title: Proteomic identification of proteins suggestive of immune-mediated response or neuronal degeneration in serum of achalasia patients.
abstract: OBJECTIVE
  The primary pathophysiologic abnormality in achalasia is known to be a loss of inhibitory myenteric ganglion cells, which may result from an immune-mediated response or neuronal degeneration. The aim of this study was to identify proteins suggestive of an immune-mediated response or neuronal degeneration in the serum of achalasia patients using a proteomic analysis.
  
  
  METHODS
  Blood samples were collected from five symptomatic achalasia patients and five sex- and age-matched healthy controls. Serum proteomic analysis was conducted, and the protein spots were identified using matrix-assisted laser desorption ionization/time-of-flight and a proteomics analyzer. The serum level of C3 was measured by enzyme-linked immunosorbent assay in nine patients with achalasia and 18 sex- and age-matched healthy controls.
  
  
  RESULTS
  Of the 658 matched protein spots, 28 spots were up-regulated over 2-fold in the serum from achalasia patients compared with that from controls. The up-regulated proteins included complement C4B5, complement C3, cyclin-dependent kinase 5, transthyretin, and alpha 2 macroglobulin. The serum levels of C3 in achalasia patients were significantly higher than those of controls.
  
  
  CONCLUSIONS
  The serum proteomic analysis of achalasia patients suggests an immune-mediated response or neuronal degeneration. Further validation studies in larger samples and the esophageal tissue of achalasia patients are required.
authors.affiliation: Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Seon Kyo
authors.initials: SK
authors.lastname: Im
authors.forename: Mari
authors.initials: M
authors.lastname: Yeo
authors.forename: Kwang Jae
authors.initials: KJ
authors.lastname: Lee
keywords: Esophageal achalasia; Immune response; Neuronal degeneration; Proteomics
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