title: Electroporation ablation of bronchial smooth muscle cells: A novel non-thermal asthma therapy.
abstract: OBJECTIVE
  Asthma is a common disease which places significant burden on the US healthcare system and which can be associated with significant patient morbidity and mortality. Current medical therapies are costly and not curative. A new approach for a more permanent asthma treatment is the use of radiofrequency ablation. However, this radiofrequency approach is thermal-based and can result in deleterious effects to the airways, such as stenosis or ulceration. We describe a novel, improved therapeutic approach for smooth muscle ablation using non-thermal DC electroporation ablation.
  
  
  METHODS
  We developed and tested prototype electroporation ablation devices that access the airways both endoscopically and via a bronchoscope. We tested the feasibility of this approach and demonstrated proof-of-concept in 2 mongrel dogs. In order to assess for smooth muscle function, we performed functional studies pre and post ablation with methacholine challenge to assess for airway reversibility. We also evaluated bronchial lesions via direct vision with bronchoscopy.
  
  
  RESULTS
  We developed novel electroporation catheters to delivery energy to the bronchial smooth muscle through an endoscopic approach. We tested these catheters in 2 acute canine studies and successfully demonstrated the ability to destroy smooth muscle tissue via novel prototypes and saline irrigation for widespread non-thermal electroporation ablation. Our functional studies demonstrate the efficacy of this approach.
  
  
  CONCLUSIONS
  We report a novel method for non-thermal bronchial smooth muscle ablation using novel prototypes and electroporation with normal saline. These early findings require further evaluation in larger, chronic canine studies to assess for use as a potential curative therapy.
authors.affiliation: Mayo Clinic Summer Externship Program, Mayo Clinic, Rochester, Minnesota.
authors.forename: Jason A
authors.initials: JA
authors.lastname: Tri
authors.affiliation: Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: Christopher V
authors.initials: CV
authors.lastname: DeSimone
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: Craig
authors.initials: C
authors.lastname: Daniels
authors.affiliation: Mayo Clinic Summer Externship Program, Mayo Clinic, Rochester, Minnesota.
authors.forename: Roshini S
authors.initials: RS
authors.lastname: Asirvatham
authors.affiliation: Mayo Clinic Ventures, Mayo Clinic, Rochester, Minnesota.
authors.forename: Susan B
authors.initials: SB
authors.lastname: Mikell
authors.affiliation: Mayo Clinic Ventures, Mayo Clinic, Rochester, Minnesota.
authors.forename: Dorothy J
authors.initials: DJ
authors.lastname: Ladewig
authors.affiliation: Mayo Clinic Ventures, Mayo Clinic, Rochester, Minnesota.
authors.forename: Kelly
authors.initials: K
authors.lastname: Krajnick
authors.affiliation: Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota; Department of Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: Samuel J
authors.initials: SJ
authors.lastname: Asirvatham