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Altered 5-hydroxytryptamine signaling in patients with constipation- and diarrhea-predominant irritable bowel syndrome.
Gastroenterology. 2006 Jan; 130(1):34-43.G

Abstract

BACKGROUND & AIMS

Evidence suggests that postprandial platelet-depleted plasma 5-hydroxytryptamine (5-HT) concentrations may be abnormal in irritable bowel syndrome (IBS). However, interpretation of the data has been hampered by the variable methodology and rather small numbers used in previous studies. Therefore, the aim of this study was to measure concentrations of platelet-depleted plasma 5-HT and its metabolite 5-HIAA under fasting and fed conditions in a large group of patients with diarrhea-predominant (d-) and constipation-predominant (c-) IBS, compared with controls. The ratio of plasma 5-HIAA:5-HT and platelet stores was also assessed.

METHODS

Twenty-nine c-IBS patients (aged, 19-53 years), 55 d-IBS patients (aged, 19-52 years), and 35 healthy volunteers (aged, 18-46 years) had platelet-depleted plasma 5-HT/5-HIAA concentrations measured using reverse-phase, high-performance liquid chromatography with fluorimetric detection before and after a standard meal.

RESULTS

d-IBS patients had raised platelet-depleted plasma 5-HT concentrations under fasting and fed conditions (P < .05). However, the postprandial relative to fasting concentration was similar to controls. In contrast, c-IBS patients failed to show an increase in platelet-depleted plasma 5-HT concentration with meal ingestion compared with controls (P < .01). c-IBS was associated with decreased 5-HIAA (P < .01) but normal 5-HIAA:5-HT ratio and d-IBS with normal 5-HIAA concentrations but reduced 5-HIAA:5-HT ratio (P < .005). C-IBS but not d-IBS patients had increased platelet 5-HT.

CONCLUSIONS

These results support the concept that d-IBS is characterized by reduced 5-HT reuptake, whereas impaired release may be a feature of c-IBS. These results also provide a rational basis for current pharmacologic approaches involving modulation of different 5-HT receptors in c- and d-IBS.

Authors+Show Affiliations

Neurogastroenterology Unit, Academic Division of Medicine and Surgery, University Hospital of South Manchester, Manchester, United Kingdom.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16401466

Citation

Atkinson, Wendy, et al. "Altered 5-hydroxytryptamine Signaling in Patients With Constipation- and Diarrhea-predominant Irritable Bowel Syndrome." Gastroenterology, vol. 130, no. 1, 2006, pp. 34-43.
Atkinson W, Lockhart S, Whorwell PJ, et al. Altered 5-hydroxytryptamine signaling in patients with constipation- and diarrhea-predominant irritable bowel syndrome. Gastroenterology. 2006;130(1):34-43.
Atkinson, W., Lockhart, S., Whorwell, P. J., Keevil, B., & Houghton, L. A. (2006). Altered 5-hydroxytryptamine signaling in patients with constipation- and diarrhea-predominant irritable bowel syndrome. Gastroenterology, 130(1), 34-43.
Atkinson W, et al. Altered 5-hydroxytryptamine Signaling in Patients With Constipation- and Diarrhea-predominant Irritable Bowel Syndrome. Gastroenterology. 2006;130(1):34-43. PubMed PMID: 16401466.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Altered 5-hydroxytryptamine signaling in patients with constipation- and diarrhea-predominant irritable bowel syndrome. AU - Atkinson,Wendy, AU - Lockhart,Stephen, AU - Whorwell,Peter J, AU - Keevil,Brian, AU - Houghton,Lesley A, PY - 2005/04/11/received PY - 2005/09/14/accepted PY - 2006/1/13/pubmed PY - 2006/2/8/medline PY - 2006/1/13/entrez SP - 34 EP - 43 JF - Gastroenterology JO - Gastroenterology VL - 130 IS - 1 N2 - BACKGROUND & AIMS: Evidence suggests that postprandial platelet-depleted plasma 5-hydroxytryptamine (5-HT) concentrations may be abnormal in irritable bowel syndrome (IBS). However, interpretation of the data has been hampered by the variable methodology and rather small numbers used in previous studies. Therefore, the aim of this study was to measure concentrations of platelet-depleted plasma 5-HT and its metabolite 5-HIAA under fasting and fed conditions in a large group of patients with diarrhea-predominant (d-) and constipation-predominant (c-) IBS, compared with controls. The ratio of plasma 5-HIAA:5-HT and platelet stores was also assessed. METHODS: Twenty-nine c-IBS patients (aged, 19-53 years), 55 d-IBS patients (aged, 19-52 years), and 35 healthy volunteers (aged, 18-46 years) had platelet-depleted plasma 5-HT/5-HIAA concentrations measured using reverse-phase, high-performance liquid chromatography with fluorimetric detection before and after a standard meal. RESULTS: d-IBS patients had raised platelet-depleted plasma 5-HT concentrations under fasting and fed conditions (P < .05). However, the postprandial relative to fasting concentration was similar to controls. In contrast, c-IBS patients failed to show an increase in platelet-depleted plasma 5-HT concentration with meal ingestion compared with controls (P < .01). c-IBS was associated with decreased 5-HIAA (P < .01) but normal 5-HIAA:5-HT ratio and d-IBS with normal 5-HIAA concentrations but reduced 5-HIAA:5-HT ratio (P < .005). C-IBS but not d-IBS patients had increased platelet 5-HT. CONCLUSIONS: These results support the concept that d-IBS is characterized by reduced 5-HT reuptake, whereas impaired release may be a feature of c-IBS. These results also provide a rational basis for current pharmacologic approaches involving modulation of different 5-HT receptors in c- and d-IBS. SN - 0016-5085 UR - https://www.unboundmedicine.com/medline/citation/16401466/Altered_5_hydroxytryptamine_signaling_in_patients_with_constipation__and_diarrhea_predominant_irritable_bowel_syndrome_ DB - PRIME DP - Unbound Medicine ER -