Department of Surgery and Translational Medicine, University of Florence, Florence, Italy.
Gastrointestinal Surgery Unit, Florence Careggi University Hospital, Florence, Italy.
Ann N Y Acad Sci. 2016 Oct;1381(1):21-33. doi: 10.1111/nyas.13127. Epub 2016 Jul 14.
The esophageal mucosa is among the sites colonized by human microbiota, the complex microbial ecosystem that colonizes various body surfaces and is increasingly recognized to play roles in several physiological and pathological processes. Our understanding of the composition of the esophageal microbiota in health and disease is challenged by the need for invasive sampling procedures and by the dynamic nature of the esophageal environment and remains limited in comparison with the information available for other body sites. Members of the genus Streptococcus appear to be the major components of the microbiota of the healthy esophagus, although the presence of several other taxa has also been reported. Dysbiosis, consisting of enrichment in some Gram-negative taxa (including Veillonella, Prevotella, Haemophilus, Neisseria, Campylobacter, and Fusobacterium), has been reported in association with gastroesophageal reflux disease and is hypothesized to contribute to the evolution of this condition toward Barrett's esophagus (which is the most common esophageal precancerous lesion) and, eventually, adenocarcinoma. Some Campylobacter species (mostly C. concisus) are also putatively involved in the progression of disease toward adenocarcinoma. However, variable findings have recently been reported in additional studies. Causative relationships between dysbiosis or specific bacterial species and esophageal diseases remain controversial and warrant further investigations.
食管黏膜是人类微生物群定植的部位之一，微生物群是定植于各种体表面的复杂微生物生态系统，其在多种生理和病理过程中发挥作用的观点正日益得到认可。由于需要进行侵入性采样程序，并且由于食管环境的动态性质，我们对健康和疾病状态下食管微生物群的组成的了解受到了挑战，与其他身体部位相比，这方面的信息仍然有限。链球菌属的成员似乎是健康食管微生物群的主要组成部分，尽管也有报道存在其他几种分类群。与胃食管反流病相关的微生物失调，由一些革兰氏阴性菌（包括韦荣球菌属、普雷沃菌属、嗜血杆菌属、奈瑟菌属、弯曲菌属和梭杆菌属）的富集组成，据推测有助于该疾病向巴雷特食管（最常见的食管癌前病变）发展，并最终发展为腺癌。一些弯曲菌属（主要是 C. concisus）也被认为与疾病向腺癌的进展有关。然而，最近在其他研究中也有报道了不同的发现。微生物失调或特定细菌与食管疾病之间的因果关系仍存在争议，需要进一步研究。
