Advances in understanding the pathogenesis of Barrett's esophagus.
Advances in understanding the pathogenesis of Barrett's esophagus.
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DOI：
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发表时间：
2014
影响因子：
1.4
通讯作者：
N. Clemons;Shze Yung Koh;W. Phillips
中科院分区：
文献类型：
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作者：
N. Clemons;Shze Yung Koh;W. Phillips
Barrett食管（BE）是一种类似膀胱的柱状上皮化生，它取代了食管远端的正常复层鳞状上皮。在临床上，BE是一个重要的实体，因为它是食管腺癌（EAC）的唯一确定的前体，EAC是一种预后极差的疾病，其发病率比全球任何其他实体癌都上升得更快。因此，由于EAC负担的增加，已经有许多研究旨在了解BE的发展，以便开发对抗这种疾病的新方法。BE是慢性反流的结果。虽然反流在推动BE发展中的核心作用已经得到很好的确立，但伴随这一过程的细胞和分子机制仍有待充分阐明。在基础层面上理解驱动因素对于合理设计旨在预防BE进展甚至逆转BE的新型治疗策略至关重要。在这篇文章中，我们回顾了一些最新的进展，有助于我们了解BE的发病机制，包括新的发现可能的细胞起源的化生上皮，和形态发生素和转录因子，puronectin驱动转换的鳞状上皮细胞的膀胱样柱状上皮。
Barrett's esophagus (BE) is an intestinal-like columnar metaplasia that replaces the normal stratified squamous epithelium in the distal esophagus. Clinically, BE is an important entity as it is the only established precursor to esophageal adenocarcinoma (EAC), a disease with an extremely poor prognosis and an incidence that is rising faster than any other solid cancer worldwide. Therefore, because of the increasing burden of EAC, there has been much research aimed at understanding the development of BE, in order to develop new ways to combat this disease. BE arises as a consequence of chronic reflux. Whilst the central role of reflux in driving the development of BE has been well established, the cellular and molecular mechanisms that accompany this process remain to be fully elucidated. Understanding the drivers at a fundamental level is crucial for the rational design of novel therapeutic strategies aimed at preventing the progression of, or even reversing, BE. In this article we review some of the recent advances that have contributed to our understanding of BE pathogenesis, including new findings on the possible cellular origins of the metaplastic epithelium, and the morphogens and transcription factors that putatively drive the conversion of the squamous epithelium to an intestinal-like columnar epithelium.