Esophageal Dysbiosis in Achalasia and Cancer Development: A Critical Review

Abstract

Background: Microorganisms provide various benefits to their human hosts, including assisting with digestion, synthesizing certain vitamins, developing the gastrointestinal and immune systems, regulating metabolism, and protecting against some pathogens. However, microbial imbalances can cause tissue damage and contribute to inflammatory disorders and cancers. Microbial dysbiosis refers to an imbalance or disruption in the normal composition and function of the microbial communities that inhabit various body parts, including the gut, oral cavity, skin, and reproductive tract. Emerging research suggests that microbial dysbiosis plays a significant role in cancer development and progression. This issue is particularly relevant in achalasia, in which food stasis, changes in endoluminal pH, and poor esophageal clearance might contribute to esophageal microbial dysbiosis. This study aimed to evaluate the association between dysbiosis and esophageal cancer development, focused on esophageal dysmotility disorders. Methods: This study is a critical review, gathering the current evidence for the association between dysbiosis and the development of esophageal cancer. Results: Studies have shown that microbiota play a role in cancer development, although the mechanisms for how they do so are not yet fully understood. One possible explanation is that microbiota alterations can lead to chronic inflammation, promoting cancer cell growth. Additionally, some bacteria produce toxins that can damage DNA and cause genomic instability, and certain bacterial products can promote tumor growth. Conclusion: Despite the close relationship between dysbiosis and cancer development in esophageal dysmotility disorders, further investigations are still needed to elucidate the precise mechanisms by which dysbiosis contributes to cancer development and to identify potential therapeutic interventions targeting the microbiota to prevent or treat cancer.

Esophageal cancer in an adult with congenital esophageal stenosis: a case report

“…Considering the long duration of symptoms and long, narrow area, the impact of the mechanical stimulation is believed to be significant. Several mechanisms for the development of squamous cell carcinoma of the esophagus in patients with esophageal achalasia, which is similarly associated with stasis within the esophagus, have been proposed [ 10 , 11 ]. Continuous chemical irritation due to salivary stasis and food decomposition in the esophagus plays a major role in inducing inflammation.…”

Proton Pump Inhibitors and Likelihood of Colorectal Cancer in the Korean Population: Insights from a Nested Case–Control Study Using National Health Insurance Data

“…The control group comprised individuals not diagnosed with CRC during the same period (n = 1,127,941). We excluded participants who were treated for the following conditions using ICD-10 codes: hiatal hernia (K449), gastric surgery (K910-K913), Zollinger-Ellison syndrome (E164), systemic sclerosis (M34), achalasia (K220), and pyloric obstruction (K311-K315), which are known to increase gastrointestinal symptoms or the risk of gastrointestinal cancer [45][46][47][48][49][50]. For the control participants, those later diagnosed with CRC (n = 3315) were also excluded.…”

Role of circular RNAs and gut microbiome in gastrointestinal cancers and therapeutic targets

“…The host immune system [ 20 ], food metabolism [ 21 ], and a variety of bioactive metabolites produced by the gut microbiota all interact with one another to influence the gut microenvironment and general health [ 22 ]. Dysbiosis, an imbalance in the gut's microbial population, has been connected to several gastrointestinal illnesses, including esophageal cancer [ 23 ], gastric cancer [ 24 ], hepatocellular cancer [ 25 ], pancreatic cancer [ 26 ], and colorectal cancer [ 27 ]. The gut microbiota can either directly or indirectly influence tumor development and therapeutic response in GI malignancies [ 19 ].…”