- Nuvaira is a treatment that involves inserting a thin tube into the airways
- A deflated balloon at the end of the tube is inflated once it is in the right position
- Tiny electrodes on the surface emit radio frequency where the faulty nerves are
- The temperatures reach 80 Celsius destroying nerves just beneath the surface
- Research suggests the hour-long treatment works almost immediately
By ROGER DOBSON FOR THE MAIL ON SUNDAY
A hot probe that blasts defective nerves in the lungs could help thousands of asthma sufferers breathe more easily.
The one-off, hour-long treatment involves inserting a device into the airways to destroy overactive nerves in the lungs that cause breathing difficulties.
It’s hoped the revolutionary technique will bring relief to those with severe asthma who struggle to keep it under control with medication.
Asthma affects about 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 up the airways in the event of one.
Nuvaira is a new asthma treatment that could help thousands of sufferers with severe asthma. The one-off, hour-long treatment involves inserting a device into the airways to destroy overactive nerves in the lungs that cause breathing difficulties (stock image)
But one sufferer in ten has severe asthma that often fails to respond to standard treatments. The consequences can be fatal – asthma kills an average of three people a day in the UK.
The new treatment, which is called Nuvaira, deploys a ground-breaking therapy called targeted lung denervation.
It’s based on the discovery that a faulty nerve that runs from the brain to the lungs may be partly to blame for asthma flare-ups.
For many years, the illness was thought to be due solely to the immune system overreacting to allergens – such as pollen – or viruses, like a cold.
But scientists now know it can also be worsened by problems with the vagus nerve – a twisting bundle of pathways running from the chest to the brain.
Branches of the vagus nerve control the muscles in the airways that manage the breathing.
In healthy lungs, the nerve sends signals to the muscles to ensure they contract and relax smoothly, allowing the airways to inhale and exhale properly.
But if the nerves are faulty, these muscles become overactive. As they tighten more and relax less, the airways become narrowed and breathing becomes harder.
Destroying these branches of the vagus nerve blocks the faulty signals, stopping the muscles in the airways from tightening and allowing more air to pass into the lungs.
Denervation involves the patient being given a general anaesthetic and a device called a bronchoscope being inserted through the mouth and into the lungs.
It has a tiny camera and a light on the tip which allows doctors to see the area they are treating.
Next, a thin tube carrying a deflated balloon is fed into the lungs. Once the balloon is in the correct position, it is inflated.
On its surface are tiny electrodes that, at the press of a button, fire radiofrequency energy (or microwaves) at the inner lining of the lungs where the faulty nerves are located.
The temperatures reach 80 Celsius – enough to penetrate several millimetres into the lining of the lung, destroying nerves just beneath the surface.
Research suggests it is effective almost immediately, allowing patients to breathe comfortably.
It has already proved successful in treating patients who suffer from chronic obstructive pulmonary disorder – a severe breathing problem often, but not always, caused by smoking.
Now 30 asthma patients at hospitals in the UK, France, Germany and the Netherlands, including some treated on the NHS, will receive the therapy as part of a three-year clinical trial.
Aircraft engineer Stuart Simpson, 54, from Wendover in Buckinghamshire, was the first person in the UK to have the lung-burning treatment. The married father-of-two has had asthma since his early 30s.
Initially, his condition was well controlled using steroid inhalers and a pump containing the drug salbutamol to relieve wheeziness.
Now 30 asthma patients at hospitals in the UK, France, Germany and the Netherlands, including some treated on the NHS, will receive the therapy as part of a three-year clinical trial (stock image)
But after a bout of pneumonia in 2004, his asthma worsened, especially during exercise.
Stuart says: ‘I’ve always maintained a high level of fitness. But then I developed exercise-induced asthma. Normally, you breathe in through the nose, so the air is warm, but when you exercise, breathing becomes faster and through the mouth, making the inhaled air colder and drier.
‘In some people with asthma, the airways are sensitive to these changes and react by getting narrower, causing asthma symptoms.’
Mainstream drugs failed to halt the effects of exercise on Stuart’s airways, so staying active became harder 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 cleared up within a couple of days. I was back at the gym within a week of the treatment.’
Subsequent tests revealed a significant increase in Stuart’s peak/flow score – a measure of lung function.
He says: ‘I still carry salbutamol at all times, just in case, but my use of pumps has reduced and it’s given me the confidence to push myself further with sport and fitness.’
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