Natural development of Barrett’s oesophagus and adenocarcinoma in experimental models of gastroesophageal reflux disease

Introduction: Development of gastroesophageal reflux disease (GERD) takes place when the balance between irritant and protecting mucous membrane mechanisms is impaired. The chronic inflammation of the oesophagus results in serious complications including Barrett’s metaplasia progression into esophageal adenocarcinoma. In the last few years the incidence of chronic gastroesophageal reflux disease has been increasing, especially in highly developed countries, and this chronic disease may result in the development of oesophageal adenocarcinoma, which is also observed with increased frequency.
Aim: Creation and comparison of chronic gastroesophageal reflux disease models, as well as estimation of their suitability for the investigation of the process of natural carcinogenesis in the oesophagus.
Material and methods: Ninety Wistar rats were used for the study on development of chronic oesophageal inflammation. Three major groups, A – side to side anastomosis, B – side to end anastomosis and C – side to end anastomosis with total gastrectomy, were selected. In each group a different operation technique was performed to induce chronic oesophageal reflux. Groups A and B were characterized by mixed gastro-duodenal reflux while group C included animals with only alkaline reflux.
Results: In all three experimental models of GERD the morphological changes of the oesophageal mucosa were observed by gross inspection starting 1 month after the surgery. Under microscopic investigation chronic inflammation of the oesophageal mucosa progressing to Barrett’s metaplasia and in some cases to cancer was also confirmed.
Conclusions: All experimental animal models developed due to GERD are highly reproducible and exhibit low mortality. Macroscopic and microscopic assessment of oesophageal inflammation that developed in response to experimental reflux confirmed that these models are suitable and useful for determination of the pathogenesis of Barrett’s related oesophageal cancer.