Systematic review: The role of bile acids in the pathogenesis of gastro-oesophageal reflux disease and related neoplasia

K. R. McQuaid, L. Laine, M. B. Fennerty, R. Souza, S. J. Spechler

Research output: Contribution to journalArticle

90 Citations (Scopus)

Abstract

Background Factors other than acid may play a role in gastro-oesophageal reflux disease (GERD) and its complications. Aim To assessed the role of bile acids in the pathogenesis of GERD, Barrett's oesophagus and Barrett's-related neoplasia. Methods We conducted a systematic review of computerised bibliographic databases for original articles involving humans or human oesophageal tissue or cells that assessed exposure to or manipulation of bile acids. Outcomes assessed included GERD symptoms; gross oesophageal injury; Barrett's oesophagus and related neoplasia; and intermediate markers of inflammation, proliferation or neoplasia. Results Eighty-three original articles were included. In in vivo studies, bile acids concentrations were higher in the oesophageal aspirates of patients with GERD than controls, and bile acids infusions triggered GERD symptoms, especially in high concentrations or in combination with acid. In ex vivo/in vitro studies, bile acids stimulated squamous oesophageal cells and Barrett's epithelial cells to produce inflammatory mediators (e.g., IL-8 and COX-2) and caused oxidative stress, DNA damage and apoptosis. They also induced squamous cells to change their gene expression pattern to resemble intestinal-type cells and caused Barrett's cells to increase expression of intestinal-type genes. Conclusions In aggregate, these studies suggest that bile acids may contribute to the pathogenesis of symptoms, oesophagitis and Barrett's metaplasia with related carcinogenesis in patients with GERD. However, all study results are not uniform and substantial differences in study parameters may explain at least some of this variation.

Original languageEnglish (US)
Pages (from-to)146-165
Number of pages20
JournalAlimentary Pharmacology and Therapeutics
Volume34
Issue number2
DOIs
StatePublished - Jul 2011

Fingerprint

Esophageal Diseases
Gastroesophageal Reflux
Bile Acids and Salts
Barrett Esophagus
Neoplasms
Epithelial Cells
Bibliographic Databases
Gene Expression
Acids
Esophagitis
Interleukin-8
DNA Damage
Carcinogenesis
Oxidative Stress
Apoptosis
Inflammation
Wounds and Injuries

ASJC Scopus subject areas

  • Pharmacology (medical)

Cite this

Systematic review : The role of bile acids in the pathogenesis of gastro-oesophageal reflux disease and related neoplasia. / McQuaid, K. R.; Laine, L.; Fennerty, M. B.; Souza, R.; Spechler, S. J.

In: Alimentary Pharmacology and Therapeutics, Vol. 34, No. 2, 07.2011, p. 146-165.

Research output: Contribution to journalArticle

@article{19d95305448c45bda88dc9f54087132d,
title = "Systematic review: The role of bile acids in the pathogenesis of gastro-oesophageal reflux disease and related neoplasia",
abstract = "Background Factors other than acid may play a role in gastro-oesophageal reflux disease (GERD) and its complications. Aim To assessed the role of bile acids in the pathogenesis of GERD, Barrett's oesophagus and Barrett's-related neoplasia. Methods We conducted a systematic review of computerised bibliographic databases for original articles involving humans or human oesophageal tissue or cells that assessed exposure to or manipulation of bile acids. Outcomes assessed included GERD symptoms; gross oesophageal injury; Barrett's oesophagus and related neoplasia; and intermediate markers of inflammation, proliferation or neoplasia. Results Eighty-three original articles were included. In in vivo studies, bile acids concentrations were higher in the oesophageal aspirates of patients with GERD than controls, and bile acids infusions triggered GERD symptoms, especially in high concentrations or in combination with acid. In ex vivo/in vitro studies, bile acids stimulated squamous oesophageal cells and Barrett's epithelial cells to produce inflammatory mediators (e.g., IL-8 and COX-2) and caused oxidative stress, DNA damage and apoptosis. They also induced squamous cells to change their gene expression pattern to resemble intestinal-type cells and caused Barrett's cells to increase expression of intestinal-type genes. Conclusions In aggregate, these studies suggest that bile acids may contribute to the pathogenesis of symptoms, oesophagitis and Barrett's metaplasia with related carcinogenesis in patients with GERD. However, all study results are not uniform and substantial differences in study parameters may explain at least some of this variation.",
author = "McQuaid, {K. R.} and L. Laine and Fennerty, {M. B.} and R. Souza and Spechler, {S. J.}",
year = "2011",
month = "7",
doi = "10.1111/j.1365-2036.2011.04709.x",
language = "English (US)",
volume = "34",
pages = "146--165",
journal = "Alimentary Pharmacology and Therapeutics",
issn = "0269-2813",
publisher = "Wiley-Blackwell",
number = "2",

}

TY - JOUR

T1 - Systematic review

T2 - The role of bile acids in the pathogenesis of gastro-oesophageal reflux disease and related neoplasia

AU - McQuaid, K. R.

AU - Laine, L.

AU - Fennerty, M. B.

AU - Souza, R.

AU - Spechler, S. J.

PY - 2011/7

Y1 - 2011/7

N2 - Background Factors other than acid may play a role in gastro-oesophageal reflux disease (GERD) and its complications. Aim To assessed the role of bile acids in the pathogenesis of GERD, Barrett's oesophagus and Barrett's-related neoplasia. Methods We conducted a systematic review of computerised bibliographic databases for original articles involving humans or human oesophageal tissue or cells that assessed exposure to or manipulation of bile acids. Outcomes assessed included GERD symptoms; gross oesophageal injury; Barrett's oesophagus and related neoplasia; and intermediate markers of inflammation, proliferation or neoplasia. Results Eighty-three original articles were included. In in vivo studies, bile acids concentrations were higher in the oesophageal aspirates of patients with GERD than controls, and bile acids infusions triggered GERD symptoms, especially in high concentrations or in combination with acid. In ex vivo/in vitro studies, bile acids stimulated squamous oesophageal cells and Barrett's epithelial cells to produce inflammatory mediators (e.g., IL-8 and COX-2) and caused oxidative stress, DNA damage and apoptosis. They also induced squamous cells to change their gene expression pattern to resemble intestinal-type cells and caused Barrett's cells to increase expression of intestinal-type genes. Conclusions In aggregate, these studies suggest that bile acids may contribute to the pathogenesis of symptoms, oesophagitis and Barrett's metaplasia with related carcinogenesis in patients with GERD. However, all study results are not uniform and substantial differences in study parameters may explain at least some of this variation.

AB - Background Factors other than acid may play a role in gastro-oesophageal reflux disease (GERD) and its complications. Aim To assessed the role of bile acids in the pathogenesis of GERD, Barrett's oesophagus and Barrett's-related neoplasia. Methods We conducted a systematic review of computerised bibliographic databases for original articles involving humans or human oesophageal tissue or cells that assessed exposure to or manipulation of bile acids. Outcomes assessed included GERD symptoms; gross oesophageal injury; Barrett's oesophagus and related neoplasia; and intermediate markers of inflammation, proliferation or neoplasia. Results Eighty-three original articles were included. In in vivo studies, bile acids concentrations were higher in the oesophageal aspirates of patients with GERD than controls, and bile acids infusions triggered GERD symptoms, especially in high concentrations or in combination with acid. In ex vivo/in vitro studies, bile acids stimulated squamous oesophageal cells and Barrett's epithelial cells to produce inflammatory mediators (e.g., IL-8 and COX-2) and caused oxidative stress, DNA damage and apoptosis. They also induced squamous cells to change their gene expression pattern to resemble intestinal-type cells and caused Barrett's cells to increase expression of intestinal-type genes. Conclusions In aggregate, these studies suggest that bile acids may contribute to the pathogenesis of symptoms, oesophagitis and Barrett's metaplasia with related carcinogenesis in patients with GERD. However, all study results are not uniform and substantial differences in study parameters may explain at least some of this variation.

UR - http://www.scopus.com/inward/record.url?scp=79959378981&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79959378981&partnerID=8YFLogxK

U2 - 10.1111/j.1365-2036.2011.04709.x

DO - 10.1111/j.1365-2036.2011.04709.x

M3 - Article

C2 - 21615439

AN - SCOPUS:79959378981

VL - 34

SP - 146

EP - 165

JO - Alimentary Pharmacology and Therapeutics

JF - Alimentary Pharmacology and Therapeutics

SN - 0269-2813

IS - 2

ER -