TY - JOUR
T1 - Obesity and its effects on the esophageal mucosal barrier
AU - Paris, Shere
AU - Ekeanyanwu, Rebecca
AU - Jiang, Yuwei
AU - Davis, Daniel
AU - Spechler, Stuart Jon
AU - Souza, Rhonda F.
N1 - Funding Information:
This work was supported by the Baylor Scott & White Research Institute.
Publisher Copyright:
Copyright © 2021 the American Physiological Society.
PY - 2021
Y1 - 2021
N2 - Obesity is associated with gastroesophageal reflux disease (GERD) and its complications including reflux esophagitis, Barrett’s esophagus, and esophageal adenocarcinoma. Traditionally, these associations have been attributed to the mechanical effect of abdominal fat in increasing intra-abdominal pressure, thereby promoting gastroesophageal reflux and causing disruption of anti-reflux mechanisms at the esophagogastric junction. However, recent studies suggest that visceral adipose tissue (VAT) produces numerous cytokines that can cause esophageal inflammation and impair esophageal mucosal barrier integrity through reflux-independent mechanisms that render the esophageal mucosa especially susceptible to GERD-induced injury. In this report, we review mechanisms of esophageal mucosal defense, the genesis and remodeling of visceral adipose tissue during obesity, and the potential role of substances produced by VAT, especially the VAT that encircles the esophagogastric junction, in the impairment of esophageal mucosal barrier integrity that leads to the development of GERD complications.
AB - Obesity is associated with gastroesophageal reflux disease (GERD) and its complications including reflux esophagitis, Barrett’s esophagus, and esophageal adenocarcinoma. Traditionally, these associations have been attributed to the mechanical effect of abdominal fat in increasing intra-abdominal pressure, thereby promoting gastroesophageal reflux and causing disruption of anti-reflux mechanisms at the esophagogastric junction. However, recent studies suggest that visceral adipose tissue (VAT) produces numerous cytokines that can cause esophageal inflammation and impair esophageal mucosal barrier integrity through reflux-independent mechanisms that render the esophageal mucosa especially susceptible to GERD-induced injury. In this report, we review mechanisms of esophageal mucosal defense, the genesis and remodeling of visceral adipose tissue during obesity, and the potential role of substances produced by VAT, especially the VAT that encircles the esophagogastric junction, in the impairment of esophageal mucosal barrier integrity that leads to the development of GERD complications.
KW - Barrier function
KW - Esophagus
KW - Obesity
UR - http://www.scopus.com/inward/record.url?scp=85115760201&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85115760201&partnerID=8YFLogxK
U2 - 10.1152/AJPGI.00199.2021
DO - 10.1152/AJPGI.00199.2021
M3 - Review article
C2 - 34405732
AN - SCOPUS:85115760201
SN - 0193-1857
VL - 321
SP - G335-G343
JO - American Journal of Physiology - Gastrointestinal and Liver Physiology
JF - American Journal of Physiology - Gastrointestinal and Liver Physiology
IS - 3
ER -