Journal of Applied Physiology AJP: Cell Physiology
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J Appl Physiol (February 17, 2005). doi:10.1152/japplphysiol.01210.2004
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Submitted on October 26, 2004
Accepted on January 9, 2005

IN VIVO EVALUATION OF THE EFFECTIVENESS OF BRONCHIAL THERMOPLASTY WITH COMPUTED TOMOGRAPHY

Robert Brown1, William Wizeman1, Christopher Danek1, and Wayne Mitzner1*

1 Environmental Health Sciences, Johns Hopkins Universty, Baltimore, MD, USA

* To whom correspondence should be addressed. E-mail: wmitzner{at}jhsph.edu.

A recent study has reported that the application of thermal energy delivered through a bronchoscope (Bronchial Thermoplasty) impairs the ability of airway smooth muscle to shorten in response to methacholine (Mch)(7). If such a technique is successful, it has the potential to serve as a therapy to attenuate airway narrowing in asthmatic subjects regardless of the initiating cause that stimulates the smooth muscle. In the present study, we have applied high-resolution computed tomography (HRCT) to accurately quantify the changes in airway area before and after a standard Mch aerosol challenge in airways treated with Bronchial Thermoplasty. We studied a total of 193 airways ranging from 2 to 15 mm in 6 dogs. These were divided into treated and control populations. The Mch dose-response curves in untreated airways and soon-to-be-treated airways were superimposable. In contrast, the dose-response curves in treated airways were shifted upward at all points, showing a significantly decreased sensitivity to Mch at both 2 and 4 weeks post-treatment. These results thus show that treated airways have significantly increased lumenal area at any dose of inhaled Mch compared to untreated airways. The work in this study thus supports the underlying concept that impairing the smooth muscle may be an effective treatment for asthma.




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