A 30-minute ‘flash freeze’ lung procedure can improve symptoms in patients with chronic bronchitis, according to a recent study led by our consultant respiratory physician, Professor Pallav Shah.
No effective treatment currently available
Chronic obstructive pulmonary disease (COPD) affects an estimated 1.2 million people in the UK, with up to a third of those with the condition experiencing chronic bronchitis.
Unlike acute bronchitis, the chronic form of the condition can last up to three months and is characterised by a long-term productive cough, a rapid decline in lung function and increased hospitalisations.
In addition, chronic bronchitis can greatly reduce quality of life, with patients avoiding social situations and activities they enjoy, as well as reducing life expectancy in those affected.
Current treatments available, such as bronchodilators and steroids, can help relieve symptoms by thinning mucus and opening the airways. However, none can stop or reverse the airway metaplasia and hypersecretion of mucus that is common in chronic bronchitis.
A novel approach
The RejuvenAir® System offers a new approach to treat the underlying cause of chronic bronchitis. It enables clinicians to deliver small, metred doses of cryogen spray at -196°C directly to the diseased epithelium of the respiratory tract during a bronchoscopy procedure.
The minimally invasive procedure, which takes around 30 minutes under general anaesthetic, instantly kills diseased ciliated epithelial and goblet cells which are overabundant in chronic bronchitis, whilst preserving the extracellular stem cells of the airways.
New healthy cells, including cilia and goblet cells, then repopulate the airways within a few days, with limited scarring. Following this regeneration of the airway epithelium, it is expected that patients will experience improvement in their cough and breathing.
Promising initial results
A prospective safety and feasibility study led by our consultant respiratory physician, Professor Pallav Shah, has shown positive outcomes.
For the study, 35 patients with chronic bronchitis were recruited to undergo the cryospray (RejuvenAir) treatment on three separate occasions (every four to six weeks).
Following treatment, there were clinically significant patient-reported outcomes reported (the primary outcome of the study) and no serious device-related adverse events, demonstrating the safety of the procedure.
“As there are no available medical treatments for chronic bronchitis with persistent sputum production, these early findings bring hope to the many patients affected with the debilitating symptoms of this condition,” said Professor Shah.
“We have started a more detailed clinical study with the liquid nitrogen cryospray (RejuvenAir) treatment, which will hopefully add more evidence of improved outcomes in these patients.”
The prospective clinical study was conducted in collaboration with Chelsea and Westminster Hospital NHS Foundation Trust and the University Medical Centre Groningen in the Netherlands, and was funded by CSA Medical, the company that manufacturers the RejuvenAir System.
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