Barrett's esophagus: environmental influences in the progression of dysplasia.
Barrett's esophagus (BE) is composed of multiple lineages including Paneth cells and endocrine cells in addition to gastric and intestinal cells. Although the origin of the BE stem cell is a matter of conjecture, the stem cells are clearly multipotent, and therefore the phenotype is restricted by genomic imprinting (termed restricted potency). Recent evidence suggests that the microenvironment may select various lineages. In this regard the proportion of gastric and specialized intestinal metaplastic cells has been attributed to the composition of the refluxate, acid or bile, respectively. Experimental evidence also implicates specific xenobiotics in this process, including bile acids. In particular we discuss the potential biologic roles of bile acids in epithelial adaptation from in vivo and in vitro models.
Boulton
Ralph A
RA
Leicester Medical School at University Hospitals Leicester Trust, Leicester Royal Infirmary, Level 4, Windsor Building, Leicester LE1 5WW, UK.
Usselmann
Bernhard
B
Mohammed
Imtiyaz
I
Jankowski
Janusz
J
D000222:Adaptation, Physiological / Q000502:physiology; D001471:Barrett Esophagus / Q000150:complications / Q000473:pathology*; D001647:Bile Acids and Salts / Q000502:physiology; D004847:Epithelial Cells / Q000502:physiology; D004938:Esophageal Neoplasms / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D004947:Esophagus / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008679:Metaplasia / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D011230:Precancerous Conditions / Q000150:complications / Q000473:pathology*
D001647:Bile Acids and Salts