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Review
. 2021 Aug 26;12(9):e00390.
doi: 10.14309/ctg.0000000000000390.

Insights Into the Oral Microbiome and Barrett's Esophagus Early Detection: A Narrative Review

Zhenzhen Zhang  1 , Grace Curran  2 , Duygu Altinok Dindar  2 , Ying Wu  3 , Hui Wu  3 , Thomas Sharpton  4   5 , Lianmei Zhao  6 , David Lieberman  7 , Fouad Otaki  7
Affiliations
Review

Insights Into the Oral Microbiome and Barrett's Esophagus Early Detection: A Narrative Review

Zhenzhen Zhang et al. Clin Transl Gastroenterol. .

Abstract

Barrett's esophagus (BE) prevalence has increased steadily over the past several decades and continues to be the only known precursor of esophageal adenocarcinoma. The exact cause of BE is still unknown. Most evidence has linked BE to gastroesophageal reflux disease, which injures squamous esophageal mucosa and can result in the development of columnar epithelium with intestinal metaplasia. However, this relationship is inconsistent-not all patients with severe gastroesophageal reflux disease develop BE. There is increasing evidence that the host microbiome spanning the oral and esophageal environments differs in patients with and without BE. Several studies have documented the oral and esophageal microbiome's composition for BE with inconsistent findings. The scarcity and inconsistency of the literature and the dynamic phenomena of microbiota all warrant further studies to validate the findings and dissect the effects of oral microbiota, which are considered a viable proxy to represent esophageal microbiota by many researchers. This review aims to summarize the variability of the oral and esophageal microbiome in BE by using the example of Streptococcus to discuss the limitations of the current studies and suggest future directions. Further characterization of the sensitivity and specificity of the oral microbiome as a potential risk prediction or prevention marker of BE is critical, which will help develop noninvasive early detection methods for BE, esophageal adenocarcinoma, and other esophageal diseases.

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Conflict of interest statement

Guarantor of the Article: Zhenzhen Zhang, PhD.

Specific author contributors: G.C. prepared the first draft of the manuscript, interpretation, and further edits. Z.Z. provided conception, review, interpretation and obtained funding. Z.Z. and G.C. performed independent data extraction and synthesis, and created the figures and tables. All authors provided critical revision of the manuscript. Y.W., H.W., T.S., L.Z., D.L., and F.O. provided writing input.

Financial support: National Institute of Health (NIH) Office of Research on Women's Health and the National Institute of Child Health and Human Development K12HD043488 (Building Interdisciplinary Research Careers in Women's Health, BIRCWH) (Z.Z.), and the Oregon Health & Science University Cancer Early Detection Advanced Research (CEDAR) center (Z.Z.).

Potential competing interests: None to report.

Figures

Figure 1.
Figure 1.
Key roles for oral microbiome/metabolites in the initiation and progression of Barrett's esophagus. The figure was created with BioRender.com.
See this image and copyright information in PMC

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