USMLE Advantage of squamous and columnar metaplasia

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MudPhud20XX

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Hi all,

So in smokers columnar to squamous metaplasia takes place. How does this help handle the stress better?

In Barret esophagus, how does squamous to columnar metaplasia help hand the stress better?

Many thanks!
 
Squamous epithelium is supposed to be more "resilient": your vocal cords take a beating opening and closing so much with high-velocity air, so they're lined with it. Other obvious sites of potential trauma include the vagina, skin, etc. Things generally turn squamous in the face of chronic stress.

Another thing about squamous metaplasia: Recall that vitamin A maintains cellular differentiation and that deficiency causes squamous metaplasia (e.g. Bitot spots). Dr. Sattar (Pathoma) mentioned that smoking can cause a relative vitamin A deficiency in reference to periductal mastitis in one of his lectures; I would assume the same reasoning could apply as an additional explanation to squamous metaplasia of the respiratory system in smoking.

The only reason Barrett's turns columnar instead is because it's actually columnar w/ goblet cells. This allows for a protective mucus lining reminiscent of the stomach's mucus layer. Again, the emphasis is on the goblet cells conferring an advantage to resist acidic stress. I would guess that if the cells didn't have the potential to include goblet cells in their metaplasia, they would stay as squamous cells.
 
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This is explained in the adaptation chapters of Robbins and Rubin..I suspect you weren't paying attention during those lectures....it is supremely basic pathophysiology.


I agree its simply path - but I doubt anyone reads robbins. can't blame him for that.
 
I am an instructor, let me say if you rent reading Robbins you're shooting yourself in the foot when it comes to the boards. At least use it as a reference when you don't understand a concept..
 
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