Impact of Esophageal Motility on Microbiome Alterations in Symptomatic Gastroesophageal Reflux Disease Patients With Negative Endoscopy: Exploring the Role of Ineffective Esophageal Motility and Contraction Reserve.
Journal
Journal of neurogastroenterology and motility
Journal Volume
30
Journal Issue
3
Pages
332 - 342
ISSN
2093-0879
Date Issued
2024-07-30
Author(s)
Wong, Ming-Wun
Lo, I-Hsuan
Liu, Po-Yu
Yang, Yu-Tang
Chen, Chun-Yao
Wong, Sunny H
Lei, Wei-Yi
Yi, Chih-Hsun
Liu, Tso-Tsai
Hung, Jui-Sheng
Liang, Shu-Wei
Gyawali, C Prakash
Chen, Chien-Lin
Abstract
Background/Aims Ineffective esophageal motility (IEM) is common in patients with gastroesophageal reflux disease (GERD) and can be associated with poor esophageal contraction reserve on multiple rapid swallows. Alterations in the esophageal microbiome have been reported in GERD, but the relationship to presence or absence of contraction reserve in IEM patients has not been evaluated. We aim to investigate whether contraction reserve influences esophageal microbiome alterations in patients with GERD and IEM. Methods We prospectively enrolled GERD patients with normal endoscopy and evaluated esophageal motility and contraction reserve with multiple rapid swallows during high-resolution manometry. The esophageal mucosa was biopsied for DNA extraction and 16S ribosomal RNA gene V3-V4 (Illumina)/full-length (Pacbio) amplicon sequencing analysis. Results Among the 56 recruited patients, 20 had normal motility (NM), 19 had IEM with contraction reserve (IEM-R), and 17 had IEM without contraction reserve (IEM-NR). Esophageal microbiome analysis showed a significant decrease in microbial richness in patients with IEM-NR when compared to NM. The beta diversity revealed different microbiome profiles between patients with NM or IEM-R and IEM-NR (P = 0.037). Several esophageal bacterial taxa were characteristic in patients with IEM-NR, including reduced Prevotella spp. and Veillonella dispar, and enriched Fusobacterium nucleatum. In a microbiome-based random forest model for predicting IEM-NR, an area under the receiver operating characteristic curve of 0.81 was yielded. Conclusions In symptomatic GERD patients with normal endoscopic findings, the esophageal microbiome differs based on contraction reserve among IEM. Absent contraction reserve appears to alter the physiology and microbiota of the esophagus. © 2024 The Korean Society of Neurogastroenterology and Motility.
Subjects
Contraction reserve
Esophageal motility disorders
High-resolution manometry
Ineffective esophageal motility
Microbiota
Type
journal article