Is a Viral Cause Behind Achalasia?

The etiology of achalasia remains unknown, but one theory is that neurotropic viruses and autoimmune factors cause achalasia by triggering an inflammatory response in the myenteric network that leads to destruction of neural cells. A small, single-institution study by Iranian investigators, however, found no link between achalasia and human papillomavirus (HPV), adenovirus, and neurotropic viruses.

The case-control study included 52 patients with achalasia and 50 controls who underwent genomic analysis for neurotropic viruses, HPV, and adenovirus using polymerase chain reaction (PCR) and reverse transcription PCR techniques. No neurotropic DNA or RNA viruses were detected in the patients with achalasia. The adenovirus genome was detected in tissue samples of 2 patients with achalasia and 3 controls and HPV was detected in 1 patient with achalasia and 2 controls; thus, no significant relationship between achalasia and the assessed viruses was found. However, the study was small and the investigators acknowledged that their findings do not rule out other viral species or resolved viral infections as the etiology of achalasia.

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Reference

Moradi A, Fazlollahi N, Eshraghi A, et al. Is there any evidence for a viral cause in achalasia? Middle East J Dig Dis. 2018;10(3):169-173. doi:10.15171/mejdd.2018.106.