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Pathogenesis and Cells of Origin of Barrett's Esophagus.

Publication ,  Journal Article
Que, J; Garman, KS; Souza, RF; Spechler, SJ
Published in: Gastroenterology
August 2019

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 for 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 origin, 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 esophagogastric junction (residual embryonic cells and transitional basal cells). We discuss the concept of metaplasia as a wound-healing response, and how cardiac mucosa might be the precursor of the intestinal metaplasia of BE. Finally, we discuss shortcomings in current diagnostic criteria for BE that have important clinical implications.

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Published In

Gastroenterology

DOI

EISSN

1528-0012

ISSN

0016-5085

Publication Date

August 2019

Volume

157

Issue

2

Start / End Page

349 / 364.e1

Related Subject Headings

  • Wound Healing
  • United States
  • Metaplasia
  • Humans
  • Gastroenterology & Hepatology
  • Gastric Mucosa
  • Esophagogastric Junction
  • Esophageal Neoplasms
  • Esophageal Mucosa
  • Epithelial Cells
 

Citation

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Que, J., Garman, K. S., Souza, R. F., & Spechler, S. J. (2019). Pathogenesis and Cells of Origin of Barrett's Esophagus. Gastroenterology, 157(2), 349-364.e1. https://doi.org/10.1053/j.gastro.2019.03.072
Que, Jianwen, Katherine S. Garman, Rhonda F. Souza, and Stuart Jon Spechler. “Pathogenesis and Cells of Origin of Barrett's Esophagus.Gastroenterology 157, no. 2 (August 2019): 349-364.e1. https://doi.org/10.1053/j.gastro.2019.03.072.
Que J, Garman KS, Souza RF, Spechler SJ. Pathogenesis and Cells of Origin of Barrett's Esophagus. Gastroenterology. 2019 Aug;157(2):349-364.e1.
Que, Jianwen, et al. “Pathogenesis and Cells of Origin of Barrett's Esophagus.Gastroenterology, vol. 157, no. 2, Aug. 2019, pp. 349-364.e1. Epmc, doi:10.1053/j.gastro.2019.03.072.
Que J, Garman KS, Souza RF, Spechler SJ. Pathogenesis and Cells of Origin of Barrett's Esophagus. Gastroenterology. 2019 Aug;157(2):349-364.e1.
Journal cover image

Published In

Gastroenterology

DOI

EISSN

1528-0012

ISSN

0016-5085

Publication Date

August 2019

Volume

157

Issue

2

Start / End Page

349 / 364.e1

Related Subject Headings

  • Wound Healing
  • United States
  • Metaplasia
  • Humans
  • Gastroenterology & Hepatology
  • Gastric Mucosa
  • Esophagogastric Junction
  • Esophageal Neoplasms
  • Esophageal Mucosa
  • Epithelial Cells