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Published in: Respiratory Research 1/2020

Open Access 01-12-2020 | Pulmonary-Function Tests | Research

Resistance of the respiratory system measured with forced oscillation technique (FOT) correlates with bronchial thermoplasty response

Authors: Annika W. M. Goorsenberg, Julia N. S. d’Hooghe, Annelies M. Slats, Joost G. van den Aardweg, Jouke T. Annema, Peter I. Bonta

Published in: Respiratory Research | Issue 1/2020

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Abstract

Background

Bronchial Thermoplasty (BT) is an endoscopic treatment for severe asthma using radiofrequency energy to target airway remodeling including smooth muscle. The correlation of pulmonary function tests and BT response are largely unknown. Forced Oscillation Technique (FOT) is an effort-independent technique to assess respiratory resistance (Rrs) by using pressure oscillations including small airways.

Aim

To investigate the effect of BT on pulmonary function, assessed by spirometry, bodyplethysmography and FOT and explore associations between pulmonary function parameters and BT treatment response.

Methods

Severe asthma patients recruited to the TASMA trial were analyzed in this observational cohort study. Spirometry, bodyplethysmography and FOT measurements were performed before and 6 months after BT. Asthma questionnaires (AQLQ/ACQ-6) were used to assess treatment response.

Results

Twenty-four patients were analyzed. AQLQ and ACQ improved significantly 6 months after BT (AQLQ 4.15 (±0.96) to 4.90 (±1.14) and ACQ 2.64 (±0.60) to 2.11 (±1.04), p = 0.004 and p = 0.02 respectively). Pulmonary function parameters remained stable. Improvement in FEV1 correlated with AQLQ change (r = 0.45 p = 0.03). Lower respiratory resistance (Rrs) at baseline (both 5 Hz and 19 Hz) significantly correlated to AQLQ improvement (r = − 0.52 and r = − 0.53 respectively, p = 0.01 (both)). Borderline significant correlations with ACQ improvement were found (r = 0.30 p = 0.16 for 5 Hz and r = 0.41 p = 0.05 for 19 Hz).

Conclusion

Pulmonary function remained stable after BT. Improvement in FEV1 correlated with asthma questionnaires improvement including AQLQ. Lower FOT-measured respiratory resistance at baseline was associated with favorable BT response, which might reflect targeting of larger airways with BT.

Trial registration

ClinicalTrials.gov Identifier: NCT02225392; Registered 26 August 2014.
Literature
1.
go back to reference Pretolani M, Dombret MC, Thabut G, Knap D, Hamidi F, Debray MP, et al. Reduction of airway smooth muscle mass by bronchial thermoplasty in patients with severe asthma. Am J Respir Crit Care Med. 2014;190:1452–4.CrossRef Pretolani M, Dombret MC, Thabut G, Knap D, Hamidi F, Debray MP, et al. Reduction of airway smooth muscle mass by bronchial thermoplasty in patients with severe asthma. Am J Respir Crit Care Med. 2014;190:1452–4.CrossRef
2.
go back to reference 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;12:1302–9.CrossRef 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;12:1302–9.CrossRef
3.
go back to reference Chakir J, Haj-Salem I, Gras D, Joubert P, Beaudoin EL, Biardel S, et al. Effects of bronchial thermoplasty on airway smooth muscle and collagen deposition in asthma. Ann Am Thorac Soc. 2015;12:1612–8.PubMed Chakir J, Haj-Salem I, Gras D, Joubert P, Beaudoin EL, Biardel S, et al. Effects of bronchial thermoplasty on airway smooth muscle and collagen deposition in asthma. Ann Am Thorac Soc. 2015;12:1612–8.PubMed
4.
go back to reference Pretolani M, Bergqvist A, Thabut G, Dombret MC, Knapp D, Hamidi F, et al. Effectiveness of bronchial thermoplasty in patients with severe refractory asthma: clinical and histopathologic correlations. J Allergy Clin Immunol. 2017;139:1176–85.CrossRef Pretolani M, Bergqvist A, Thabut G, Dombret MC, Knapp D, Hamidi F, et al. Effectiveness of bronchial thermoplasty in patients with severe refractory asthma: clinical and histopathologic correlations. J Allergy Clin Immunol. 2017;139:1176–85.CrossRef
5.
go back to reference d’Hooghe JNS, Goorsenberg AWM, ten Hacken NHT, Weersink EJM, Roelofs JJTH, Mauad D, et al. Airway smooth muscle reduction after bronchial thermoplasty in severe asthma correlates with FEV1. Clin Exp Immunol. 2019;49(4):541–4. d’Hooghe JNS, Goorsenberg AWM, ten Hacken NHT, Weersink EJM, Roelofs JJTH, Mauad D, et al. Airway smooth muscle reduction after bronchial thermoplasty in severe asthma correlates with FEV1. Clin Exp Immunol. 2019;49(4):541–4.
6.
go back to reference Cox G, Thomson NC, Rubin AS, Niven RM, Corris PA, Siersted HC, et al. Asthma control during the year after bronchial thermoplasty. N Engl J Med. 2007;356:1327–37.CrossRef Cox G, Thomson NC, Rubin AS, Niven RM, Corris PA, Siersted HC, et al. Asthma control during the year after bronchial thermoplasty. N Engl J Med. 2007;356:1327–37.CrossRef
7.
go back to reference Pavord ID, Cox G, Thomson NC, Rubin AS, Corris PA, Niven RM, et al. Safety and efficacy of bronchial thermoplasty in symptomatic, severe asthma. Am J Respir Crit Care Med. 2007;176:1185–91.CrossRef Pavord ID, Cox G, Thomson NC, Rubin AS, Corris PA, Niven RM, et al. Safety and efficacy of bronchial thermoplasty in symptomatic, severe asthma. Am J Respir Crit Care Med. 2007;176:1185–91.CrossRef
8.
go back to reference Castro M, Rubin AS, Laviolette M, Fiterman J, De Andrade LM, Shah PL, et al. Effectiveness and safety of bronchial thermoplasty in the treatment of severe asthma: a multicenter, randomized, double-blind, sham-controlled clinical trial. Am J Respir Crit Care Med. 2010;181:116–24.CrossRef Castro M, Rubin AS, Laviolette M, Fiterman J, De Andrade LM, Shah PL, et al. Effectiveness and safety of bronchial thermoplasty in the treatment of severe asthma: a multicenter, randomized, double-blind, sham-controlled clinical trial. Am J Respir Crit Care Med. 2010;181:116–24.CrossRef
9.
go back to reference Oostveen E, MacLeod D, Lorino H, Farre R, Hantos Z, Desager K, et al. The forced oscillation technique in clinical practice: methodology, recommendations and future developments. Eur Respir J. 2003;22:1026–41.CrossRef Oostveen E, MacLeod D, Lorino H, Farre R, Hantos Z, Desager K, et al. The forced oscillation technique in clinical practice: methodology, recommendations and future developments. Eur Respir J. 2003;22:1026–41.CrossRef
11.
go back to reference Anderson WJ, Zajda E, Lipworth BJ. Are we overlooking persistent small airways dysfunction in community-managed asthma? Ann Allergy Asthma Immunol. 2012;109(3):185–9.CrossRef Anderson WJ, Zajda E, Lipworth BJ. Are we overlooking persistent small airways dysfunction in community-managed asthma? Ann Allergy Asthma Immunol. 2012;109(3):185–9.CrossRef
12.
go back to reference Kaminsky DA, Bates JHT. Breathing In and Out: Airway Resistance. In: Kaminsky DA, Irvin CG, editors. Pulmonary Function Testing. Principles and Practice. Cham: Humana press; 2018. p. 127–50.CrossRef Kaminsky DA, Bates JHT. Breathing In and Out: Airway Resistance. In: Kaminsky DA, Irvin CG, editors. Pulmonary Function Testing. Principles and Practice. Cham: Humana press; 2018. p. 127–50.CrossRef
13.
go back to reference Bousquet J, Mantzouranis E, Cruz, Ait-Khaled N, Baena-Cagnani CE, Bleecker ER, et al. Uniform definition of asthma severity, control, and exacerbations: document presented for the World Health Organization Consultation on Severe Asthma. J Allergy Clin Immunol. 2010;126:926–38.CrossRef Bousquet J, Mantzouranis E, Cruz, Ait-Khaled N, Baena-Cagnani CE, Bleecker ER, et al. Uniform definition of asthma severity, control, and exacerbations: document presented for the World Health Organization Consultation on Severe Asthma. J Allergy Clin Immunol. 2010;126:926–38.CrossRef
14.
go back to reference Bel EH, Sousa A, Fleming L, Bush A, Chung KF, Versnel J, et al. Diagnosis and definition of severe refractory asthma: an international consensus statement from the innovative medicine initiative (IMI). Thorax. 2011;66:910–7.CrossRef Bel EH, Sousa A, Fleming L, Bush A, Chung KF, Versnel J, et al. Diagnosis and definition of severe refractory asthma: an international consensus statement from the innovative medicine initiative (IMI). Thorax. 2011;66:910–7.CrossRef
15.
go back to reference Cox G, Miller JD, McWilliams A, Fitzgerald JM, Lam S. Bronchial thermoplasty for asthma. Am J Respir Crit Care Med. 2006;173:965–9.CrossRef Cox G, Miller JD, McWilliams A, Fitzgerald JM, Lam S. Bronchial thermoplasty for asthma. Am J Respir Crit Care Med. 2006;173:965–9.CrossRef
16.
go back to reference d’Hooghe JNS, Ten Hacken NHT, Weersink EJM, Sterk PJ, Annema JT, Bonta PI. Emerging understanding of the mechanism of action of bronchial thermoplasty in asthma. Pharmacol Ther. 2018;181:101–7.CrossRef d’Hooghe JNS, Ten Hacken NHT, Weersink EJM, Sterk PJ, Annema JT, Bonta PI. Emerging understanding of the mechanism of action of bronchial thermoplasty in asthma. Pharmacol Ther. 2018;181:101–7.CrossRef
17.
go back to reference Bonta PI, Chanez P, Annema JT, Shah PL, Niven R. Bronchial thermoplasty in severe asthma: best practice recommendations from an expert panel. Respiration. 2018;95(5):289–300.CrossRef Bonta PI, Chanez P, Annema JT, Shah PL, Niven R. Bronchial thermoplasty in severe asthma: best practice recommendations from an expert panel. Respiration. 2018;95(5):289–300.CrossRef
18.
go back to reference d’Hooghe JN, Eberl S, Annema JT, Bonta PI. Propofol and remifentanil sedation for bronchial thermoplasty: a prospective cohort trial. Respiration. 2017;93:58–64.CrossRef d’Hooghe JN, Eberl S, Annema JT, Bonta PI. Propofol and remifentanil sedation for bronchial thermoplasty: a prospective cohort trial. Respiration. 2017;93:58–64.CrossRef
19.
go back to reference Juniper EF, O'Byrne PM, Guyatt GH, Ferrie PJ, King DR. Development and validation of a questionnaire to measure asthma control. Eur Respir J. 1999;14(4):902–7.CrossRef Juniper EF, O'Byrne PM, Guyatt GH, Ferrie PJ, King DR. Development and validation of a questionnaire to measure asthma control. Eur Respir J. 1999;14(4):902–7.CrossRef
20.
go back to reference Juniper EF, Buist AS, Cox FM, Ferrie PJ, King DR. Validation of a standardized version of the asthma quality of life questionnaire. Chest. 1999;115:1265–70.CrossRef Juniper EF, Buist AS, Cox FM, Ferrie PJ, King DR. Validation of a standardized version of the asthma quality of life questionnaire. Chest. 1999;115:1265–70.CrossRef
21.
go back to reference Chupp G, Laviolette M, Cohn L, McEvoy C, Bansal S, Shifren A, et al. Long-term outcomes of bronchial thermoplasty in subjects with severe asthma: a comparison of 3-year follow-up results from two prospective multicentre studies. Eur Respir J. 2017;(2):50. https://doi.org/10.1183/13993003.00017-2017. Chupp G, Laviolette M, Cohn L, McEvoy C, Bansal S, Shifren A, et al. Long-term outcomes of bronchial thermoplasty in subjects with severe asthma: a comparison of 3-year follow-up results from two prospective multicentre studies. Eur Respir J. 2017;(2):50. https://​doi.​org/​10.​1183/​13993003.​00017-2017.
22.
go back to reference Langton D, Ing A, Bennetts K, Wang W, Farah C, Peters M, et al. Bronchial thermoplasty reduces gas trapping in severe asthma. BMC Pulm Med. 2018;18:155.CrossRef Langton D, Ing A, Bennetts K, Wang W, Farah C, Peters M, et al. Bronchial thermoplasty reduces gas trapping in severe asthma. BMC Pulm Med. 2018;18:155.CrossRef
23.
go back to reference Langton D, Ing A, Sha J, Bennetts K, Hersch N, Kwok M, et al. Measuring the effects of bronchial thermoplasty using oscillometry. Respirology. 2018;24(5):431–6.CrossRef Langton D, Ing A, Sha J, Bennetts K, Hersch N, Kwok M, et al. Measuring the effects of bronchial thermoplasty using oscillometry. Respirology. 2018;24(5):431–6.CrossRef
24.
go back to reference Donovan GM, Elliot JG, Green FHY, James AL, Noble PB. Unravelling a clinical paradox – why does bronchial thermoplasty work in asthma? Am J Respir Cell Mol Biol. 2018;59:355–62.CrossRef Donovan GM, Elliot JG, Green FHY, James AL, Noble PB. Unravelling a clinical paradox – why does bronchial thermoplasty work in asthma? Am J Respir Cell Mol Biol. 2018;59:355–62.CrossRef
25.
go back to reference Zanon M, Strieder DL, Rubin AS, Watte G, Marchiori E, Cardoso PFG, et al. Use of MDCT to assess the results of bronchial Thermoplasty. Am J Roentgenol. 2017;209(4):752–6.CrossRef Zanon M, Strieder DL, Rubin AS, Watte G, Marchiori E, Cardoso PFG, et al. Use of MDCT to assess the results of bronchial Thermoplasty. Am J Roentgenol. 2017;209(4):752–6.CrossRef
26.
go back to reference Konietzke P, Weinheimer O, Wielputz MO, Wagner WL, Kaukel P, Eberhardt R, et al. Quantitative CT detects changes in airway dimensions and air-trapping after bronchial thermoplasty for severe asthma. Eur J Radiol. 2018;107:33–8.CrossRef Konietzke P, Weinheimer O, Wielputz MO, Wagner WL, Kaukel P, Eberhardt R, et al. Quantitative CT detects changes in airway dimensions and air-trapping after bronchial thermoplasty for severe asthma. Eur J Radiol. 2018;107:33–8.CrossRef
27.
go back to reference Ishii S, Iikura M, Shimoda Y, Izumi S, Hojo M, Sugiyama H. Evaluation of expiratory capacity with severe asthma following bronchial thermoplasty. Respirol Case Rep. 2018;7(1):e00387. Ishii S, Iikura M, Shimoda Y, Izumi S, Hojo M, Sugiyama H. Evaluation of expiratory capacity with severe asthma following bronchial thermoplasty. Respirol Case Rep. 2018;7(1):e00387.
28.
go back to reference Postma DS, Brightling C, Baldi S, Van den Berge M, Fabbri LM, Gagnatelli A, et al. Exploring the relevance and extent of small airways dysfunction in asthma (ATLANTIS): baseline data form a prospective cohort study. Lancet Respir Med. 2019;7(5):402–16.CrossRef Postma DS, Brightling C, Baldi S, Van den Berge M, Fabbri LM, Gagnatelli A, et al. Exploring the relevance and extent of small airways dysfunction in asthma (ATLANTIS): baseline data form a prospective cohort study. Lancet Respir Med. 2019;7(5):402–16.CrossRef
Metadata
Title
Resistance of the respiratory system measured with forced oscillation technique (FOT) correlates with bronchial thermoplasty response
Authors
Annika W. M. Goorsenberg
Julia N. S. d’Hooghe
Annelies M. Slats
Joost G. van den Aardweg
Jouke T. Annema
Peter I. Bonta
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Respiratory Research / Issue 1/2020
Electronic ISSN: 1465-993X
DOI
https://doi.org/10.1186/s12931-020-1313-6

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