Clinical Research
Copyright ©2005 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 14, 2005; 11(46): 7277-7283
Published online Dec 14, 2005. doi: 10.3748/wjg.v11.i46.7277
Bacterial biota in reflux esophagitis and Barrett’s esophagus
Zhiheng Pei, Liying Yang, Richard M Peek, Jr Steven M Levine, David T Pride, Martin J Blaser
Zhiheng Pei, Departments of Pathology and Medicine, New York University School of Medicine, New York, NY 10016, the United States of America, and Department of Veterans Affairs New York Harbor Health System, New York, NY 10010, United States
Liying Yang, Department of Pathology, New York University School of Medicine, New York, NY 10016, United States
Richard M Peek, Jr, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37212, United States
Jr Steven M Levine, Department of Medicine, New York University School of Medicine, New York, NY 10016, United States
David T Pride, Departments of Medicine and Microbiology, New York University School of Medicine, New York, NY 10016, United States
Martin J Blaser, Departments of Medicine and Microbiology, New York University School of Medicine, New York, NY 10016, the United States of America, and Department of Veterans Affairs New York Harbor Health System, New York, NY 10010, United States
Author contributions: All authors contributed equally to the work.
Supported by R01CA97946, R21DK57941, R01GM63270, R01 DK58587, and R01CA77955, and by the General Clinical Research Center core grant to New York University School of Medicine (NIH/NCRR M01 RR00096) from the National Institutes of Health, by the Medical Research Service of the Department of Veterans Affairs, and by the Ellison Medical Foundation
Correspondence to: Zhi-Heng Pei, MD, PhD, Department of Pathology and Laboratory Services (113), Department of Veterans Affairs New York Harbor Health System , 423 E 23rd Street, New York, NY 10010, United States. zhiheng.pei@med.nyu.edu.
Telephone: +1-2129515492 Fax: +1-2122527167
Received: April 1, 2005
Revised: April 23, 2005
Accepted: April 30, 2005
Published online: December 14, 2005
Abstract

AIM: To identify the bacterial flora in conditions such as Barrett’s esophagus and reflux esophagitis to determine if they are similar to normal esophageal flora.

METHODS: Using broad-range 16S rDNA PCR, esophageal biopsies were examined from 24 patients [9 with normal esophageal mucosa, 12 with gastroesophageal reflux disease (GERD), and 3 with Barrett’s esophagus]. Two separate broad-range PCR reactions were performed for each patient, and the resulting products were cloned. In one patient with Barrett’s esophagus, 99 PCR clones were analyzed.

RESULTS: Two separate clones were recovered from each patient (total = 48), representing 24 different species, with 14 species homologous to known bacteria, 5 homologous to unidentified bacteria, and 5 were not homologous (<97% identity) to any known bacterial 16S rDNA sequences. Seventeen species were found in the reflux esophagitis patients, 5 in the Barrett’s esophagus patients, and 10 in normal esophagus patients. Further analysis concentrating on a single biopsy from an individual with Barrett’s esophagus revealed the presence of 21 distinct bacterial species. Members of four phyla were represented, including Bacteroidetes, Firmicutes, Proteobacteria, and Actinobacteria. Microscopic examination of each biopsy demonstrated bacteria in intimate association with the distal esophageal epithelium, suggesting that the presence of these bacteria is not transitory.

CONCLUSION: These findings provide evidence for a complex, residential bacterial population in esophageal reflux-related disorders. While much of this biota is present in the normal esophagus, more detailed comparisons may help identify potential disease associations.

Keywords: Bacterial biota; Esophagus; 16S rDNA PCR