Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Bile – not Acid – is Bad Guy in Triggering Precancerous Condition Associated with Reflux Disease

25.04.2012
For many people with gastroesophageal reflux disease or GERD, acid reflux drugs are the answer to their woes, curbing the chronic heartburn and regurgitation of food or sour liquid characteristic of the disorder.

But when it comes to Barrett’s esophagus, a condition commonly found in people with GERD, acid control may be less important than beating back another bodily fluid – bile.

A new study published in the Annals of Surgery shows that bile – a digestive fluid that leaks backwards from the stomach into the esophagus along with acid in patients with GERD – plays a critical and previously unrecognized role in the development of Barrett’s esophagus. Study authors say the findings provide new avenues for the prevention and treatment of the condition, which is the only known cause of a rare but often deadly type of cancer called esophageal adenocarcinoma.

“Our ultimate goal is to understand the biology of Barrett’s so that we may find drugs that inhibit or reverse the condition, thus preventing cancer,” said lead study author Jeffrey H. Peters, M.D., an internationally recognized expert in surgery of the esophagus and stomach and the Seymour I. Schwartz Professor and Chair of the Department of Surgery at the University of Rochester Medical Center. “The finding that bile is important is key because current drug therapies for GERD focus largely on acid control.”

Acid-reducing drugs called proton pump inhibitors or PPIs are some of the most popular and best-selling drugs in America according to IMS Health, an organization that tracks pharmacy data. While the drugs do a great job of masking GERD symptoms by neutralizing stomach acid, Peters’ research suggests they may not be the answer when it comes to blocking Barrett’s esophagus. Other research even indicates that such drugs may actually make patients more prone to developing Barrett’s.

Normally, our esophagus – the muscular tube connecting the mouth to the stomach – is lined with skin-like tissue. But, in people with Barrett’s, it’s replaced by tissue that more closely resembles the lining of our intestine, which is smooth and red. Peters’ team found that bile that washes up from the stomach into the esophagus shuts off genes responsible for the normal, skin-like lining of the organ, and turns on genes that produce the intestine-like lining that is the hallmark of Barrett’s.

They discovered that acid, on the other hand, didn’t largely influence the change from one cell type to another.

While previous research established that reflux components encouraged the development of intestinal tissue in the esophagus that alone was never enough to produce the changes that led to Barrett’s.

“The main leap this study makes is that normal esophageal cell growth must be turned off and intestinal cell growth must be turned on in order for the disease to take hold,” noted Peters, who is president elect of the International Society of Diseases of the Esophagus. “We found that bile promotes both processes.”

Study author Tony E. Godfrey, Ph.D., says the findings make perfectly good sense. “In people with Barrett’s, the inside of the esophagus looks like the inside of the intestine. Bile is normally found in the intestinal environment, so when stem cells in the esophagus are exposed to bile that is what they change to.”

According to Godfrey, a research associate professor in the Department of Surgery, the lining of the esophagus is shed and replaced on a regular basis, so blocking bile’s ability to thwart the production of normal esophageal cells may be one potential treatment strategy. Currently, the only way to stop all reflux components, including bile, is to surgically reconstruct the faulty barrier between the esophagus and the stomach.

The team performed the first-ever analysis of all genes that are turned on and off in normal esophageal cells exposed chronically to bile or acid. The findings were tested and confirmed in human samples of normal esophageal cells and in cells from patients with Barrett’s esophagus.

The research is especially exciting for Peters, who regularly treats patients with Barrett’s as well as patients who develop esophageal adenocarcinoma. Though uncommon, Peters says it’s one of the fastest-rising cancers in the world, likely due to the increase in obesity, which triggers reflux disease and Barrett’s. Unfortunately, it is an extremely aggressive cancer that is usually caught at a very late stage, so prevention strategies are greatly needed.

The Department of Surgery at the Medical Center funded the study. In addition to Peters – who serves as the associate editor of the Annals of Surgery – and Godfrey, Marie Reveiller, Ph.D., Sayak Ghatak, Liana Toia, Mary D’Souza, Ph.D., Zhongren Zhou, M.D., Ph.D., and Santhoshi Bandla, Ph.D., from the University of Rochester contributed to the research. Scientists from the Ontario Institute for Cancer Research in Toronto and the Pittsburgh Cancer Institute at the University of Pittsburgh also participated in the study.

For Media Inquiries:
Emily Boynton
585-273-1757
Email Emily Boynton

Emily Boynton | EurekAlert!
Further information:
http://www.urmc.rochester.edu

More articles from Health and Medicine:

nachricht Millions through license revenues
27.04.2017 | Rheinische Friedrich-Wilhelms-Universität Bonn

nachricht New High-Performance Center Translational Medical Engineering
26.04.2017 | Fraunhofer ITEM

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Making lightweight construction suitable for series production

More and more automobile companies are focusing on body parts made of carbon fiber reinforced plastics (CFRP). However, manufacturing and repair costs must be further reduced in order to make CFRP more economical in use. Together with the Volkswagen AG and five other partners in the project HolQueSt 3D, the Laser Zentrum Hannover e.V. (LZH) has developed laser processes for the automatic trimming, drilling and repair of three-dimensional components.

Automated manufacturing processes are the basis for ultimately establishing the series production of CFRP components. In the project HolQueSt 3D, the LZH has...

Im Focus: Wonder material? Novel nanotube structure strengthens thin films for flexible electronics

Reflecting the structure of composites found in nature and the ancient world, researchers at the University of Illinois at Urbana-Champaign have synthesized thin carbon nanotube (CNT) textiles that exhibit both high electrical conductivity and a level of toughness that is about fifty times higher than copper films, currently used in electronics.

"The structural robustness of thin metal films has significant importance for the reliable operation of smart skin and flexible electronics including...

Im Focus: Deep inside Galaxy M87

The nearby, giant radio galaxy M87 hosts a supermassive black hole (BH) and is well-known for its bright jet dominating the spectrum over ten orders of magnitude in frequency. Due to its proximity, jet prominence, and the large black hole mass, M87 is the best laboratory for investigating the formation, acceleration, and collimation of relativistic jets. A research team led by Silke Britzen from the Max Planck Institute for Radio Astronomy in Bonn, Germany, has found strong indication for turbulent processes connecting the accretion disk and the jet of that galaxy providing insights into the longstanding problem of the origin of astrophysical jets.

Supermassive black holes form some of the most enigmatic phenomena in astrophysics. Their enormous energy output is supposed to be generated by the...

Im Focus: A Quantum Low Pass for Photons

Physicists in Garching observe novel quantum effect that limits the number of emitted photons.

The probability to find a certain number of photons inside a laser pulse usually corresponds to a classical distribution of independent events, the so-called...

Im Focus: Microprocessors based on a layer of just three atoms

Microprocessors based on atomically thin materials hold the promise of the evolution of traditional processors as well as new applications in the field of flexible electronics. Now, a TU Wien research team led by Thomas Müller has made a breakthrough in this field as part of an ongoing research project.

Two-dimensional materials, or 2D materials for short, are extremely versatile, although – or often more precisely because – they are made up of just one or a...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Fighting drug resistant tuberculosis – InfectoGnostics meets MYCO-NET² partners in Peru

28.04.2017 | Event News

Expert meeting “Health Business Connect” will connect international medical technology companies

20.04.2017 | Event News

Wenn der Computer das Gehirn austrickst

18.04.2017 | Event News

 
Latest News

Wireless power can drive tiny electronic devices in the GI tract

28.04.2017 | Medical Engineering

Ice cave in Transylvania yields window into region's past

28.04.2017 | Earth Sciences

Nose2Brain – Better Therapy for Multiple Sclerosis

28.04.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>