“…Once Barrett's esophagus is established, further inflammation induced damage of the columnar cells leads to cell mutations, notably, loss of tumor suppressor genes, TP53 and CDK2NA which in turn, increases mutation of SMAD (leads to dysregulated cell growth) and the expression of AT-rich interactive domain-containing protein 1A, ARID1A) (part of a protein complex responsible for activating genes normally silenced by chromatin structure). The final result is chromosome instability (CIN) and malignant transformation to EAC [19]. Abbreviations: AT-rich interactive domain-containing protein 1A (ARID1A), bile acid (BA), bone morphogenetic protein (BMP, growth factor), caudal homeobox gene 1 (CDX1), chromosomal instability (CIN), cyclin-dependent kinase inhibitor 2A (CDKN2A, tumor suppressor), esophageal adenocarcinoma (EAC), gastric acid esophageal reflux disease (GERD), interleukin (IL) (IL-1β, IL-6, inflammatory cytokines), squamocolumnar junction (SCJ), tumor protein 54 (TP53, tumor suppressor) (B) ESCC development.…”