Role of microbial dysbiosis in the pathogenesis of esophageal mucosal disease: A paradigm shift from acid to bacteria?

The interactions between the gut bacteria and the host's immune system play a key role in the pathogenesis of gastrointestinal diseases, including those impacting the esophagus. Although relatively stable, several factors may disrupt the delicate balance between the luminal esophageal microbiome (EM) and the host. These changes are thought to be a product of age, diet, antibiotics and other medication use, oral hygiene, smoking, and/or expression of antibiotic products (bacteriocins) by other flora. These effects may lead to persistent dysbiosis, which increases the risk of local inflammation, systemic inflammation, and ultimately…