Liu et al. (2013) also observed Firmicutes, Proteobacteria, Bacteroides, Fusobacterium, and Actinobacter in 6 cases of BE. These studies suggested a potential rational toward a self defense mechanism against pathogenic bacteria. Therefore, presence of metaplastic Paneth-like cells in these lesions may represent an adaptive antibacterial response by the infected mucosa. However, besides an antibacterial role, defensins were also proposed to reduce E-cadherin in esophageal epithelium to possibly accelerate the BE pathogenesis (Nomura et al., 2013). The gene discussed is CDH1; the disease is Barrett esophagus.