Tetrahydroxylated bile acids prevents malignant progression of Barret esophagus in vitro by inhibiting the interleukin-1β-nuclear factor kappa-B pathway

BACKGROUND Barrett esophagus (BE), a metaplastic adaptive process to gastrointestinal reflux, is associated with a higher risk of developing esophageal adenocarcinoma. However, the factors and mechanism that drive the malignant progression of BE is not well understood. AIM To investigate the role of bile acids, a component of the reflux fluid, in the malignant progression of BE. METHODS Using engineered green fluorescent protein- labeled adult tissue-resident stem cells isolated from BE clinical biopsies (BE-ASCs) as the target, we studied the effect of hydrophobic deoxycholic acid (DCA) and hydrophilic tetrahydroxylated bile acids (THBA) on cell viability by fluorescence intensity analysis, mucin production by dark density measurement, tissue structure by pathology analysis, expression of different pro-inflammatory factors gene by quantitative polymerase chain reaction and proteins by Western blot. RESULTS We found that hydrophobic DCA has cytotoxic and proinflammatory effects through activation of interleukin-1β (IL-1β)-nuclear factor kappa-B (NF-κB) inflammatory pathway on BE-ASCs. This action results in impaired cell viability, tissue intactness, reduced mucin production, and increased transition to disorganized atypical cells without intestinal features. In contrast, co-culture with hydrophilic THBA inhibited the IL-1β-NF-κB inflammatory pathway with maintenance of mature intestinal type cellular and histomorphology. CONCLUSION Our data indicates that the hydrophilic bile acid THBA can counteract the cytotoxic and proinflammatory effect of hydrophobic DCA and prevent the malignant progression of BE by inhibiting the IL-1β-NF-κB pathway.