Lung denervation for moderate to severe COPD: a pil

[gerald]

This like it could be promising for those people with Chronic Bronchitis.   It basically act uses an electrical to open the bronchial tubes and prevent the muscles from constricting again.  It opens the bronchial tubes and reduces the production of mucous.

Only 22 people were involved in the initial study but it appears to show some impressive results with FEV1 improvements of 30% after 1 year.

The entire report is available through the link


-----------------------------------------------------------------------

Targeted lung denervation for moderate to severe COPD: a pilot study

Abstract

Background Parasympathetic pulmonary nerves release acetylcholine that induces smooth muscle constriction. Disruption of parasympathetic pulmonary nerves improves lung function and COPD symptoms.

Aims To evaluate ‘targeted lung denervation’ (TLD), a novel bronchoscopic therapy based on ablation of parasympathetic pulmonary nerves surrounding the main bronchi, as a potential therapy for COPD.

Methods This 1-year, prospective, multicentre study evaluated TLD in patients with COPD forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) (FEV1/FVC <0.70; FEV1 30%–60% predicted). Patients underwent staged TLD at 20 watts (W) or 15 W following baseline assessment off bronchodilators. Assessments were repeated on tiotropium before treatment and off bronchodilators at 30, 90, 180, 270 and 365 days after TLD. The primary endpoint was freedom from documented and sustained worsening of COPD directly attributable to TLD to 1 year. Secondary endpoints included technical feasibility, change in pulmonary function, exercise capacity, and quality of life.

Results Twenty-two patients were included (n=12 at 20 W, n=10 at 15 W). The procedures were technically feasible 93% of the time. Primary safety endpoint was achieved in 95%. Asymptomatic bronchial wall effects were observed in 3 patients at 20 W. The clinical safety profiles were similar between the two energy doses. At 1 year, changes from baseline in the 20 W dose compared to the 15 W dose were: FEV1 (+11.6%±32.3 vs +0.02%±15.1, p=0.324), submaximal cycle endurance (+6.8 min±12.8 vs 2.6 min±8.7, p=0.277), and St George's Respiratory Questionnaire (−11.1 points ±9.1 vs −0.9 points ±8.6, p=0.044).

Conclusions Bronchoscopic TLD, based on the concept of ablating parasympathetic pulmonary nerves, was feasible, safe, and well tolerated. Further investigation of this novel therapy is warranted.

Trial registration number NCT01483534.

thorax.bmj.com/content/early/2015/03/03/thoraxjnl-2014-206146

[skate4life]

Sounds like an alternative to LAMA action - lessoning broncho constriction. But for many, there are more actions involved like airway inflammation that narrows the bronchial tubes. My emphysema is 100% inflammation - no cough, no mucus, no spasms. Ironically it was Daliresp with its anti-inflammation action that finally gave me relief on top of triple therapy.

I've seen this report before......thought the same thing, that it is too narrow a method to be of significant help. IMHO

[gerald]

There is a new study starting up on this topic.  The clinic trial will involve 520 people, starts in January 2019, and should be complete by 2021.  So we may have better confirmation as to its effectiveness (if we live that long).


clinicaltrials.gov/ct2/show/NCT03639051?lupd_s=07%2F22%2F2018&lupd_d=30