Airway wall extracellular matrix changes induced by bronchial thermoplasty in severe asthma

• DOI: 10.1016/j.jaci.2023.09.035
• Publication Date: 2023-10-05T15:55:08Z
• Authors: Pieta C. Wijsman; Annika W.M. Goors...; Noa Keijzer; Julia N.S. d’Hooghe; Nick H.T. ten Hacken; Pallav L. Shah; Els J.M. Weersink; Jôse Mara de Brito; Natalia de Souza ...; Thais Mauad; Martijn C. Nawijn; Judith M. Vonk; Jouke T. Annema; Janette K. Burgess; Peter I. Bonta
• Keywords: Reticular connective tissue; Bronchial thermoplasty

BackgroundAirway remodeling is a prominent feature of asthma, which involves increased airway smooth muscle mass and altered extracellular matrix composition. Bronchial thermoplasty (BT), bronchoscopic treatment for severe targets remodeling.ObjectiveWe sought to investigate the effect BT on composition its association with clinical outcomes.MethodsThis substudy TASMA trial. Thirty patients asthma were BT-treated, whom 13 treated 6 months standard therapy (control group) before BT. Demographic data, data including pulmonary function, bronchial biopsies collected. Biopsies at BT-treated nontreated locations analyzed by histological immunohistochemical staining. Associations between histology outcomes explored.ResultsSix after treatment, it was found that reticular basement membrane thickness reduced from 7.28 μm 5.74 (21% relative reduction) percentage area tissue positive collagen 26.3% 29.8% (13% increase). Collagen structure analysis revealed reduction in curvature frequency fibers. The fibulin-1 fibronectin 2.5% 5.9%, respectively (relative increase 124% 15%). No changes elastin. negatively associated FEV1 reversibility.ConclusionsBesides mass, has an impact arrangement characterized occupied less dense fiber organization. Both are change reversibility. Airway remodeling. We outcomes. This explored. Six Besides