Emerging Insights Into The Esophageal Microbiome
Emerging Insights Into The Esophageal Microbiome
Emerging Insights Into The Esophageal Microbiome
Esophageal Microbiome
Jurnal Reading
H. pylori infections began to decline and antibiotic use began to expand starting in the mid-20 th century. This was
followed in time by marked rises in the incidence of esophageal adenocarcinoma and eosinophilic esophagitis.
TECHNIQUES FOR SAMPLING
AND ANALYZING THE
ESOPHAGEAL MICROBIOME
Jurnal Reading
STEVANUS IMMANUEL SILAHOOIJ
Techniques for Sampling and
Analyzing
1. Endoscopy techniques
- Brushings or biopsies.
o Invasive, expense , limited sample sizes (microbiome studies)
o Endoscopic mucosal brushings : superior yield of bacterial DNA and increased
the ratio of bacterial DNA to host DNA compare to biopsies.
2. Non-endoscopic techniques
- Enterotest™ Esophageal String Test
- Cytosponge (tethered capsule) : higher quantities of microbial DNA than
endoscopic brushes or biopsies
- Inflatable balloons
NATIVE ESOPHAGEAL
MICROBIOME
Jurnal Reading
STEVANUS IMMANUEL SILAHOOIJ
Native Esophageal Microbiome
■ The esophagus was not a sterile site and did not simply contain a transient microbial
population introduced from the oral cavity
■ Ninety-five species-level operational taxonomic units were identified, belonging to
six phyla:
- Firmicutes (70%),
- Bacteroidetes (20%)
- Actinobacteria (4%)
- Proteobacteria (2%)
- Fusobacteria (2%)
- TM7 (1%).
The most common genera of bacteria were Streptococcus, Prevotella, and
Veillonella.
FACTORS THAT
INFLUENCE THE
ESOPHAGEAL
MICROBIOME
Jurnal Reading
STEVANUS IMMANUEL SILAHOOIJ
Factors that Influence the Esophageal
Microbiome
(PPIs
)
Diet
Factors that Influence the Esophageal
Microbiome : PPIs
Diet
Factors that Influence the Esophageal
Microbiome : DIET
■ In a prospective study of 33 children with EoE, The reintroduction of allergenic foods
led to an increase in the prevalence of Granulicatella and Campylobacter
■ Our group recently conducted a study: We found that increasing fiber intake positively
correlated with increased relative abundance of Firmicutes and decreased relative
abundance of Proteobacteria and Gramnegative bacteria as a whole.
■ Interestingly, there were relatively few microbiome alterations based on dietary fat
intake. However, longitudinal studies are necessary to better determine how diet alters
the esophageal microbiome.
Diet
BARRETT’S ESOPHAGUS
(BE)
AND ESOPHAGEAL
ADENOCARCINOMA (EAC)
Jurnal Reading
STEVANUS IMMANUEL SILAHOOIJ
Barrett’s Esophagus (BE) and
Esophageal Adenocarcinoma (EAC)
■ The dramatic increase in incidence of EAC is beyond what would be
expected just based on increased rates of GERD, obesity and smoking
■ Widespread use of antibiotics potentially led to dramatic, population-level
shifts in the upper gastrointestinal microbiome
■ Helicobacter pylori is inversely associated with EAC risk
■ The combination of the rise in antibiotic use, decreased H.pylori prevalence
and significant dietary changes in the mid-20th century, along with the
inverse relationship between H. pylori infection and the development of
EAC, all point to a role of the upper gastrointestinal microbiome in the
pathogenesis of EAC.
The Barrett’s Esophagus- and Reflux-
Associated Microbiome
■ Studies to date suggest that BE and reflux esophagitis are associated with
a modestly distinct esophageal microbiome compared to patients without
esophageal disease.
■ Such studies could both identify potential targets for risk modification and
explore the clinical utility of markers for disease risk.
■ Future studies will hopefully elucidate the roles of specific bacteria in the
esophagus and identify novel therapeutic approaches to modify disease risk
and improve outcomes
EMERGING INSIGHTS
INTO THE ESOPHAGEAL
MICROBIOME
THANK YOU
STEVANUS IMMANUEL SILAHOOIJ