Opinion Review
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 14, 2020; 26(22): 2889-2901
Published online Jun 14, 2020. doi: 10.3748/wjg.v26.i22.2889
Circulating exosomal miRNAs as potential biomarkers for Barrett's esophagus and esophageal adenocarcinoma
Jing Lv, He-Ping Zhao, Kun Dai, Yan Cheng, Jun Zhang, Lei Guo
Jing Lv, He-Ping Zhao, Department of Clinical Laboratory, Honghui Hospital, Xi'an Jiaotong University, Xi'an 710054, Shaanxi Province, China
Kun Dai, Department of Clinical Laboratory, Yanliang Railway Hospital of Xi’an, Xi'an 710089, Shaanxi Province, China
Yan Cheng, Jun Zhang, Department of Gastroenterology, Second Affiliated Hospital of Xi’an Jiaotong University, Xi'an 710004, Shaanxi Province, China
Lei Guo, Department of Spinal Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an 710054, Shaanxi Province, China
Author contributions: Lv J and Guo L searched and reviewed published articles, and wrote the manuscript; Zhao HP, Cheng Y, and Zhang J critically reviewed and revised the manuscript; Guo L and Dai K made substantial contributions to the conception and design of this study; all authors approved the final version of the article to be published.
Supported by the Shaanxi Natural Science Foundation of China, No. 2019JQ-978 and No. 2018JQ8029; and the National Natural Science Foundation of China, No. 81700474.
Conflict-of-interest statement: The authors declare no conflict of interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Lei Guo, MD, Doctor, Surgeon, Department of Spinal Surgery, Honghui Hospital, Xi'an Jiaotong University, No. 555, Youyi Dong Road, Xi'an 710054, Shaanxi Province, China. guolei0711@163.com
Received: December 28, 2019
Peer-review started: December 28, 2019
First decision: March 21, 2020
Revised: March 26, 2020
Accepted: May 26, 2020
Article in press: May 26, 2020
Published online: June 14, 2020
Abstract

Exosomes, a class of extracellular vesicles, are small membrane-bound vesicles derived from almost all cell types that can play important roles in intercellular communication. Exosomes contain proteins, lipids, and nucleic acids that are obtained from the parental cells and participate in various pathophysiological processes, including cell growth, migration, inflammation, immune regulation, and tumor pathogenesis. Moreover, exosomes might be applied in clinical settings, such as diagnosis, treatment, and outcome prediction of diseases, including various cancers. The incidence rates of Barrett's esophagus (BE) and esophageal adenocarcinoma (EAC) have increased in recent decades, and studies have proposed specific factors that may contribute to the development and progression of these diseases. However, how exosomes play a role in this pathological process needs to be clarified. Studies have identified candidate microRNAs (miRNAs) that might be related to BE/EAC. Further studies are needed to ascertain whether circulating exosomal miRNAs are altered before or after disease onset, which could also help understand the pathophysiology of and find potential targets for prevention, diagnosis, and therapy in BE/EAC. This review summarizes recent findings on the features of circulating exosomal miRNAs in BE/EAC, which could be valuable for the early diagnosis, therapeutic approaches, and outcome prediction of BE/EAC.

Keywords: Barrett's esophagus, Esophageal adenocarcinoma, Biomarkers, Exosomes, Circulation, MicroRNA

Core tip: Barrett's esophagus (BE) is the only recognized precursor of esophageal adenocarcinoma (EAC), which is a common malignancy with a poor prognosis. Exosomes contain proteins, lipids, and nucleic acids and participate in various pathophysiological processes. The role of exosomes in BE/EAC progression cannot be ignored. Current studies on circulating exosomal microRNAs (miRNAs) in BE/EAC have mainly focused on miRNA profiling, and little is known about the associations between circulating exosomes and the pathogenesis of BE/EAC. This review focuses on the features of circulating exosomal miRNAs in BE/EAC, which might be potential biomarkers and play a causative role in BE/EAC pathogenesis.