Achalasia is a serious motility disorder of the esophagus that impacts more than 5,000 people in the US each year. Patients with achalasia experience damage to muscle and nerve cells in the esophagus, resulting in a loss of the peristaltic activity that normally pushes food through the esophagus into the stomach, and failure of the lower esophageal sphincter (LES) to relax with swallowing, which further blocks the transit of food. Thus, achalasia patients experience severe swallowing difficulty that adversely impacts their quality of life. Because the etiology of achalasia is not known, current therapies do not cure the disease and only address its symptoms. Exciting new research from Baylor Scott & White Research Institute (BSWRI) shows that LES muscle in achalasia exhibits profound mast cell degranulation, a hallmark of allergy-induced inflammation. This work adds support to the novel hypothesis developed by BSWRI researchers that achalasia might be an allergic disorder.
Tumorigenesis is a complex process regulated by multiple factors in the cancer cells and the surrounding tumor microenvironment. Because the microenvironment can accelerate tumor growth and contribute to therapeutic resistance, there is great interest in developing cancer therapeutics that directly target the microenvironment. Pancreatic adenocarcinoma is an important example of an aggressive and deadly cancer supported by an abundant microenvironment of non-malignant cells. Chemotherapies and targeted therapies only have modest efficacy against pancreatic adenocarcinoma, leading to an overall 5-year survival rate of 9%, and the microenvironment is thought to contribute to this drug resistance. Thus, the pancreatic tumor microenvironment is under active investigation as a source of new possibilities for therapeutic development.
In a recent Grand Rounds presentation, Stuart Spechler, MD, Co-Director of the Center of Esophageal Diseases at Baylor University Medical Center and Co-Director of the Center for Esophageal Research at Baylor Scott and White Research Institute, presented new findings for patients with PPI-refractory heartburn.