An oolong?

• The disease was long thought to be the result of cells in the esophagus turning into cells of the gut, but researchers have discovered that the disease is actually caused by cells in the stomach that have the properties and appearance of the gut

• The disease is a risk factor for esophageal cancer, and the findings may lead to new treatments for the disease

For most cells in the body, identity is indisputable: bladder cells cannot mimic blood cells, and liver cells are still liver cells

A rare exception is considered Barrett's esophagus, in which the lining of the esophagus resembles that of the small intestine

Two recent studies by scientists at Dana-Farber Cancer Institute correct a longstanding misconception about the origins of Barrett's esophagus, which could lead to new treatments or treatments for reducing the risk of esophageal cancer.

"Barrett's esophagus is caused by long-standing gastrointestinal reflux disease (GERD), in which stomach acid is continuously refluxed into the esophagus," said Ramesh Shivdasani, senior author of both papers

These changes are easy to see under the microscope

In this Gastroenterology paper, Shivdasani and his colleagues studied these gut-like cells at the molecular level

Shivdasani and colleagues examined chromatin organization in biopsy samples of human Barrett's esophagus

The finding also leaves considerable ambiguity: Is the tissue made up of stomach and intestinal cells, or part stomach and part intestinal cells?

The answer came when technological advances enabled researchers to probe chromatin organization in individual cells

This finding suggests that Barrett's esophagus, after all, did not violate the adage against the complete conversion of one cell type to another

The paper "Genes and Development" takes an important step towards solving this conundrum

Singh, the first author of both studies, went on to show that CDX2 turns on about a quarter of gut-related genes

These findings allowed the researchers to construct a hypothesis about what happens at the cellular and molecular levels as Barrett's esophagus develops

He went on to say that this research may eventually lead to treatments to prevent or alleviate Barrett's esophagus

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Magazine

Genes & Development

DOI

10.