Mechanisms of Barrett's oesophagus: intestinal differentiation, stem cells, and tissue models

Best Pract Res Clin Gastroenterol. 2015 Feb;29(1):3-16. doi: 10.1016/j.bpg.2014.11.001. Epub 2014 Nov 12.


Barrett's oesophagus (BE) is defined as any metaplastic columnar epithelium in the distal oesophagus which replaces normal squamous epithelium and which predisposes to cancer development. It is this second requirement, the predisposition to cancer, which makes this condition both clinically highly relevant and an important area for ongoing research. While BE has been defined pathologically since the 1950's (Allison and Johnstone, Thorax 1955), and identified as a risk factor for esophageal adenocarcinoma since the 1970's (Naef A.P., et al J Thorac Cardiovasc Surg. 1975), our understanding of the molecular events giving rise to this condition remains limited. Herein we will examine what is known about the intestinal features of BE and how well it recapitulates the intestinal epithelium, including stem identity and function. Finally, we will explore laboratory models of this condition presently in use and under development, to identify new insights they may provide into this important clinical condition.

Keywords: (3-10) gastroesophageal reflux disease (GERD); BMP4; Barrett's oesophagus (BE); Cdx2; Esophageal adenocarcinoma (EAC); Hedgehog; Human 3D organotypic model systems (OTC); Multi-layered epithelium (MLE); Sox2; Tissue engineering.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Adenocarcinoma / etiology
  • Adenocarcinoma / pathology
  • Animals
  • Barrett Esophagus / etiology*
  • Barrett Esophagus / pathology*
  • Esophageal Neoplasms / etiology
  • Esophageal Neoplasms / pathology
  • Humans
  • Intestinal Mucosa / pathology
  • Precancerous Conditions / etiology*
  • Precancerous Conditions / pathology*
  • Risk Factors
  • Stem Cells / pathology

Supplementary concepts

  • Adenocarcinoma Of Esophagus