Commentary on: Do proton pump inhibitors prevent Barrett’s esophagus progression to high-grade dysplasia and esophageal adenocarcinoma? An updated meta-analysis

Excerpt

Compared to the general population, patients with Barrett’s esophagus had a more than 11-fold increased risk of esophageal adenocarcinoma (EAC). As the incidence of EAC continues to increase and its high mortality rate, attention has turned to chemoprophylaxis to delay or halt the progression of Barrett’s esophagus to tumor formation. It has been shown that during persistence of the mitogen-activated protein kinase pathway and pulsating acid exposure, the proliferation rate of metaplastic cells increases, thereby transmitting growth regulatory signals to enhance proliferation and reduce apoptosis (Hvid-Jensen et al. 2014). Thus, inhibition of these pathways by minimizing acid-induced stimulation may help prevent progression from Barrett’s esophagus to severe dysplasia or EAC. …