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Review
. May-Jun 2014;20(3):207-10.
doi: 10.1097/PPO.0000000000000044.

Microbiome in Reflux Disorders and Esophageal Adenocarcinoma

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Free PMC article
Review

Microbiome in Reflux Disorders and Esophageal Adenocarcinoma

Liying Yang et al. Cancer J. .
Free PMC article

Abstract

The incidence of esophageal adenocarcinoma has increased dramatically in the United States and Europe since the 1970s without apparent cause. Although specific host factors can affect risk of disease, such a rapid increase in incidence must be predominantly environmental. In the stomach, infection with Helicobacter pylori has been linked to chronic atrophic gastritis, an inflammatory precursor of gastric adenocarcinoma. However, the role of H. pylori in the development of esophageal adenocarcinoma is not well established. Meanwhile, several studies have established that a complex microbiome in the distal esophagus might play a more direct role. Transformation of the microbiome in precursor states to esophageal adenocarcinoma-reflux esophagitis and Barrett metaplasia-from a predominance of gram-positive bacteria to mostly gram-negative bacteria raises the possibility that dysbiosis is contributing to pathogenesis. However, knowledge of the microbiome in esophageal adenocarcinoma itself is lacking. Microbiome studies open a new avenue to the understanding of the etiology and pathogenesis of reflux disorders.

Figures

Figure 1
Figure 1
In situ visualization of bacteria in esophageal mucosal biopsies. A and B: Confocal sections of mucosal biopsy specimens stained for cell viability, containing mixtures of living (yellow) and dead (red) organisms. Microcolony and aggregate formation can be seen in mucosal samples from control subjects (A) and from patients with Barrett’s esophagus (B). C and D: Fluorescence light micrographs of transverse sections of Barrett’s esophageal mucosae showing colonization by streptococci (C) and Campylobacter species (D), using 16S ribosomal RNA oligonucleotide probes labeled with FITC and cy3. Figure originally published in Journal of Clinical Infectious Diseases and permission to reuse of the figure is granted by the Journal.

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