Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jul 1;116(7):1537-1541.
doi: 10.14309/ajg.0000000000001196.

Effects of Central Obesity on Esophageal Epithelial Barrier Function

Ying Y Gibbens  1 , Ramona Lansing  2 , Michele L Johnson  2 , Christopher H Blevins  3 , David A Katzka  2 , Prasad G Iyer  2
Affiliations

Effects of Central Obesity on Esophageal Epithelial Barrier Function

Ying Y Gibbens et al. Am J Gastroenterol. .

Abstract

Introduction: We assessed if obesity perturbs the esophageal epithelial barrier function independent of promotion of gastroesophageal reflux (GER).

Methods: Thirty-eight participants were divided into 4 groups: Obesity-/GER-, Obesity+/GER-, Obesity-/GER+, and Obesity+/GER+. Esophageal intercellular space and desmosome density (structural integrity) and fluorescein leak (functional integrity) were measured.

Results: The Obesity+/GER- group demonstrated increased intercellular space, reduced desmosome density, and increased fluorescein leak compared with control subjects. These changes were similar but not additive to findings seen in Obesity-/GER + and Obesity+/GER+ patients.

Discussion: Central obesity impairs structural and functional integrity of the esophageal barrier independent of GER, likely predisposing to esophageal injury.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Central obesity is associated with ICS dilation, decreased desmosome density and increased permeability in the esophageal epithelium. (A). TEM images of esophageal epithelium at 5cm above the GEJ (magnification 10K). Purple arrows indicate dilated ICS. Red arrows indicate regions of ICS devoid of desmosomes. (B). The ICS in the Obesity+/GER- group is statistically increased as compared to the Obesity-/GER- control subjects. Obesity-/GER+ and Obesity+/GER+ groups also exhibit statistically significant ICS dilation. (C). Desmosomes are evenly distributed in Obesity-/GER- group (yellow arrow) but more sparsely found in the Obesity+/GER-, Obesity-/GER+ and Obesity+/GER+ groups (red arrows). (D). The desmosome density (as expressed as number of desmosomes per μm of membrane) is significantly reduced in the Obesity+/GER-, Obesity-/GER+ and Obesity+/GER+ groups. (E). Images captured from the confocal microscopy video of esophageal epithelium at 5cm above GEJ. The fluorescein leak intensity at the intercellular space appears to be higher in. (F). Quantitative analysis shows that fluorescein leak intensity in the Obesity+/GER-, Obesity-/GER+ and Obesity+/GER+ groups (which is normalized to that of Obesity-/GER- group) is significantly elevated.
Figure 2.
Figure 2.
Desmosome density and increase membrane permeability are strongly associated with ICS dilation. (A). Linear regression analysis demonstrated a significant association between reduced desmosome density and the ICS dilation. (B). Linear regression analysis showed a significant association between the fluorescein leak intensity and the ICS dilation.
See this image and copyright information in PMC

References

    1. Savarino E V, de Bortoli N, de Cassan C, et al. The natural history of gastro-esophageal reflux disease: A comprehensive review. Dis Esophagus. 2017;30(2). doi:10.1111/dote.12511 - DOI - PubMed
    1. Caviglia R, Ribolsi M, Maggiano N, et al. Dilated intercellular spaces of esophageal epithelium in nonerosive reflux disease patients with physiological esophageal acid exposure. Am J Gastroenterol. 2005;100(3):543–548. doi:10.1111/j.1572-0241.2005.40978.x - DOI - PubMed
    1. Dent J Microscopic Esophageal Mucosal Injury in Nonerosive Reflux Disease. Clin Gastroenterol Hepatol. 2007;5(1). doi:10.1016/j.cgh.2006.08.006 - DOI - PubMed
    1. Vela MF, Craft BM, Sharma N, Freeman J, Hazen-Martin D. Refractory heartburn: Comparison of intercellular space diameter in documented GERD vs. Functional heartburn. Am J Gastroenterol. 2011;106(5):844–850. doi:10.1038/ajg.2010.476 - DOI - PubMed
    1. Caviglia R, Ribolsi M, Gentile M, et al. Dilated intercellular spaces and acid reflux at the distal and proximal oesophagus in patients with non-erosive gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2007;25(5):629–636. doi:10.1111/j.1365-2036.2006.03237.x - DOI - PubMed

Publication types