Differential expression of mitochondrial energy metabolism profiles across the metaplasia–dysplasia–adenocarcinoma disease sequence in Barrettʹs oesophagus

Contemporary clinical management of Barrettʹs oesophagus has highlighted the lack of accurate predictive markers of disease progression to oesophageal cancer. This study aims to examine alterations in mitochondrial energy metabolism profiles across the entire disease progression sequence in Barrettʹs oesophagus. An in-vitro model was used to screen 84 genes associated with mitochondrial energy metabolism. Three energy metabolism genes (ATP12A, COX4I2, COX8C) were significantly altered across the in-vitro Barrettʹs disease sequence. In-vivo validations across the Barrettʹs sequence demonstrated differential expression of these genes. Tissue microarrays demonstrated significant alterations in both epithelial and stromal oxidative phosphorylation (ATP5B and Hsp60) and glycolytic (PKM2 and GAPDH) protein markers across the in-vivo Barrettʹs sequence. Levels of ATP5B in sequential follow up surveillance biopsy material segregated Barrettʹs non progressors and progressors to HGD and cancer. Utilising the Seahorse XF24 flux analyser, in-vitro Barrettʹs and adenocarcinoma cells exhibited altered levels of various oxidative parameters. We show for the first time that mitochondrial energy metabolism is differentially altered across the metaplasia–dysplasia–adenocarcinoma sequence and that oxidative phosphorylation profiles have predictive value in segregating Barrettʹs non progressors and progressors to adenocarcinoma.