How to Make a Barrett Esophagus: Pathophysiology of Columnar Metaplasia of the Esophagus

Overview

Journal Dig Dis Sci

Specialty Gastroenterology

Date 2005 Apr 7

PMID 15810619

Citations 17

Authors

Philippe G Guillem

Affiliations

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Abstract

Barrett esophagus is defined as a specialized intestinal replacing the squamous epithelium of the esophageal mucosa in response to gastroesophageal reflux. Barrett metaplasia is a healing process that develops to protect the esophagus from further damage. Although mechanisms by which Barrett metaplasia evolves toward dysplasia and adenocarcinoma have been extensively studied, the process by which squamous epithelium is replaced by specialized intestinal metaplasia is poorly understood. Barrett esophagus develops when defense mechanisms in the esophageal mucosa (luminal secretion of mucus, bicarbonate, growth factors, etc.) are overwhelmed by an ongoing cycle of mucosal injury and repair. Hydrogen ion, pepsin, trypsin, and bile acids are considered harmful agents that synergistically invade the esophageal mucosa. Areas of destroyed squamous epithelium are then progressively reepithelized by a columnar epithelium that may originate from multipotent stem cells located within the basal layer of the normal esophageal mucosa or in the ducts of submucosal glands.

Citing Articles

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Cryospray ablation using pressurized CO2 for ablation of Barrett's esophagus with early neoplasia: early termination of a prospective series.

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Barrett oesophagus: lessons on its origins from the lesion itself.

McDonald S, Lavery D, Wright N, Jansen M Nat Rev Gastroenterol Hepatol. 2014; 12(1):50-60.

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Chronic pepsin exposure promotes anchorage-independent growth and migration of a hypopharyngeal squamous cell line.

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Toll-like receptor 4 activation in Barrett's esophagus results in a strong increase in COX-2 expression.

Verbeek R, Siersema P, Ten Kate F, Fluiter K, Souza R, Vleggaar F J Gastroenterol. 2013; 49(7):1121-34.

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