Digestive Diseases and Sciences

, Volume 55, Issue 2, pp 307–311

Neural Autoantibody Profile of Primary Achalasia

  • Robert E. Kraichely
  • Gianrico Farrugia
  • Sean J. Pittock
  • Donald O. Castell
  • Vanda A. Lennon
Original Article


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.


Autoimmune gastrointestinal dysmotility Achalasia Autoimmune Neural autoantibodies Glutamic acid decarboxylase-65 


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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Robert E. Kraichely
    • 1
  • Gianrico Farrugia
    • 1
  • Sean J. Pittock
    • 2
    • 3
  • Donald O. Castell
    • 4
  • Vanda A. Lennon
    • 2
    • 3
    • 5
    • 6
  1. 1.Enteric NeuroScience Program, Division of Gastroenterology and HepatologyMayo Clinic College of MedicineRochesterUSA
  2. 2.Department of NeurologyMayo Clinic College of MedicineRochesterUSA
  3. 3.Department of Laboratory Medicine and PathologyMayo Clinic College of MedicineRochesterUSA
  4. 4.Medical University of South CarolinaCharlestonUSA
  5. 5.Department of ImmunologyMayo Clinic College of MedicineRochesterUSA
  6. 6.Neuroimmunology LaboratoryMayo ClinicRochesterUSA

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