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The Cellular Origin of Barrett’s Esophagus and Its Stem Cells

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Stem Cells Heterogeneity - Novel Concepts

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 1123))

Abstract

The incidence of esophageal adenocarcinoma is rapidly increasing in Western countries. This is despite the introduction of sophisticated endoscopic techniques and our ability to readily monitor the presumed precursor lesion known as Barrett’s esophagus. Preemptive approaches, including radiofrequency ablation (RFA), and photodynamic therapy (PDT) for Barrett’s esophagus and dysplasia are achieving dramatic initial results. Although the long-term efficacy of these nonspecific ablative therapies is awaiting longitudinal studies, reports of recurrences are increasing. More targeted therapies, particularly directed at the stem cells of Barrett’s esophagus, demand knowing the origin of this intestinal metaplasia (IM). The prevailing concept holds that Barrett’s esophagus arises from the “transcommitment” of esophageal stem cells to produce an intestine-like epithelium. An alternative explanation derives from the discovery of a discrete population of residual embryonic cells (RECs) existing at the gastroesophageal junction in normal individuals that expands and colonizes regions of the esophagus denuded by chronic reflux. These RECs form IM within days of esophageal injury, suggesting a novel mechanism of tumorigenesis.

A corollary of this work is that the Barrett’s stem cell is distinct from that of the squamous epithelium and, once identified, will form the basis of new preemptive strategies for addressing Barrett’s and its related neoplasia.

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Author information

Authors and Affiliations

  1. McGovern Medical School, University of Texas Health Science Center in Houston, Houston, TX, USA

    Wa Xian

  2. Department of Biology and Biochemistry, University of Houston, Houston, TX, USA

    Marcin Duleba, Yanting Zhang & Frank McKeon

  3. Division of Molecular and Cellular Medicine, National Cancer Center Research Institute, Tokyo, Japan

    Yusuke Yamamoto

  4. Department of Medicine, National University of Singapore, Singapore, Singapore

    Khek Yu Ho

  5. Department of Pathology, Brigham and Women’s Hospital, Boston, MA, USA

    Christopher Crum

Authors
  1. Wa Xian
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  2. Marcin Duleba
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  3. Yanting Zhang
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  4. Yusuke Yamamoto
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  5. Khek Yu Ho
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  6. Christopher Crum
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  7. Frank McKeon
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Correspondence to Wa Xian .

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Editors and Affiliations

  1. Department of Radiology, Columbia University Medical Center, New York, NY, USA

    Alexander Birbrair

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Xian, W. et al. (2019). The Cellular Origin of Barrett’s Esophagus and Its Stem Cells. In: Birbrair, A. (eds) Stem Cells Heterogeneity - Novel Concepts. Advances in Experimental Medicine and Biology, vol 1123. Springer, Cham. https://doi.org/10.1007/978-3-030-11096-3_5

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