Chronic inflammatory gastric reflux alters the esophageal microenvironment and induces metaplastic transformation of the epithelium, a precancerous condition termed Barrett’s esophagus (BE). The microenvironmental niche, which includes the extracellular matrix (ECM), substantially influences cell phenotype. ECM harvested from normal porcine esophageal mucosa (eECM) was formulated as a mucoadhesive hydrogel, and shown to largely retain basement membrane and matrix-cell adhesion proteins. Dogs with BE were treated orally with eECM hydrogel and omeprazole (n = 6) or omeprazole alone (n = 2) for 30 days. eECM treatment resolved esophagitis, reverted metaplasia to a normal, squamous epithelium in four of six animals, and downregulated the pro-inflammatory tumor necrosis factor–α⁺ cell infiltrate compared to control animals. The metaplastic tissue in control animals (n = 2) did not regress. The results suggest that in vivo alteration of the microenvironment with a site-appropriate, mucoadhesive ECM hydrogel can mitigate the inflammatory and metaplastic response in a dog model of BE.

慢性炎症性胃反流改变食管微环境并诱导上皮化生转化，这是一种称为巴雷特食管（BE）的癌前病变。包括细胞外基质 (ECM) 在内的微环境生态位极大地影响细胞表型。从正常猪食管粘膜 (eECM) 中采集的 ECM 被配制为粘膜粘附水凝胶，并显示其在很大程度上保留了基底膜和基质细胞粘附蛋白。患有 BE 的狗口服 eECM 水凝胶和奥美拉唑 ( n = 6) 或单独奥美拉唑 ( n = 2) 治疗 30 天。与对照动物相比，eECM 治疗解决了食管炎，使六只动物中的四只化生恢复为正常的鳞状上皮，并下调了促炎性肿瘤坏死因子 -α ^{+细胞浸润。}对照动物（ n = 2）的化生组织没有消退。结果表明，使用适当部位的粘膜粘附 ECM 水凝胶改变体内微环境可以减轻 BE 狗模型的炎症和化生反应。