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Microbiome of the Aerodigestive Tract in Health and Esophageal Disease

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Abstract

The diverse human gut microbiome is comprised of approximately 40 trillion microorganisms representing up to 1000 different bacterial species. The human microbiome plays a critical role in gut epithelial health and disease susceptibility. While the interaction between gut microbiome and gastrointestinal pathology is increasingly understood, less is known about the interaction between the microbiome and the aerodigestive tract. This review of the microbiome of the aerodigestive tract in health, and alterations in microbiome across esophageal pathologies highlights important findings and areas for future research. First, microbiome profiles are distinct along the aerodigestive tract, spanning the oral cavity to the stomach. In patients with reflux-related disease such as gastro-esophageal reflux disease, Barrett’s esophagus, and esophageal adenocarcinoma, investigators have observed an overall increase in gram negative bacteria in the esophageal microbiome compared to healthy individuals. However, whether differences in microbiome promote disease development, or if these shifts are a consequence of disease remains unknown. Interestingly, use of proton pump inhibitor therapy is also associated with shifts in the microbiome, with distinct shifts and patterns along the aerodigestive tract. The relationship between the human gut microbiome and esophageal pathology is a ripe area for investigation, and further understanding of these pathways may promote development of novel targets in prevention and therapy for esophageal diseases.

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Abbreviations

BE:

Barret esophagus

EAC:

Esophageal adenocarcimoma

GERD:

Gastroesophageal reflux disease

PPI:

Proton pump inhibitor

EOE:

Eosinophilic esophagitis

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Funding

This review was supported by SDDRC (NIH DK120515).

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Authors and Affiliations

  1. Division of Gastroenterology, UCSD Center for Esophageal Diseases, University of California, San Diego School of Medicine, 9500 Gilman Drive MC 0956, La Jolla, CA, 92093, USA

    Aws Hasan, Bernd Schnabl, Madeline Greytak & Rena Yadlapati

  2. Tulane University School of Medicine, New Orleans, LA, USA

    Laith K. Hasan

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  2. Laith K. Hasan
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Contributions

AH: Investigation, Drafting and revision of manuscript, Project Administration, Final approval; LH: Investigation, Drafting and revision of manuscript, Final approval; BS: Investigation, Revision of manuscript, Final approval; MG: Investigation, Revision of manuscript, Final approval; RY: Investigation, Revision of manuscript, Supervision, Final approval

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Correspondence to Rena Yadlapati.

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Conflict of interest

BS has been consulting for Ferring Research Institute, HOST Therabiomics, Intercept Pharmaceuticals, Mabwell Therapeutics and Patara Pharmaceuticals. BS’s institution UC San Diego has received research support from Axial Biotherapeutics, BiomX, CymaBay Therapeutics, NGM Biopharmaceuticals, and Synlogic Operating Company. RY: Consultant: Medtronic, Ironwood Pharmaceuticals, Diversatek; Research support: Ironwood Pharmaceuticals; Advisory Board: Phathom Pharmaceuticals. AH, LH, MG: None.

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Hasan, A., Hasan, L.K., Schnabl, B. et al. Microbiome of the Aerodigestive Tract in Health and Esophageal Disease. Dig Dis Sci 66, 12–18 (2021). https://doi.org/10.1007/s10620-020-06720-6

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  • DOI: https://doi.org/10.1007/s10620-020-06720-6

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