Autoimmune and viral risk factors are associated with achalasia: A case‐control study

Gaber, Charles; Cotton, Cary C.; Eluri, Swathi; Lund, Jennifer L.; Farrell, Timothy M.; Dellon, Evan S.

doi:10.1111/nmo.14312

Cited by 22 publications

(22 citation statements)

References 43 publications

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“…1.23-1.80). In line with results of Gaber et al, 1 the strongest associations were observed for systemic sclerosis (OR = 10.72, 95% CI:…”

Section: E T T E R T O T H E E D I T O R Autoimmune Disorders Are Pos...supporting

confidence: 90%

“…Systemic sclerosis (OR = 8.1, 95% CI: 3.34-19.80) and Addison's disease (OR = 3.83, 95% CI: 1.83-8.04) had the strongest associations with achalasia. 1 We can confirm these results for Germany. Our study was based on data from the Disease Analyzer database, which contains drug prescriptions, diagnoses, and basic medical and demographic data directly obtained and in anonymous format from computer systems used in the practices of general practitioners and specialists.…”

Section: E T T E R T O T H E E D I T O R Autoimmune Disorders Are Pos...supporting

confidence: 65%

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Autoimmune disorders are positively associated with achalasia

Kostev¹,

Roderburg

Loosen

2022

Neurogastroenterology Motil

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“…1.23-1.80). In line with results of Gaber et al, 1 the strongest associations were observed for systemic sclerosis (OR = 10.72, 95% CI:…”

Section: E T T E R T O T H E E D I T O R Autoimmune Disorders Are Pos...supporting

confidence: 90%

Section: E T T E R T O T H E E D I T O R Autoimmune Disorders Are Pos...supporting

confidence: 65%

Autoimmune disorders are positively associated with achalasia

Kostev¹,

Roderburg

Loosen

2022

Neurogastroenterology Motil

View full text Add to dashboard Cite

“…Gaber et al reported between 6 769 cases of achalasia and 27 076 controls, higher odds ratio (OR) of achalasia with autoimmune conditions (OR=1.26, 95%CI=1.11-1.42). 7 The presence of any of the viral infections studied was also associated with an increased risk of achalasia (OR=1.58, 95%CI=1.23-2.01). Varicella zoster virus (OR=3.84, 95%CI=1.94-7.62) and human papilloma virus (OR=1.77, 95%CI=1.15-2.73) had a close association with achalasia.…”

Section: Discussionmentioning

confidence: 90%

“…The distribution and final results of this plexitis is variable, and can be modified by the response of the host or the etiological stimulus. 7 High-resolution esophageal manometry is the ideal test for the diagnosis of achalasia, and has made possible to establish several phenotypes. Type I: absence of smooth muscle contractility of the esophageal body represents the late stage with loss of muscle tone and dilation of the esophagus.…”

Section: Discussionmentioning

confidence: 99%

Long COVID-19 and achalasia: a possible relationship?

Aponte

Daulabani

Parra

et al. 2022

Int J Community Med Public Health

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Achalasia is a rare esophageal motor disorder with a worldwide prevalence of around 10 cases per 100 000 inhabitants, and an incidence of one new case per 100 000 inhabitants per year. It is characterized by loss or decrease of myenteric plexus neurons in the distal esophagus and lower esophageal sphincter, presenting dysphagia and regurgitation. The objective of this work was to show that the presence of type II achalasia could be a sequela of the COVID-19 infection. Patient histories were reviewed during the 2015-2021 period, the frequencies of achalasia with and without COVID-19 were calculated. Patient profiles were constructed by using cluster analysis based on clinical variables. It was found that frequency of patients with achalasia during the years 2020 and 2021 was higher than that observed in previous years, and by the year 2021, 2/3 of the patients with achalasia had presented COVID-19 infection, in addition, the patients with type I achalasia presented different profiles than patients with type II achalasia according to the cluster analysis, and the frequency of COVID-19 was much lower in patients with type I achalasia. These results seem to indicate type II achalasia could be a sequela of COVID-19 infection. The possible etiopathogenic implications of these results are discussed, as well as their clinical relevance.

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“…Many studies indicated that autoimmune-mediated inflammation may be the main cause of achalasia [1]. A matched case-control study which enrolled 6769 cases and 27,076 controls, found that the presence of autoimmune conditions and viral infections was also associated with an increased risk of achalasia [27]. other previous studies [8,10,28] and suggested that aberrant autoimmune and viral infections may contribute to the occurrence of achalasia.…”

Section: Discussionmentioning

confidence: 98%

“M1/M2” Muscularis Macrophages Are Associated with Reduction of Interstitial Cells of Cajal and Glial Cells in Achalasia

et al. 2022

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Background and Aims Several studies showed muscularis macrophages (MMφ) are associated with GI motility disorders. The purpose of this study was to preliminary explore the association between MMφ and achalasia. Methods Tissue samples of the lower esophageal sphincter (LES) high-pressure zone were obtained from 27 achalasia patients and 10 controls. Immunohistochemistry for MMφ, interstitial cells of Cajal (ICC), neuronal nitric oxide synthase (nNOS), and glial cells were conducted. Histological characteristics were compared between groups, and correlation analysis was performed. Results Fewer ICC was found in achalasia compared with controls (P = 0.018), and the level of M1 macrophages was higher than that in controls no matter in terms of the number or the proportion of M1(P = 0.026 for M1 and 0.037 for M1/MMφ). Statistical differences were found between two groups in terms of proportion of M2 and ratio of M1 to M2 (P = 0.048 for M2/ MMφ and < 0.001 for M1/M2). For the correlation analysis, significant correlations were detected between levels of nNOS, ICC, and glial cells in patients with achalasia (P = 0.026 for nNOS and ICC, 0.001 for nNOS and glial cells, 0.019 for ICC and glial cells). There were significant correlations between M2/MMφ and levels of ICC (P = 0.019), glial cells (P = 0.004), and nNOS (P = 0.135). Conclusion Patients with achalasia had a higher level of M1/M2 ratio in LES and significant correlations were found between M2/MMφ and numbers of ICC and glial cells, which suggested that MMφ were probably associated with occurrence and development of achalasia.

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Autoimmune and viral risk factors are associated with achalasia: A case‐control study

Cited by 22 publications

References 43 publications

Autoimmune disorders are positively associated with achalasia

Autoimmune disorders are positively associated with achalasia

Long COVID-19 and achalasia: a possible relationship?

“M1/M2” Muscularis Macrophages Are Associated with Reduction of Interstitial Cells of Cajal and Glial Cells in Achalasia

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