{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T06:54:13Z","timestamp":1781679253170,"version":"3.54.5"},"reference-count":34,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T00:00:00Z","timestamp":1681948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003711","name":"Ministry of Science and Technology","doi-asserted-by":"publisher","award":["109\u20102628\u2010B\u2010002\u2010036"],"award-info":[{"award-number":["109\u20102628\u2010B\u2010002\u2010036"]}],"id":[{"id":"10.13039\/501100003711","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003711","name":"Ministry of Science and Technology","doi-asserted-by":"publisher","award":["110\u20102628\u2010B\u2010002\u2010048"],"award-info":[{"award-number":["110\u20102628\u2010B\u2010002\u2010048"]}],"id":[{"id":"10.13039\/501100003711","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003711","name":"Ministry of Science and Technology","doi-asserted-by":"publisher","award":["MOST 111\u20102314\u2010B\u2010002\u2010189\u2010MY3"],"award-info":[{"award-number":["MOST 111\u20102314\u2010B\u2010002\u2010189\u2010MY3"]}],"id":[{"id":"10.13039\/501100003711","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005762","name":"National Taiwan University Hospital","doi-asserted-by":"publisher","award":["NTUH 110\u2010005025"],"award-info":[{"award-number":["NTUH 110\u2010005025"]}],"id":[{"id":"10.13039\/501100005762","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005762","name":"National Taiwan University Hospital","doi-asserted-by":"publisher","award":["NTUH 111\u2010S0174"],"award-info":[{"award-number":["NTUH 111\u2010S0174"]}],"id":[{"id":"10.13039\/501100005762","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Achalasia often presents with chronic food stasis and fermentation in the esophageal lumen, which may lead to alterations of the esophageal microbiome, with associated mucosal inflammation and dysplastic changes. The study aims to evaluate the characteristics of the esophageal microbiome in achalasia and changes of the esophageal microbiome before and after peroral endoscopic myotomy (POEM).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a prospective case\u2013control study. This study enrolled patients with achalasia and asymptomatic subjects as control group. Endoscopic brushing for esophageal microbiome collection was performed in all subjects, with additional follow\u2010up endoscopy and brushing 3\u00a0months after POEM in achalasia patients. The composition of the esophageal microbiome was determined and compared between (1) achalasia patients and asymptomatic controls and (2) achalasia patients before and after POEM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010one achalasia patients (mean age 53.5\u00a0\u00b1\u00a016.2\u00a0years; male 45.2%) and 15 controls were analyzed. We observed a distinct esophageal microbial community structure in achalasia patients, with increased Firmicutes and decreased Proteobacteria when compared with the control group at the phylum level. The discriminating enriched genera in achalasia patients were <jats:italic>Lactobacillus<\/jats:italic>, followed by <jats:italic>Megasphaera<\/jats:italic> and <jats:italic>Bacteroides<\/jats:italic>, and the amount of <jats:italic>Lactobacillus<\/jats:italic> was associated with the severity of achalasia. Twenty patients were re\u2010examined after POEM, and a high prevalence of erosive esophagitis (55%) was noted, alongside an increase in genus <jats:italic>Neisseria<\/jats:italic> and decrease in <jats:italic>Lactobacillus<\/jats:italic> and <jats:italic>Bacteroides<\/jats:italic>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The altered esophageal microenvironment in achalasia leads to dysbiosis with a high abundance of genus <jats:italic>Lactobacillus<\/jats:italic>. Increased <jats:italic>Neisseria<\/jats:italic> and decreased <jats:italic>Lactobacillus<\/jats:italic> were observed after POEM. The long\u2010term effect of microbial changes warrants further study.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.16192","type":"journal-article","created":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T13:32:23Z","timestamp":1681997543000},"page":"1307-1315","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Characteristics of the esophageal microbiome in patients with achalasia and its changes before and after peroral endoscopic myotomy: A pilot study"],"prefix":"10.1111","volume":"38","author":[{"given":"Chia\u2010Chu","family":"Yeh","sequence":"first","affiliation":[{"name":"Department of Internal Medicine National Taiwan University Hospital  Taipei Taiwan"},{"name":"Good Liver Clinic  Taipei Taiwan"},{"name":"Graduate Institute of Clinical Medicine National Taiwan University College of Medicine  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chieh\u2010Chang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine National Taiwan University Hospital  Taipei Taiwan"},{"name":"Graduate Institute of Clinical Medicine National Taiwan University College of Medicine  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chien\u2010Chuan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming\u2010Lun","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine National Taiwan University Hospital  Taipei Taiwan"},{"name":"Department of Integrated Diagnostics and Therapeutics National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia\u2010Feng","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics National Taiwan University Children's Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsiu\u2010Po","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming\u2010Shiang","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7483-7538","authenticated-orcid":false,"given":"Ping\u2010Huei","family":"Tseng","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,4,20]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.2996"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/dote\/dox072"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.2147\/CEG.S141642"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-114426"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-230X-13-22"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.8859"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.13127"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/19490976.2021.1909459"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2009.04.046"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(92)91428-7"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.5009\/gnl16545"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0129055"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1067\/mtc.2000.110463"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.169.2.9242756"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12477"},{"key":"e_1_2_6_17_1","article-title":"Clinical efficacy and safety of peroral endoscopic myotomy for esophageal achalasia: a multicenter study in Taiwan","author":"Shieh TY","year":"2021","journal-title":"J. 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