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Neural Autoantibody Profile of Primary Achalasia

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Abstract

The etiology and pathogenesis of primary achalasia are both unknown. Postulated mechanisms include autoimmune, viral-immune, and central neurodegenerative. The aim of this study is to investigate the serum profile of neural autoantibodies in patients with primary achalasia. Coded sera from 70 patients with primary achalasia and 161 healthy control subjects, matched in sex, age, and smoking habits, were screened for antibodies targeting neuronal, glial, and muscle autoantigens. No specific myenteric neuronal antibody was identified. However, the overall prevalence of neural autoantibodies in patients with primary achalasia was significantly higher than in healthy control subjects (25.7 vs. 4.4%, P < 0.0001). Most noteworthy was the 21.4% frequency of glutamic acid decarboxylase-65 antibody in patients with achalasia (versus 2.5% in control subjects), in the absence of diabetes or companion antibodies predictive of type 1 diabetes. This profile of autoantibodies suggests an autoimmune basis for a subset of primary achalasia.

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Acknowledgments

We thank Carissa Dege and Sue Nodtvedt for excellent technical assistance. This work was supported by grants from the National Institutes of Health DK068055, DK 71209, DK52766, DK57061, and DK65154.

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Authors and Affiliations

  1. Enteric NeuroScience Program, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN, USA

    Robert E. Kraichely & Gianrico Farrugia

  2. Department of Neurology, Mayo Clinic College of Medicine, Rochester, MN, USA

    Sean J. Pittock & Vanda A. Lennon

  3. Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN, USA

    Sean J. Pittock & Vanda A. Lennon

  4. Medical University of South Carolina, Charleston, SC, USA

    Donald O. Castell

  5. Department of Immunology, Mayo Clinic College of Medicine, Rochester, MN, USA

    Vanda A. Lennon

  6. Neuroimmunology Laboratory, Mayo Clinic, 828 Guggenheim Building, Rochester, MN, 55905, USA

    Vanda A. Lennon

Authors
  1. Robert E. Kraichely
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  2. Gianrico Farrugia
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  3. Sean J. Pittock
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  4. Donald O. Castell
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  5. Vanda A. Lennon
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Correspondence to Vanda A. Lennon.

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Kraichely, R.E., Farrugia, G., Pittock, S.J. et al. Neural Autoantibody Profile of Primary Achalasia. Dig Dis Sci 55, 307–311 (2010). https://doi.org/10.1007/s10620-009-0838-9

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  • DOI: https://doi.org/10.1007/s10620-009-0838-9

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