An exploratory study of predictors of bronchial thermoplasty

• Project/Area Number: 17K09615
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Respiratory organ internal medicine
• Research Institution: Kobe University
• Principal Investigator: Kobayashi Kazuyuki 神戸大学, 医学部附属病院, 准教授 (50403275)
• Co-Investigator(Kenkyū-buntansha): 西村 善博 神戸大学, 医学部附属病院, 教授 (20291453) ; 山本 正嗣 神戸大学, 医学部附属病院, 助教 (40542139) ; 永野 達也 神戸大学, 医学研究科, 助教 (80624684)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Project Status: Completed (Fiscal Year 2019)
• Budget Amount: ¥4,680,000 (Direct Cost: ¥3,600,000、Indirect Cost: ¥1,080,000); Fiscal Year 2019: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000); Fiscal Year 2018: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000); Fiscal Year 2017: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
• Keywords: 気管支喘息 / 気管支サーモプラスティ / 喘息 / Xenon肺換気CT / Xenon CT

Outline of Final Research Achievements

Bronchial thermoplasty is a bronchoscopic procedure performed in patients with severe asthma. Recent studies have reported that airway hypersensitivity and airway inflammation itself are improved. However, the direct therapeutic mechanism has not been elucidated, and it is not clear whether the improvement of airway stenosis due to bronchial thermoplasty is localized or whether the restriction of air flow in the entire bronchus is improved. Bronchial thermoplasty was performed between January 2017 and April 2018 at Kobe University Hospital, and the asthma control test score was 12.2 ± 5.76 before treatment increased to 20.7 ± 1.92 after treatment (P <0.05). The degree of air trapping was improved not only in the treated upper and lower lobes but also in the middle lobe. On the other hand, the FeNO test and respiratory function test showed no improvement.

Academic Significance and Societal Importance of the Research Achievements

本研究により、気管支サーモプラスティの作用機序が明らかとなるのみならず、気道平滑筋細胞を介した喘息の制御機構が明らかとなると期待される。基礎研究の面では、呼気凝縮液を利用することで、気管支平滑筋増生の評価や気管支サーモプラスティ療法の適応を決めるバイオマーカーの検索への応用が期待でき、臨床の面では、Xenon吸入によるDual Energy肺換気CTの呼吸器疾患への適応拡大、気道平滑筋細胞由来の炎症性サイトカインや炎症性メディエーターを標的とする新規治療薬の開発に結び付くと期待される。

Research Products

• [Presentation] Xenon肺換気CTで評価した気管支サーモプラスティによる換気改善効果 (2019)
  • Author(s): 堂國良太、小林和幸、大野良治、永野達也、田村大介、梅澤佳乃子、桂田直子、中田恭介、山本正嗣、立原素子、上領博、西村善博
  • Organizer: 第59回日本呼吸器学会学術講演会
• [Presentation] Xenon Ventilation Computed Tomography and Bronchial Thermoplasty for Asthma (2018)
  • Author(s): Ryota Dokuni, Kazuyuki Kobayashi, Yoshiharu Ohno, Tatsuya Nagano, Daisuke Tamura, Kanoko Umezawa, Naoko Katsurada, Kyosuke Nakata, Masatsugu Yamamoto, Motoko Tachihara, Hiroshi Kamiryo, Yoshihiro Nishimura
  • Organizer: World Congress of Asthma 2018
  • Int'l Joint Research