biology Review The Role of Microbiota in the Pathogenesis of Esophageal Adenocarcinoma Megan R. Gillespie 1, Vikrant Rai 2 , Swati Agrawal 3 and Kalyana C. Nandipati 3,* 1 School of Medicine, Creighton University, 2500 California Plaza, Omaha, NE 68178, USA;
[email protected] 2 Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA 91766, USA;
[email protected] 3 Department of Surgery, Creighton University School of Medicine, 2500 California Plaza, Omaha, NE 68178, USA;
[email protected] * Correspondence:
[email protected]; Tel.: +1-402-280-5292 Simple Summary: Esophageal adenocarcinoma has a poor 5-year survival rate and is among the highest mortality cancers. Changes in the esophageal microbiome have been associated with cancer pathogenesis; however, the molecular mechanism remains obscure. This review article critically analyzes the molecular mechanisms through which microbiota may mediate the development and progression of esophageal adenocarcinoma and its precursors-gastroesophageal reflux disease and Barrett’s esophagus. It summarizes changes in esophageal microbiome composition in normal and pathologic states and subsequently discusses the role of altered microbiota in disease progression. The potential role of esophageal microbiota in protecting against the development of esophageal adenocarcinoma is also discussed. By doing so, this article highlights specific directions for future research developing microbiome-mediated therapeutics for esophageal adenocarcinoma. Abstract: Esophageal adenocarcinoma (EAC) is associated with poor overall five-year survival. The Citation: Gillespie, M.R.; Rai, V.; incidence of esophageal cancer is on the rise, especially in Western societies, and the pathophysiologic Agrawal, S.; Nandipati, K.C. The Role of Microbiota in the Pathogenesis of mechanisms by which EAC develops are of extreme interest.