Diseases of the esophagus, such as gastroesophageal reflux (GER), can result in changes to mucosal integrity, neurological function, and the microbiome. Although poorly understood, both age and GER can lead to changes to the enteric nervous system. In addition, the esophagus has a distinct microbiome that can be altered in GER. Mucosal integrity is also at risk due to persistent damage from acid. Diagnostic tools, such as ambulatory pH/impedance testing and esophageal mucosal impedance, can assess short‐term and longitudinal GER burden, which can also assess the risk for mucosal compromise. The quality of the mucosal barrier is determined by its intercellular spaces, tight junctions, and tight junction proteins, which are represented by claudins, occludins, and adhesion molecules. Fortunately, there are protective factors for mucosal integrity that are secreted by the esophageal submucosal mucous glands and within saliva that are augmented by mastication. These protective factors have potential as therapeutic targets for GER. In this article, we aim to review diagnostic tools used to predict mucosal integrity, aging, and microbiome changes to the esophagus and esophageal mucosal defense mechanisms.

中文翻译：

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健康和疾病中的食管黏膜屏障：黏膜病理生理学和保护机制

食道疾病，如胃食管反流 (GER)，可导致粘膜完整性、神经功能和微生物群的变化。尽管知之甚少，但年龄和 GER 都会导致肠道神经系统发生变化。此外，食道具有独特的微生物组，可以在 GER 中改变。由于酸的持续损害，粘膜完整性也处于危险之中。诊断工具，如动态 pH/阻抗测试和食管黏膜阻抗，可以评估短期和纵向 GER 负担，也可以评估黏膜受损的风险。粘膜屏障的质量取决于其细胞间隙、紧密连接和紧密连接蛋白，这些蛋白以密蛋白、封闭蛋白和粘附分子为代表。幸运的是，食管黏膜下黏液腺和唾液中分泌的黏膜完整性保护因子通过咀嚼得到增强。这些保护因素有可能成为 GER 的治疗靶点。在本文中，我们旨在回顾用于预测食管和食管粘膜防御机制的粘膜完整性、老化和微生物组变化的诊断工具。