ACOX3 and gastroesophageal reflux disease: As shown in Fig. 3E, exclusively downregulated in GERD (Dataset EV3D) corresponding to the enrichment term “Peroxisome” (KEGG) included PRDX5 (an antioxidant enzyme), ACOX3 (involved in β-oxidation of branched-chain fatty acids), ABCD3 (a transporter for importing fatty acids into peroxisomes), SCP2 (critical for lipid transfer and metabolism within peroxisomes), and EPHX2 (detoxifying epoxides) presumably indicating peroxismal dysfunction.