New insights into the pathophysiology of achalasia and implications for future treatment
| العنوان: | New insights into the pathophysiology of achalasia and implications for future treatment |
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| المؤلفون: | Luis Alfonso Martín Del Campo, Miguel A. Valdovinos, Gonzalo Torres-Villalobos, Samuel Torres-Landa, Enrique Coss-Adame, Janette Furuzawa-Carballeda |
| المصدر: | World Journal of Gastroenterology |
| بيانات النشر: | Baishideng Publishing Group Inc, 2016. |
| سنة النشر: | 2016 |
| مصطلحات موضوعية: | Pathology, medicine.medical_specialty, Allgrove Syndrome, Manometry, Achalasia, Myenteric Plexus, Disease, Review, Bioinformatics, Pathophysiology, Esophageal Sphincter, Lower, Autoimmune Diseases, 03 medical and health sciences, 0302 clinical medicine, Heartburn, Autoimmune disease, medicine, Genetic predisposition, otorhinolaryngologic diseases, Humans, Esophageal Motility Disorders, Autoantibodies, Inflammation, Molecular pathology, business.industry, Gastroenterology, General Medicine, medicine.disease, Dysphagia, Treatment, Esophageal Achalasia, 030220 oncology & carcinogenesis, Etiology, Quality of Life, 030211 gastroenterology & hepatology, Peristalsis, medicine.symptom, business, Deglutition Disorders, Adrenal Insufficiency |
| الوصف: | Idiopathic achalasia is an archetype esophageal motor disorder, causing significant impairment of eating ability and reducing quality of life. The pathophysiological underpinnings of this condition are loss of esophageal peristalsis and insufficient relaxation of the lower esophageal sphincter (LES). The clinical manifestations include dysphagia for both solids and liquids, regurgitation of esophageal contents, retrosternal chest pain, cough, aspiration, weight loss and heartburn. Even though idiopathic achalasia was first described more than 300 years ago, researchers are only now beginning to unravel its complex etiology and molecular pathology. The most recent findings indicate an autoimmune component, as suggested by the presence of circulating anti-myenteric plexus autoantibodies, and a genetic predisposition, as suggested by observed correlations with other well-defined genetic syndromes such as Allgrove syndrome and multiple endocrine neoplasia type 2 B syndrome. Viral agents (herpes, varicella zoster) have also been proposed as causative and promoting factors. Unfortunately, the therapeutic approaches available today do not resolve the causes of the disease, and only target the consequential changes to the involved tissues, such as destruction of the LES, rather than restoring or modifying the underlying pathology. New therapies should aim to stop the disease at early stages, thereby preventing the consequential changes from developing and inhibiting permanent damage. This review focuses on the known characteristics of idiopathic achalasia that will help promote understanding its pathogenesis and improve therapeutic management to positively impact the patient’s quality of life. |
| اللغة: | English |
| تدمد: | 2219-2840 1007-9327 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a96eaafb902e70f1bd47d51641a03023Test http://europepmc.org/articles/PMC5028805Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....a96eaafb902e70f1bd47d51641a03023 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 22192840 10079327 |
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