16. doi:10.1136/bmjopen-2021-053854
13. Hatch M, Lilburn P, Scott C, Ing A, Langton D. Safety and efficacy of bronchial thermoplasty in Australia 5 years post-procedure. Respirology. 2023;28(11):1053-1059. doi:10.1111/resp.14568
14. Puente-Maestu L, Llanos Flores M, Benedetti P, et al. Effectiveness and Safety of Bronchial Thermoplasty in Severe Asthma in Clinical Practice in Spain. Biomed Hub. 2018;3(3):1-9. Published 2018 Nov 1. doi:10.1159/000492075
15. Goorsenberg AWM, d'Hooghe JNS, Slats AM, van den Aardweg JG, Annema JT, Bonta PI. Resistance of the respiratory system measured with forced oscillation technique (FOT) correlates with bronchial thermoplasty response. Respir Res. 2020;21(1):52. Published 2020 Feb 12. doi:10.1186/s12931-020-1313-6
16. Langton D, Ing A, Bennetts K, et al. Bronchial thermoplasty reduces gas trapping in severe asthma. BMC Pulm Med. 2018;18(1):155. Published 2018 Sep 24. doi:10.1186/s12890-018-0721-6
17. Nishi K, Yoshimura C, Morita K, et al. Effectiveness of bronchial thermoplasty in patients with asthma exhibiting overweight/obesity and low quality of life. World Allergy Organ J. 2023;16(3):100756. Published 2023 Mar 20. doi:10.1016/j.waojou.2023.100756
18. Pretolani M, Bergqvist A, Thabut G, et al. Effectiveness of bronchial thermoplasty in patients with severe refractory asthma: Clinical and histopathologic correlations. J Allergy Clin Immunol. 2017;139(4):1176-1185. doi:10.1016/j.jaci.2016.08.009
19. Wijsman PC, Goorsenberg AWM, Keijzer N, et al. Airway wall extracellular matrix changes induced by bronchial thermoplasty in severe asthma. J Allergy Clin Immunol. 2024;153(2):435-446.e4. doi:10.1016/j.jaci.2023.09.035
20. Denner DR, Doeing DC, Hogarth DK, Dugan K, Naureckas ET, White SR. Airway Inflammation after Bronchial Thermoplasty for Severe Asthma. Ann Am Thorac Soc. 2015;12(9):1302-1309. doi:10.1513/AnnalsATS.201502-082OC
21. Goorsenberg AWM, d'Hooghe JNS, Srikanthan K, et al. Bronchial Thermoplasty Induced Airway Smooth Muscle Reduction and Clinical Response in Severe Asthma. The TASMA Randomized Trial. Am J Respir Crit Care Med. 2021;203(2):175-184. doi:10.1164/rccm.201911-2298OC
22. Wijsman PC, Goorsenberg AWM, d'Hooghe JNS, et al. Airway smooth muscle and long-term clinical efficacy following bronchial thermoplasty in severe asthma. Thorax. 2024;79(4):359-362. Published 2024 Mar 15. doi:10.1136/thorax-2023-220967
23. Chakir J, Haj-Salem I, Gras D, et al. Effects of Bronchial Thermoplasty on Airway Smooth Muscle and Collagen Deposition in Asthma. Ann Am Thorac Soc. 2015;12(11):1612-1618. doi:10.1513/AnnalsATS.201504-208OC
24. Facciolongo N, Di Stefano A, Pietrini V, et al. Nerve ablation after bronchial thermoplasty and sustained improvement in severe asthma. BMC Pulm Med. 2018;18(1):29. Published 2018 Feb 8. doi:10.1186/s12890-017-0554-8
25. Langton D, Sloan G, Banks C, Bennetts K, Plummer V, Thien F. Bronchial thermoplasty increases airway volume measured by functional respiratory imaging. Respir Res. 2019;20(1):157. Published 2019 Jul 16. doi:10.1186/s12931-019-1132-9
26. Langton D, Bennetts K, Thien F, Plummer V, Noble PB. Bronchial thermoplasty reduces ventilation heterogeneity measured by multiple breath nitrogen washout. Respir Res. 2020;21(1):308. Published 2020 Nov 23. doi:10.1186/s12931-020-01575-x
27. Langton D, Bennetts K, Noble P, Plummer V, Thien F. Bronchial thermoplasty reduces airway resistance. Respir Res. 2020;21(1):76. Published 2020 Mar 30. doi:10.1186/s12931-020-1330-5
28. Langton D, Banks C, Noble PB, Plummer V, Thien F, Donovan GM. The effect of bronchial thermoplasty on airway volume measured 12 months post-procedure. ERJ Open Res. 2020;6(4):00300-2020. Published 2020 Nov 2. doi:10.1183/23120541.00300-2020
29. Dokuni R, Kobayashi K, Ohno Y, et al. Effect of Bronchial Thermoplasty on Air Trapping Assessed by Xenon Ventilation Computed Tomography. Intern Med. 2021;60(13):2027-2032. doi:10.2169/internalmedicine.6493-20
30. Langton D, Sha J, Guo S, et al. Bronchial thermoplasty versus mepolizumab: Comparison of outcomes in a severe asthma clinic. Respirology. 2020;25(12):1243-1249. doi:10.1111/resp.13830
31. Niven RM, Simmonds MR, Cangelosi MJ, Tilden DP, Cottrell S, Shargill NS. Indirect comparison of bronchial thermoplasty versus omalizumab for uncontrolled severe asthma. J Asthma. 2018;55(4):443-451. doi:10.1080/02770903.2017.1337789
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Katarzyna Torbacka, Zuzanna Wróbel, Katarzyna Rozkosz, Maja Torbacka, Joanna Kaczor, Natalia Wróbel, Aleksandra Sosin, Wojciech Bednarz, Olga Jakubik, Patrycja Podlejska

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 63
Number of citations: 0