Thus, the finding of aldehyde-DNA damage in EAC carries clinical impact, as ALDH-enhancing and aldehyde-scavenging agents exist which augment aldehyde detoxification (exemplified by metformin in this work)31, with potential implications for chemopreventative strategies in the pre-EAC metaplastic condition, Barrett’s esophagus. This evidence concerns the gene LDHA and Barrett esophagus.