Pathogenesis and Cells of Origin of Barrett's Esophagus

In patients with Barrett ’s esophagus (BE), metaplastic columnar mucosa, containing epithelial cells with gastric and intestinal features, replaces esophageal squamous mucosa damaged by gastroesophageal reflux disease. This condition is estimated to affect 5.6% of adults in the United States, and is a major risk factor fo r esophageal adenocarcinoma. Despite the prevalence and importance of BE, its pathogenesis is incompletely understood and there are disagreements over the cells of origin. We review mechanisms of BE pathogenesis, including transdifferentiation and transcommitment, and discuss potential cells of orig in including basal cells of the squamous epithelium, cells of esophageal submucosal glands and their ducts, cells of the proximal stomach, and specialized populations of cells at the esophago-gastric junction (residual embryonic cells and transitional basal cells).

Source: Gastroenterology - May 9, 2019 Category: Gastroenterology Authors: Jianwen Que, Katherine S. Garman, Rhonda F. Souza, Stuart Jon Spechler Source Type: research