Estimation of Serum Anti-Neuronal Antibodies in Idiopathic Esophageal Achalasia

Background/Aims:Esophageal achalasia is a motility disorder of the esophagus characterized by the loss of inhibitory neurons in the distal esophagus and lower esophageal sphincter. Although esophageal achalasia is idiopathic in nature, autoimmune mechanisms have been proposed. We set out to determine the presence of anti-neuronal antibodies in the serum of the subjects. Methods:We studied 8 patients with well-characterized achalasia (through clinical, x-ray, endoscopy, and manometric examinations). We used immunoblot and ELISA to estimate anti-Hu antibodies, and anti-Ro antibodies respectively, and performed neurologic examinations. Results:None of the 8 patients had serum anti-Hu or anti-Ro, while all 8 patients revealed normal neurologic conditions. Conclusions:Despite these negative results, the involvement of autoimmune mechanism as the pathophysiology of the esophageal achalasia cannot be excluded because this study included only a small number of patients. There remains a possibility of the involvement of other anti-neuronal antibodies.ope