[Pathogenesis of Barrett's esophagus--new findings in the experimental studies of duodenal reflux models]

Nihon Rinsho. 2005 Aug;63(8):1341-9.
[Article in Japanese]

Abstract

Duodeno-gastro-esophageal reflux has been thought to induce Barrett's esophagus. Recently, we designed a new duodenal reflux model using rats, and studied sequential morphological changes of esophageal mucosa leading to Barrett's esophagus. A specialized columnar epithelium (SCE) developed 20 weeks after operation. Barrett's epithelium originated from pyloric-foveolar metaplasia of stem cells in the basal layer of the esophageal squamous epithelium. The pyloric-foveolar metaplasia was then followed by the appearance of goblet cells, becoming a typical SCE. The expression of homeobox gene Cdx2 was seen in this process, thereby suggesting a role of Cdx2 in intestinal differentiation of Barrett's esophagus. We noticed the pyloric-foveolar metaplasia followed by the appearance of goblet cells is common to entire gut in regenerative process, and proposed a concept of GRCL (gut regenerative cell lineage), and an implication of GRCL in digestive tract carcinogenesis was discussed.

Publication types

  • Review

MeSH terms

  • Animals
  • Barrett Esophagus / etiology*
  • Barrett Esophagus / genetics
  • Barrett Esophagus / pathology
  • CDX2 Transcription Factor
  • Disease Models, Animal
  • Duodenogastric Reflux / complications*
  • Esophagus / cytology
  • Esophagus / pathology
  • Gene Expression
  • Goblet Cells / pathology
  • Homeodomain Proteins / metabolism
  • Humans
  • Intestinal Mucosa / cytology
  • Intestinal Mucosa / pathology
  • Metaplasia / genetics
  • Mucous Membrane / cytology
  • Mucous Membrane / pathology
  • Rats
  • Regeneration / physiology
  • Transcription Factors / metabolism

Substances

  • CDX2 Transcription Factor
  • Cdx2 protein, mouse
  • Homeodomain Proteins
  • Transcription Factors