Aspirin may protect against Barrett's esophagus
New research has shown that aspirin may have a protective effect against the development of Barrett’s esophagus.
“If you are predisposed to developing Barrett’s esophagus, our research suggests that taking aspirin on a regular basis might prevent the condition from developing and the cancers that go along with it,” Rhonda F. Souza, MD, co-director of the Center for Esophageal Research at Baylor Scott & White Research Institute, said in a press release.
Previous studies have shown that acid and bile salts induce the expression of caudal-related homeobox transcription factor 2 (CDX2) — a gene involved in the pathogenesis of Barrett’s intestinal-type metaplasia — in esophageal squamous cells from patients with Barrett’s esophagus (normal esophageal squamous [NES]-B cells), but not in those from patients with GERD who do not have Barrett’s esophagus (NES-G cells). CDX2 is a target of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-B) signaling, which aspirin, but not other NSAIDs, can inhibit.
Therefore, Souza and colleagues studied the mechanisms behind the differences in CDX2 expression between NES-B and -G cells, as well as aspirin’s effects on CDX2 expression, in part to better understand why some GERD patients develop Barrett’s esophagus and others do not.
The investigators prepared NES-B and -G cell lines from patient biopsy specimens, tested them with acid and bile salts, with and without aspirin, and found distinct differences in the molecular pathways of cells from Barrett’s patients that can induce CDX2 expression.
In addition, the study showed that aspirin can potentially protect against Barrett’s esophagus by inhibiting the NF-B pathway that promotes CDX2 expression and inflammation.
Further, the findings suggested that aspirin given before and after radiofrequency ablation can potentially augment the procedure by inhibiting abnormal tissue regrowth.
“For patients who have been shown to develop Barrett’s, this research suggests that putting them on aspirin following the RFA procedure may delay or prevent the intestinal lining from returning,” Souza said in the press release.
Based on these findings, an NIH-funded randomized controlled trial led by The University of Texas MD Anderson Cancer Center researchers is currently recruiting patients in the U.S. to better understand the effects of aspirin in preventing recurrent Barrett’s esophagus after RFA, according to the press release. – by Adam Leitenberger
Disclosures: The researchers report no relevant financial disclosures.