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Autoantibodies to Auerbach's plexus in achalasia
W B Storch1, V F Eckardt, M Wienbeck
1Institute for Laboratory Medicine, Mönchengladbach, Germany.
Cellular and Molecular Biology (Noisy-Le-Grand, France)
|December 1, 1995
Summary
Autoimmune responses targeting Auerbach's plexus are linked to achalasia, a rare esophageal motility disorder. This study found specific IgG antibodies in most achalasia patients, suggesting a role for autoimmunity in the disease's development.
Area of Science:
- Gastroenterology
- Immunology
- Pathophysiology
Background:
- Achalasia is an esophageal motor disorder defined by reduced ganglion cells in Auerbach's plexus.
- The etiology of achalasia remains largely unknown.
- Autoimmune phenomena have been anecdotally reported in achalasia patients.
Purpose of the Study:
- To investigate the occurrence and significance of circulating antibodies against Auerbach's plexus in achalasia patients.
- To determine if these antibodies are specific to achalasia compared to other gastrointestinal and neuromuscular conditions.
Main Methods:
- Standard indirect immunofluorescence was employed to detect IgG antibodies.
- Antibodies targeting the cytoplasm of Auerbach's plexus were quantified.
- Patient cohorts included individuals with achalasia, healthy controls, Hirschsprung's disease, esophageal cancer, peptic esophagitis, and myasthenia gravis.
Main Results:
- IgG antibodies against Auerbach's plexus were detected in 37 out of 58 achalasia patients (64% sensitivity).
- Antibodies were found in only 4 out of 54 healthy controls (93% specificity), with a statistically significant difference (p < 0.0001).
- Antibodies were absent in patients with Hirschsprung's disease, esophageal cancer, and were rare in peptic esophagitis and myasthenia gravis.
Conclusions:
- The findings strongly suggest that autoimmunity directed against Auerbach's plexus plays a significant role in the pathogenesis of achalasia.
- While the presence of antibodies is confirmed, the precise mechanism by which autoimmunity contributes to achalasia requires further elucidation.