Review
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 21, 2016; 22(35): 7892-7907
Published online Sep 21, 2016. doi: 10.3748/wjg.v22.i35.7892
New insights into the pathophysiology of achalasia and implications for future treatment
Janette Furuzawa-Carballeda, Samuel Torres-Landa, Miguel Ángel Valdovinos, Enrique Coss-Adame, Luis A Martín del Campo, Gonzalo Torres-Villalobos
Janette Furuzawa-Carballeda, Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, CP 14080, Mexico
Samuel Torres-Landa, Luis A Martín del Campo, Gonzalo Torres-Villalobos, Department of Experimental Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, CP 14080, Mexico
Miguel Ángel Valdovinos, Enrique Coss-Adame, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, CP 14080, Mexico
Author contributions: Furuzawa-Carballeda J, Torres-Landa S, Valdovinos MA, Coss-Adame E, Martín del Campo LA and Torres-Villalobos G performed the study, and drafted and reviewed the manuscript.
Conflict-of-interest statement: The authors report no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Gonzalo Torres-Villalobos, MD, PhD, Department of Experimental Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga No. 15, Col. Belisario Domínguez Sección XVI, Mexico City, CP 14080, Mexico. torresvgm@yahoo.com.mx
Telephone: +52-55-54070900-2501 Fax: +52-55-55732096
Received: April 1, 2016
Peer-review started: April 6, 2016
First decision: June 20, 2016
Revised: July 6, 2016
Accepted: August 5, 2016
Article in press: August 5, 2016
Published online: September 21, 2016
Core Tip

Core tip: Primary achalasia is associated with loss of ganglion cells in the esophagus and in the lower esophageal sphincter. In the last decade, achalasia pathophysiology has been widely studied, and investigations have aimed to expand clinical management beyond mere treatment of symptoms and towards attacking the specific cause of the disease. While the etiologies remain unclear and no cure exists, the most recent findings suggest an interaction between autoimmune and inflammatory responses, possibly triggered by viral infection, in genetically susceptible individuals. This article reviews the recent advances in understanding the disease pathogenesis with implications for improving therapeutic management.