Imbalance of Innate and Adaptive Immunity in Esophageal Achalasia

作者：L.C. Yao, Zuqiang Liu, Wei‐Feng Chen, Jiaqi Xu, Xiaoyue Xu, Jiaxin Xu, Liyun Ma, Xiaoqing Li, Quan‐Lin Li, Ping-Hong Zhou · 发表于：Journal of Neurogastroenterology and Motility · 年份：2023 · DOI：10.5056/jnm21246 · 被引用次数：8 · 研究领域：Gastroesophageal reflux and treatments、Dysphagia Assessment and Management、Esophageal and GI Pathology

Background/Aims: Previous studies reveal that immune-mediated neuroinflammation plays a key role in the etiology of esophageal achalasia. However, the understanding of leucocyte phenotype and proportion is limited. This study aim to evaluate the phenotypes of leukocytes and peripheral blood mononuclear cells transcriptomes in esophageal achalasia. Methods: We performed high-dimensional flow cytometry to identified subsets of peripheral leukocytes, and further validated in lower esophageal sphincter histologically. RNA sequencing was applied to investigate the transcriptional changes in peripheral blood mononuclear cells of patients with achalasia. Cell-type Identification by Estimating Relative Subsets of RNA Transcripts (CIBERSORT) was used for estimating the immune cell types. A differential gene expression analysis was performed and the differential expressed genes were subjected to gene ontology, Kyoto Encyclopedia of Genes and Genomes network, protein-protein interaction network construction. Results: An imbalance between innate and adaptive immune cells occurred in achalasia. Specifically, neutrophils and CD8+ T cells increased both in peripheral blood and lower esophageal sphincter in achalasia. Eosinophils decreased in peripheral blood but massively infiltrated in lower esophageal sphincter. CIBERSORT analysis of peripheral blood mononuclear cells RNA sequencing displayed an increased prevalence of CD8+ T cells. 170 dysregulated genes were identified in achalasia, whi...