BACKGROUND: Asthma is a chronic disease affecting the airways of 20 million Americans. Inside the lungs of an asthma patient, the airway walls are inflamed and sensitive. The airways of an asthma patient will react severely to allergens, irritants, physical exertion, or stress. When the airways react, they get narrower. It's the smooth muscle inside the airways that contracts and can lead to an asthma attack. Currently, there are several medicinal treatments for asthma. Long-term-control medications are used to control chronic symptoms and prevent attacks. These drugs control inflammation and include inhaled corticosteroids like fluticasone (Flovent), and budesonide (Pulmicort). Quick-relief medications, or rescue medications, are used during asthma attacks. There are also medications that reduce a patient's sensitivity to allergens.

NEW TREATMENT: Researchers are now testing a non-drug treatment for asthma. Bronchial thermoplasty is a potential new asthma treatment currently undergoing clinical testing. Developed by Asthmatx, Inc., bronchial thermoplasty has the potential to provide asthma relief to people who do not respond to conventional asthma treatment. Ali Musani, M.D., from the University of Pennsylvania Health System is one of the researchers testing the new treatment. "It's a breakthrough in the treatment of asthma because it is a non-pharmacological approach in the treatment of asthma for the first time ever," says Dr. Musani. Although it is not clear if this treatment would be able to replace medications, Dr. Musani says it has the potential to do that. "Even the safest medicines have some side effects," he says.

HOW IT WORKS: Acute asthma attacks involve contraction of the smooth muscle in the airway wall. In bronchial thermoplasty, doctors snake a bronchoscope through the nose or mouth and into the affected airways. The bronchoscope deploys a small basket in the end, which expands in the airway. The basket has five arms that come in contact with the lining of the airway. Each of the arms deliver a very controlled, short burst of electrical energy. This provides thermal energy and destroys several areas of the smooth muscle lining the airway. After the treatment, the smooth muscle will not be able to contract as strongly when an asthma attack is triggered. "The goal is to reduce these muscles and decrease the strength of that contraction and frequency of the contraction over the next months to years," says Dr. Musani.

CLINICAL TRIALS: The American Journal of Respiratory and Critical Care Medicine published results of a small bronchial thermoplasty clinical trial in May. Researchers gave the treatment to 16 adults with mild to moderate asthma. All of the participants did not respond to current asthma treatments. After two years, the researchers report 75 percent of the patients reported an improvement. The researchers write that bronchial thermoplasty seems to be a well-tolerated asthma treatment with minimal side effects. Almost all participants said they would be willing to undergo the asthma treatment a second time.