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ArticleDigestive diseases and sciences2026

Characteristics of the Esophageal Microbiota in Patients with Achalasia.

Yuxia Xie, Wenjie Xiong, Han Chen, Wangqi Chen, Qinghua Li, Suxuan Hou, Haochen Zhou, Hong Zhu, Bixing Ye

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Article in Digestive diseases and sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

9 authors.

Yuxia Xie *Department of Gastroenterology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China.
Wenjie Xiong *Department of Gastroenterology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China.
Han Chen *Department of Gastroenterology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China.
Wangqi ChenDepartment of Gastroenterology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China.
Qinghua LiDepartment of Gastroenterology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China.
Suxuan HouDepartment of Gastroenterology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China.
Haochen ZhouDepartment of Gastroenterology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China.
Hong ZhuDepartment of Gastroenterology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China. zhuhong1059@126.com.
Bixing YeDepartment of Gastroenterology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China.

Funding

Chongqing Natural Science Foundation General Project . CSTB2024NSCQ-MSX1197the National Natural Science Foundation of China No. 82470565Yong Scholars Fostering Fund of the First Affiliated Hospital of Nanjing Medical University JSPH-MC-2023-18
6 · The paper itself

Abstract

backgroundAchalasia (AC) is clinically characterized by chronic intraluminal food stasis and bacterial fermentation, which may contribute to esophageal dysbiosis. This research seeks to analyze the microbiome of individuals with AC, pinpoint significant biomarkers, and explore their relationships with clinical and electrophysiological factors to enhance our comprehension of the mechanisms underlying AC.

methodsThis study, conducted at a single center, involved 16S rRNA sequencing of esophageal mucosal samples collected from individuals with achalasia and a control group. We assessed microbial diversity, identified distinct taxa using LEfSe, predicted functional capabilities through PICRUSt, and examined the relationship between microbiota and clinical parameters. Biomarkers were identified using a random forest algorithm and subsequently validated through qPCR.

resultsPatients with achalasia displayed notable dysbiosis in their esophageal microbiome, marked by changes in community structure while showing no significant shifts in diversity. There was a marked increase in the opportunistic bacterium Fusobacterium, alongside a reduction in beneficial species such as Akkermansia and Ligilactobacillus. The presence of Pseudomonas and Ralstonia was linked to the Eckardt score. The rise in Fusobacterium was further validated through qPCR analysis. Functional predictions suggested an increase in acetyl-CoA biosynthesis among these patients. Notably, levels of Fusobacterium were positively associated with critical clinical indicators, including pressures in the lower and upper esophageal sphincters and the Eckardt score.

conclusionsEsophageal dysbiosis is associated with esophageal hypomotility in achalasia patients.

Indexed as

DysbiosisEsophageal AchalasiaEsophagusMicrobiotaAdultAgedCase-Control StudiesFemaleHumansMaleMiddle AgedRNA, Ribosomal, 16SRNA, Ribosomal, 16SAchalasiaEsophageal microbiomeFusobacteriumMicrobiome dysbiosis

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.