Relationship between airway smooth muscle and asthma: the role of temperature in the treatment

Asthma is a chronic disease characterized by chronic inflammation, hyperresponsiveness, and reversible obstruction of the lower respiratory tract (RT). Airway muscles (ASM) play a central role in the pathophysiology of asthma, being essential for the narrowing and remodeling of the RT. Local hyperthermia of the ASM, achieved by bronchial thermoplasty (BT) and inhalation of a heated helium-oxygen mixture (thermal heliox, t-He/O₂), reduces the ASM mass and contractile activity, which may have a positive pathogenetic effect on the symptoms and course of asthma.

The aim of this review is to study the relationship between the temperature of the ASM and the functional state in patients with asthma, as well as the therapeutic effect of thermotherapy in this disease based on an analysis of the literature from PubMed and Google Scholar.

Methods. 85 publications in PubMed and Google Scholar were selected by searching the following key words: “ASM”, “contraction of ASM”, “relaxation of ASM”, “hyperreactivity of the airways”, “chronic inflammation”, “asthma”, “hyperthermia of the airways”, “bronchial thermoplasty”, “thermal helium-oxygen mixture” (t-He/O₂).

Results. Based on literature data, an assessment was made of the clinical efficacy and safety of two methods of thermal modulation of ASM: BT and inhalation of t-He/O₂. Local hyperthermia of the ASM, achieved by BT and inhalation of a t-He/O₂ reduces the mass and contractile activity of ASM, which may have a positive pathogenetic effect on the symptoms and further course of BA.

Conclusion. Studying the role of temperature in maintaining local inflammation and the development of bronchial obstruction syndrome is not only of great scientific importance, but also has unquestionable practical value for the development of new promising methods of treating asthma.

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