Bronchial thermoplasty: Quo vadis?

Introduction: In recent years a number of emerging new therapies have become available for the treatment of severe asthma among which bronchial thermoplasty is the only nonpharmacologic intervention that has been approved by the United States Food and Drug Administration in 2010.¹ Although bronchial thermoplasty has great promise for the patient with severe asthma and is now within the therapeutic armamentarium of the allergist-immunologist, the modality has paradoxically raised both excitement and curiosity but also questions as to when and how to recommend its use² as well as concerns relating to any potential harm that may be associated with the procedure.^3–5 In the interest of assisting the allergist-immunologist in the decision-making process for the use of this new treatment modality, two separate articles by Dunn and Wechsler ME⁶ and Iyler and Lim⁷ are presented in this issue of the Proceedings that offer opposing viewpoints on the role of bronchial thermoplasty in a pro/con debate format. In addition, employing a novel publication format, each author was given an opportunity to make rebuttal comments to each other's presentation which are printed below in this editorial. It is our hope that this information will be useful and will assist the allergist-immunologist in making the best therapeutic decisions for the patient with severe asthma.