Center for Clinical and Translational Science, Creighton University School of Medicine, Omaha, NE, USA.
Expert Rev Clin Immunol. 2013 Jun;9(6):517-33. doi: 10.1586/eci.13.38.
The incidence of reflux-related esophageal disease - Barrett's esophagus and esophageal adenocarcinoma - is rising, and the prognosis remains poor. Evidence exists that 1,25-dihydroxyvitamin D may augment the course of colon, breast and prostate cancer but little knowledge exists regarding its impact on disease of the esophagus. Important immune cells involved in reflux-related esophageal disease include CD4(+) T cells, macrophages and dendritic cells, and key signaling pathways include Wnt, Hedgehog, NFκ-B and IL-6-JAK-STAT. There is an inter-relationship between these entities and 1,25-dihydroxyvitamin D, which has been described in animal models and some human tissue. Despite this, there is an incomplete understanding of how the immune cell population and signaling pathways contribute to the course and prognosis of Barrett's esophagus and esophageal adenocarcinoma. More investigation with a focus on the clinical outcomes of patients with Barrett's esophagus and esophageal adenocarcinoma and the immune cell population and cell signaling activity in the diseased esophagus is necessary to determine the immunomodulatory role of 1,25-dihydroxyvitamin D in the pathogenesis of esophageal diseases.
反流相关食管疾病（巴雷特食管和食管腺癌）的发病率正在上升，且预后仍然较差。有证据表明 1,25-二羟维生素 D 可能会促进结肠癌、乳腺癌和前列腺癌的发展，但对于其对食管疾病的影响知之甚少。参与反流相关食管疾病的重要免疫细胞包括 CD4(+)T 细胞、巨噬细胞和树突状细胞，关键信号通路包括 Wnt、Hedgehog、NFκ-B 和 IL-6-JAK-STAT。这些实体之间存在相互关系，这种关系在动物模型和一些人体组织中已有描述。尽管如此，人们对免疫细胞群和信号通路如何影响巴雷特食管和食管腺癌的病程和预后仍缺乏全面的了解。需要更多的研究，重点关注巴雷特食管和食管腺癌患者的临床结局以及患病食管中的免疫细胞群和细胞信号活性，以确定 1,25-二羟维生素 D 在食管疾病发病机制中的免疫调节作用。
