Obesity and its effects on the esophageal mucosal barrier

Shere Paris, Rebecca Ekeanyanwu, Yuwei Jiang, Daniel Davis, Stuart Jon Spechler, Rhonda F. Souza

Research output: Contribution to journalReview articlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)G335-G343
JournalAmerican Journal of Physiology - Gastrointestinal and Liver Physiology
Volume321
Issue number3
DOIs
StatePublished - 2021

Keywords

  • Barrier function
  • Esophagus
  • Obesity

ASJC Scopus subject areas

  • Physiology
  • Hepatology
  • Gastroenterology
  • Physiology (medical)

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