PT - JOURNAL ARTICLE AU - Morten Hvidtfeldt AU - Asger Sverrild AU - Alexis Pulga AU - Laurits Frøssing AU - Alexander Silberbrandt AU - Caroline Sanden AU - Carl Magnus Clausson AU - Daisy Bornesund AU - Jonas Erjefält AU - Celeste Porsbjerg TI - Mucosal cryobiopsies: a new method for studying airway pathology in asthma AID - 10.1183/23120541.00666-2021 DP - 2022 Jan 01 TA - ERJ Open Research PG - 00666-2021 VI - 8 IP - 1 4099 - http://openres.ersjournals.com/content/8/1/00666-2021.short 4100 - http://openres.ersjournals.com/content/8/1/00666-2021.full SO - erjor2022 Jan 01; 8 AB - Background In vivo studies of airway pathology in obstructive lung disease are limited by poor quality of specimens obtained with forceps. Obtainment of cryobiopsies has increased diagnostic yield in cancer and interstitial lung disease but has not been used in patients with asthma. In a recent pilot study, we found mucosal cryobiopsies to be larger and more intact than conventional forceps biopsies. The aim of the present study was to compare quality and safety of mucosal cryobiopsies versus conventional forceps biopsies in patients with asthma.Methods Endobronchial biopsies were obtained with forceps and cryoprobe from patients with asthma not currently treated with inhaled steroids and evaluated histologically.Results A total of 240 cryobiopsies and 288 forceps biopsies were obtained from 48 patients. Bleeding from the biopsy site was common but self-limiting. No major complications related to the procedure were seen. Cryobiopsy cross areas were four times larger compared with forceps. Stretches of intact epithelium were detected in all cryobiopsies compared to 33% in forceps biopsies. Further, the length of intact epithelium was on average four times longer in the cryobiopsies. Importantly, there was a good preservation of both antigens and mRNA in the cryobiopsies ensuring a suitability and robustness for immunohistochemistry and in situ hybridisation.Conclusion Obtainment of mucosal cryobiopsies in patients with asthma is safe and yields biopsies that are significantly larger and morphologically better preserved compared with traditional forceps biopsies. The cryotechnique thus seems to be a promising tool for future in vivo studies of airway pathology.The cryotechnique is a promising, safe tool for obtaining mucosal biopsies in patients with asthma, yielding larger and better-preserved specimens compared with forceps biopsies, increasing utility for evaluating airway pathology https://bit.ly/3sHlVzd