A hot probe that blows defective nerves into the lungs can help thousands of asthma patients breathe easier.
The one-time, one-hour treatment involves the introduction of a device into the airways to destroy overactive nerves in the lungs that cause breathing difficulties.
It is hoped that the revolutionary technique will bring relief to people with severe asthma who have difficulty keeping it under control with medication.
Asthma affects around 5.4 million people in the UK. Many manage their condition well with a combination of inhaled steroids – to prevent attacks – and pumps to open the airways in the case of one.
Nuvaira is a new asthma treatment that can help thousands of patients with severe asthma. The one-time, one-hour treatment includes the introduction of a device into the airways to destroy overactive nerves in the lungs causing breathing difficulties (stock image)
But one in ten patients has severe asthma that often does not respond to standard treatments. The consequences can be fatal – asthma kills an average of three people a day in the UK.
The new treatment, called Nuvaira, uses a groundbreaking therapy called targeted lung denervation.
It is based on the discovery that a defective nerve that runs from the brain to the lungs may partly be the cause of asthma attacks.
For years it was thought that the disease was only due to the immune system that reacted too strongly to allergens – such as pollen – or viruses, such as a cold.
But scientists now know that it can also be exacerbated by problems with the vagus nerve – a winding bundle of paths that run from the breast to the brain.
Branches of the vagus nerve regulate the muscles in the airways that regulate breathing.
In healthy lungs, the nerve sends signals to the muscles to ensure that they contract and relax smoothly, allowing the respiratory tract to breathe and exhale properly.
But if the nerves are defective, these muscles become overactive. As they tighten and relax, the airways become narrower and breathing becomes more difficult.
Destroying these branches of the vagus nerve blocks the defective signals, so that the muscles in the airways do not become tighter and more air enters the lungs.
Denervation means that the patient receives a general anesthetic and a device called a bronchoscope is inserted through the mouth and into the lungs.
The treatment works by introducing a device called a bronchoscope through the mouth and into the lungs. The thin tube carries a deflated balloon that is fed into the lungs. Once the balloon is in the correct position, it is inflated and the small electrodes emit radio frequency energy
It has a small camera and a light on the point with which doctors can see the area they are treating.
A thin tube with a deflated balloon is then fed into the lungs. If the balloon is in the correct position, it will inflate.
There are small electrodes on the surface that, at the push of a button, release radio frequency energy (or microwaves) into the inner wall of the lungs where the defective nerves are located.
The temperatures reach 80 Celsius – enough to penetrate a few millimeters into the lining of the lung, destroying the nerves just below the surface.
Research suggests that it is effective almost immediately, allowing patients to breathe comfortably.
It has already been successful in the treatment of patients suffering from chronic obstructive pulmonary disease – a serious respiratory problem that is often, but not always, caused by smoking.
Now, 30 asthma patients in hospitals in the UK, France, Germany, and the Netherlands, including some treated at the NHS, will receive the therapy as part of a three-year clinical study.
Aircraft engineer Stuart Simpson, 54, from Wendover in Buckinghamshire, was the first person in the UK to receive lung burn treatment. The married father of two has had asthma since his early 30s.
Initially his condition was well controlled with the help of steroid inhalers and a pump with the drug salbutamol to relieve wheezing.
Now, 30 asthma patients in hospitals in the UK, France, Germany, and the Netherlands, including some treated at the NHS, will receive the therapy as part of a three-year clinical study (stock image)
But after an attack of pneumonia in 2004, his asthma deteriorated, especially during exercise.
Stuart says: “I have always maintained a high fitness level. But then I developed asthma caused by exercise. Normally you breathe in through the nose, so that the air is warm, but when you train, breathing becomes faster and through the mouth, making the air inhaled colder and drier.
“For some people with asthma, the airways are sensitive to these changes and respond by getting narrower, causing asthma symptoms.”
The regular medication could not stop the effects of exercise on Stuart’s airways, so staying active became more difficult for him.
Stuart underwent the procedure in March at the Royal Brompton Hospital in London.
He says: “Afterwards I had a bit of a sore throat and a cough, but that was gone in a few days. I was back in the gym within a week after the treatment. “
Subsequent tests revealed a significant increase in Stuart’s peak / current score – a measure of lung function.
He says: “I still wear salbutamol, just in case, but my use of pumps has decreased and it gives me the confidence to push myself further with sport and fitness.”