Roles of Microbes in Esophageal Disease

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Background

Research on gut microbiota sequencing has gradually changed the understanding of gastrointestinal diseases, and the vital role of microbes in esophageal diseases has received extensive attention. An increase of proteobacteria has been reported in children with active eosinophilic esophagitis (EoE), which indicates microbiota dysbiosis may be involved in the pathogenesis of EOE. A shift from Gram-positive to Gram-negative bacteria occurs in reflux esophagitis (RE) and Barrett's esophagus (BE). The shift especially Enterobacteriaceae, Campylobacters, and acid-producing bacteria, periodontal pathogens might be involved in the pathogenesis of esophageal adenocarcinoma (EAC). Thus, increased Gram-negative bacterial products in stages of RE-BE-EAC pathway activate Toll-like receptors on esophageal endothelial cells, causing an inflammatory cascade leading to cell injury and relaxation of the low esophageal sphincter. Additionally, increased Actinomyces and Atopobium accompanied by decreased Fusobacterium and Porphyromonas were reported in esophageal squamous cell carcinoma (ESCC), which may be related to disease development. Although many studies have found the correlation between microbes and esophageal diseases, the pathogenic mechanism, diagnosis, and management of microbes in esophageal diseases, still need further research.

In light of the increasing association between altered microbiota and esophageal diseases, the mechanism of specific microbe in the occurrence and development of esophageal diseases needs to be further studied. In addition, oral or fecal microbes can be promulgated as non-invasive diagnostic or prognostic markers for esophageal diseases, especially EAC and ESCC. Moreover, the modulation of gut microbiota, such as probiotics, prebiotics, synbiotics, etc. may become new strategies for the management of esophageal disease, particularly in adjuvant therapy of EAC and ESCC. The Research Topic will cover issues in these relevant aspects, which can transform discoveries of basic research into clinical applications.

This Research Topic focuses on the field of microbiota alternation and its effects on the host as well as the pathogenesis mechanism to deepen our knowledge of gut microbe roles in esophageal diseases. Reviews and original research articles on the following (but not limited to) topics are welcomed:

• Identification of differential microorganisms in esophageal diseases.
• Effects and associated mechanisms of microorganisms in esophageal diseases.
• Diagnosis and prognosis of esophageal disease by microbes, especially early detection of EAC and ESCC.
• Management of esophageal diseases by modulating microbes, including the enhancement of esophageal tumor therapies.

Keywords: esophageal disease, microbe, pathogenesis mechanism, diagnosis, management

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