Abstract
Achalasia is a motility disorder of theesophagus characterized by the loss of inhibitoryneurons in the distal esophagus. Although idiopathic innature, autoimmune mechanisms have been proposed, and we set out to determine the presence of myentericneuronal antibodies. We prospectively studied 18patients with well-characterized achalasia (by clinical,x-ray, and manometric evidence), nine withgastroesophageal reflux disease, and analyzed the sera from 22disease-free controls. Using double-label, indirectimmunofluorescence techniques, rat esophageal andintestinal sections were double-labeled with sera(dilutions of 1:50 to 1:400) from the three groups andwith neurofilament antibody to localize neurons. Sevenof 18 achalasia patients had sera that stained themajority of neurons within plexi in the esophageal and intestinal sections, including both NADPHdiaphorase (nitric oxide synthase) -positiveand-negative neurons. None of the gastroesophagealreflux patients or the controls showed staining.Neuronal antibodies in achalasia provide an attractive hypothesisto explain this diffuse, possibly immune-based disorder.
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Verne, G.N., Sallustio, J.E. & Eaker, E.Y. Anti-Myenteric Neuronal Antibodies in Patients with Achalasia (A Prospective Study). Dig Dis Sci 42, 307–313 (1997). https://doi.org/10.1023/A:1018857617115
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DOI: https://doi.org/10.1023/A:1018857617115