Alterations to the Esophageal Microbiome Associated with Progression from Barrett's Esophagus to Esophageal Adenocarcinoma
Alterations to the Esophageal Microbiome Associated with Progression from Barrett's Esophagus to Esophageal Adenocarcinoma
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DOI：
10.1158/1055-9965.epi-19-0008
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发表时间：
2019-10-01
影响因子：
3.8
通讯作者：
Abrams, Julian A.
中科院分区：
文献类型：
--
作者：
Snider, Erik J.;Compres, Griselda;Abrams, Julian A.
背景资料：食管腺癌的发病率在过去的半个世纪中急剧上升，其根本原因尚不完全清楚。上消化道微生物组的广泛转移可能是部分原因。本研究的目的是描述从Barrett食管进展到食管adenocarcino.Methods发生的食管微生物组的改变：对有和没有Barrett食管的患者进行病例对照研究，这些患者计划接受上消化道内窥镜检查。收集人口统计学、临床和饮食摄入数据，并在内镜检查期间收集食管刷检。结果：共45名患者入选并纳入分析[16名对照; 14名Barrett食管无异型增生（NDBE）; 6名低度异型增生（LGD）; 5名高度异型增生（HGD）;和4名食管腺癌]。非Barrett食管和Barrett食管之间的α多样性没有差异，但有证据表明，根据Simpson指数评估，食管腺癌患者的多样性降低。在从LGD到HGD的过渡期，组成发生了明显的变化，HGD和食管腺癌患者的厚壁菌门减少，变形菌门增加。此外，HGD或食管腺癌患者的肠杆菌科和嗜粘蛋白阿克曼氏菌增加，韦荣氏菌减少。在研究人群中，服用质子泵抑制剂的患者链球菌增加，革兰氏阴性菌总体减少。结论：在HGD和食管腺癌患者中观察到Barrett食管相关微生物组的变化，某些潜在致病菌增加。影响：微生物组可能在食管癌发生中发挥作用。
Background: The incidence of esophageal adenocarcinoma has risen dramatically over the past half century, and the underlying reasons are incompletely understood. Broad shifts to the upper gastrointestinal microbiome may be partly responsible. The goal of this study was to describe alterations in the esophageal microbiome that occur with progression from Barrett's esophagus to esophageal adenocarcinoma.Methods: A case-control study was performed of patients with and without Barrett's esophagus who were scheduled to undergo upper endoscopy. Demographic, clinical, and dietary intake data were collected, and esophageal brushings were collected during the endoscopy. 16S rRNA gene sequencing was performed to characterize the microbiome.Results: A total of 45 patients were enrolled and included in the analyses [16 controls; 14 Barrett's esophagus without dysplasia (NDBE); 6 low-grade dysplasia (LGD); 5 high-grade dysplasia ( HGD); and 4 esophageal adenocarcinoma]. There was no difference in alpha diversity between non-Barrett's esophagus and Barrett's esophagus, but there was evidence of decreased diversity in patients with esophageal adenocarcinoma as assessed by Simpson index. There was an apparent shift in composition at the transition from LGD to HGD, and patients with HGD and esophageal adenocarcinoma had decreased Firmicutes and increased Proteobacteria. In addition, patients with HGD or esophageal adenocarcinoma had increased Enterobacteriaceae and Akkermansia muciniphila and reduced Veillonella. In the study population, patients taking proton pump inhibitors had increased Streptococcus and decreased Gram-negative bacteria overall.Conclusions: Shifts in the Barrett's esophagus-associated microbiomewere observed in patients withHGDand esophageal adenocarcinoma, with increases in certain potentially pathogenic bacteria.Impact: The microbiome may play a role in esophageal carcinogenesis.