How Good Is the Neosquamous Epithelium?

Orlando, Roy C.

doi:10.1159/000357185

Cited by 14 publications

(10 citation statements)

References 69 publications

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“…Dye-and molecule-based transfer measurements may also be made to assess the ability of molecules, such as fluorescein, to traverse the barrier as a measure of transmembrane flux. 40,41 This technique, however, is technically challenging with several technical minutiae to be considered for a successful study.…”

Section: Assessing the Epithelial Barrier Functionmentioning

confidence: 99%

The Esophageal Epithelial Barrier in Health and Disease

Blevins

Iyer

Vela

et al. 2018

Clinical Gastroenterology and Hepatology

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Dysfunction in the esophageal epithelial barrier function is a major source for morbidity. To better understand the pathophysiologic pathways of the diseases associated with barrier dysfunction, including gastroesophageal reflux disease, eosinophilic esophagitis, Barrett's esophagus, and obesity, it is important to understand the esophageal epithelial embryologic development, microscopic anatomy with a special focus on the barrier structure and function, extraepithelial defense mechanisms, and how these change in the diseased state. In recent years, significant progress has been made in elucidating the esophageal barrier structure and function both in vitro and in vivo. This has enhanced the understanding of mechanisms of disease, and may also allow identification of therapeutic targets that can help in the management of these diseases. This review provides a detailed discussion regarding the esophageal epithelial barrier structure and function, the current and historical techniques used to study the barrier, and how it is affected by common esophageal diseases.

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Section: Assessing the Epithelial Barrier Functionmentioning

confidence: 99%

The Esophageal Epithelial Barrier in Health and Disease

Blevins

Iyer

Vela

et al. 2018

Clinical Gastroenterology and Hepatology

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“…Although it is not covered in detail in this review of genetics and genomics in BE and EA, it is worth mentioning that recent research by a number of investigators has shown BE intestinal metaplasia has a number of properties that appear to be selective protective adaptations to the harsh, genotoxic environment in which BE arises 2, 132 . Some of these adaptations, such as crypt architecture have long been thought to have evolved as a mechanism to prevent cancer by decreasing clonal expansions of mutations 133 .…”

Section: Genomic Evolution Of Ea and Bementioning

confidence: 99%

Genetic Insights in Barrett’s Esophagus and Esophageal Adenocarcinoma

Reid

Paulson

2015

Gastroenterology

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Beginning in the 1980s, an alarming rise in the incidence of esophageal adenocarcinoma (EA) led to screening of patients with reflux to detect Barrett’s esophagus (BE) and surveillance of BE to detect early EA. This strategy, based on linear progression disease models, resulted in selective detection of BE that does not progress to EA over a lifetime (overdiagnosis) and missed BE that rapidly progresses to EA (underdiagnosis). Here we review the historical thought processes that resulted in this undesired outcome and the transformation in our understanding of genetic and evolutionary principles governing neoplastic progression that has come from application of modern genomic technologies to cancers and their precursors. This new synthesis provides improved strategies for prevention and early detection of EA by addressing the environmental and mutational processes that can determine “windows of opportunity” in time to detect rapidly progressing BE and distinguish it from slowly or non-progressing BE.

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“…Actually, fewer DNA content abnormalities and lower crypt proliferation rates have been observed in buried metaplasia than in the surface metaplastic epithelium [17]. However, according to Orlando, the neosquamous epithelium has a defective barrier function that is more permeable and leaky than normal squamous esophageal epithelium [18]. Besides the question of “risk” is the question of “origin”.…”

Section: Discussionmentioning

confidence: 99%

Buried Barrett’s Esophagus with High-Grade Dysplasia after Radiofrequency Ablation

Castela¹,

Serrano²,

Ferro³

et al. 2019

Clin Endosc

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Radiofrequency ablation therapy is an effective endoscopic option for the eradication of Barrett’s esophagus that appears to reduce the risk of esophageal cancer. A concern associated with this technique is the development of subsquamous/buried intestinal metaplasia, whose clinical relevance and malignant potential have not yet been fully elucidated. Fewer than 20 cases of subsquamous neoplasia after the successful radiofrequency ablation of Barrett’s esophagus have been reported to date. Here, we describe a new case of subsquamous neoplasia (high-grade dysplasia) following radiofrequency ablation that was managed with endoscopic resection. Our experience suggests that a meticulous endoscopic inspection prior to and after radiofrequency ablation is fundamental to reduce the risk of buried neoplasia development.

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How Good Is the Neosquamous Epithelium?

Cited by 14 publications

References 69 publications

The Esophageal Epithelial Barrier in Health and Disease

The Esophageal Epithelial Barrier in Health and Disease

Genetic Insights in Barrett’s Esophagus and Esophageal Adenocarcinoma

Buried Barrett’s Esophagus with High-Grade Dysplasia after Radiofrequency Ablation

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