Research discovers genetic link to Barrett's esophagus, esophageal cancer

July 26, 2011

EMBARGOED UNTIL 4PM EST Tuesday, July 26, 2011, Cleveland: Researchers have identified genetic mutations in patients with Barrett's esophagus (BE) and/or the cancer esophageal adenocarcinoma (EAC). None of these mutations were found in patients not affected by BE/EAC, suggesting a previously unknown heritable cause. Identifying genetic markers will allow risk assessment, early detection, improved disease management, and ultimately increased survival.

BE is estimated to occur in up to 10 percent of the population, and its incidence has increased more than three-fold since 1970. Related to gastroesophageal reflux disease (GERD), BE is believed to be a precursor to EAC. EAC is typically not diagnosed until its advanced stages, when chances of survival are poor.

This study, published in the July 27, 2011 issue of the Journal of the American Medical Association and led by Charis Eng, M.D., Ph.D., Chair and Founding Director of the Genomic Medicine Institute of Lerner Research Institute at Cleveland Clinic, was conducted from 2005 to 2010 at 16 different institutions across the United States and involved 298 participants with BE, EAC, or both. To identify genes linked specifically to BE/EAC, the group used the latest in genomics approaches and state-of-the art technology, along with functional genomic validation, to identify MSR1, ASCC1, and CTHRC1 as three genes mutated in 11 percent of the BE/EAC patients studied, indicative of a significant genetic predisposition. Mutations in MSR1 were the most common, affecting seven percent of the patients studied.

Identifying BE/EAC predisposition genes also gives valuable insight to how the disease occurs. Preliminary evidence from this study suggests a role for specific molecular pathways, including inflammation, in the development of BE/EAC, as well as a potential link of the mutated genes to additional cancers as well.

"We are absolutely thrilled to now know three distinct genes that link to BE/EAC," said Dr. Eng. "This is essential for improving risk assessment, disease management, and saving lives."
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About Cleveland Clinic

Celebrating its 90th anniversary, Cleveland Clinic is a nonprofit multispecialty academic medical center that integrates clinical and hospital care with research and education. It was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation. Cleveland Clinic has pioneered many medical breakthroughs, including coronary artery bypass surgery and the first face transplant in the United States. U.S. News & World Report consistently names Cleveland Clinic as one of the nation's best hospitals in its annual "America's Best Hospitals" survey. About 2,800 full-time salaried physicians and researchers and 11,000 nurses represent 120 medical specialties and subspecialties. Cleveland Clinic Health System includes a main campus near downtown Cleveland, nine community hospitals and 15 Family Health Centers in Northeast Ohio, Cleveland Clinic Florida, the Lou Ruvo Center for Brain Health in Las Vegas, Cleveland Clinic Canada, and opening in 2013, Cleveland Clinic Abu Dhabi. In 2010, there were 4 million visits throughout the Cleveland Clinic health system and 155,000 hospital admissions. Patients came for treatment from every state and from more than 100 countries. Visit us at www.clevelandclinic.org. Follow us at www.twitter.com/ClevelandClinic.

Lerner Research Institute

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