Elucidation of esophageal achalasia based on their subtypes from the multiple perspectives.

2022 Fiscal Year Final Research Report

• Project/Area Number: 20K08334
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 53010:Gastroenterology-related
• Research Institution: Kyushu University
• Principal Investigator: IHARA EIKICHI 九州大学, 医学研究院, 准教授 (80612390)
• Project Period (FY): 2020-04-01 – 2023-03-31
• Keywords: 食道アカラシア / 高解像度食道内圧検査 / アカラシアサブタイプ

Outline of Final Research Achievements

In this study, we elucidated the physiological mechanisms of esophageal motility and the pathology of esophageal achalasia. (1) Lower esophageal sphincter (LES) relaxation induced by stimulation of neuronal nicotinic acetylcholine receptors involves hyperpolarization of Cajal interstitial cells via the neurotransmitter ATP. (2) Myosin light chain phosphorylation level is significantly decreased in patients with esophageal achalasia. (3) Proportions of more than 20 types of bacterial including anaerobic bacteria and α-diversity were increased in esophageal flora of patients with achalasia. (4) We could create a mathematical model that imitates esophageal motility based on the results of high-resolution esophageal manometry. The internal pressure findings of esophageal achalasia could be reproduced using the model.

Free Research Field

消化器内科学

Academic Significance and Societal Importance of the Research Achievements

食道運動は、食道期の嚥下機能を担う。食道運動が破綻した食道運動機能障害は、つらい症状・嚥下困難から「快食」が妨げられ、生活の質を低下させるのみならず、重症化すれば「誤嚥性肺炎」をきたし生命予後に影響を及ぼすため重要な疾患である。しかしながら、これまで方法論の限界によって、食道期の嚥下機能に関する研究は発展途上であった。本研究の社会的意義は、食道運動の生理機序と破綻状態である食道アカラシアの病態の一端を解明に成功したことで、高齢社会において「快食」と「誤嚥予防」に観点から健康長寿に貢献する今後の研究開発の突破口をつくったことである。