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Articles

Title: The role of obesity and leptin in the pathogenesis of Barrett's esophagus and esophageal adenocarcinoma

Author:
Jolanta Majka, Aleksandra Szlachcic, Rafał Pabiańczyk, Tomasz Brzozowski, Stanisław J. Konturek, Wiesław W. Pawlik
Type:
Review articles
Language:
PL
Journal:
Polish Gastroenterology
Year:
2009
Volume:
16
Number:
5
Start page:
370
Final page:
374
ISSN:
1232-9886
Keywords:
Barrett?s esophagus, leptin, cyclooxygenase-2, prostaglandins, growth factors
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Barrett?s esophagus (BE) is a precancerous condition that may lead to the development of esophageal adenocarcinoma (EAC). In the last decade, rapid growth in the incidence of BE and EAC has been observed, and gastroesophageal reflux disease (GERD) and obesity are the most frequent coexisting gastrointestinal pathologies reported in persons living in developed countries. The etiologies of BE and EAC are not fully explained, although GERD and obesity seem to be important risk factors leading to chronic esophageal inflammation and, consequently, to dysfunction of the esophagus. Epidemiological studies indicate high correlation between BE and obesity, especially central and visceral. This is a review of the latest literature concerning the involvement of leptin, the major long-term hormonal signal from adipocytes for the hypothalamic regulation of food intake and energy expenditure via the gut-brain axis. The influence of leptin on cell proliferation and apoptosis, inflammation, angiogenesis, and carcinogenesis is discussed. The contributions of growth factors and prostaglandins to the mechanism of leptin?s effects on normal and Barrett?s esophageal mucosa and in the development of metaplasia and dysplasia are described. Finally, this paper attempts to provide a short overview on obesity as one of the risk factors responsible for GERD, BE, and EAC.