Increased presence of serotonin-producing cells in colons with diverticular disease may indicate involvement in the pathophysiology of the condition

Abstract

Increased presence of SCs and the higher proportion of high and moderate staining cells (indicating increased hormone content) indicate the possible role of serotonin in DD. This may be contributing to the pathogenesis of the condition by altered colonic motility in the affected segments in a similar way as in irritable bowel syndrome.

Review article: the current and evolving treatment of colonic diverticular disease

“…Indeed, an increased presence of serotonin-producing cells has been identified in resected colonic specimens with diverticulitis. 107 It remains unknown if this is a causative association; however, another study has identified increased serotonin expression in symptomatic patients with diverticula. 108 A third group has attempted to implicate hypersensitivity to acetylcholine, caused by decreased activity of choline acetyltransferase.…”

Colonic Diverticular Disease: Abnormalities of Neuromuscular Function

“…For instance, the decreased action of non-adrenergic non-cholinergic inhibitory nerves and other agents such as nitric oxide might determine high intraluminal pressure caused by colonic hypersegmentation, as observed in both the left- and right-sided colon with diverticula [46,47], whereas the increase of vasoactive intestinal polypeptide (that has an inhibitory action on peristalsis [48]) might initiate or contribute to the motility changes observed in CDD [49]. In addition, by focusing on the relationship between low-grade mucosal inflammation and enteric neurosignaling, it is now evident that the mucosal neurotransmitters may play some important role in the motility disturbance of these patients [50], as shown by the higher number of serotonin-containing cells found in CDD [51], the significant attenuation of serotonin transporter expression and function (likely secondary to previous inflammation) in patients with recent history of acute diverticulitis [52], and the increase in colonic mucosal neuropeptides in symptomatic patients, which may reflect resolved previous inflammation [53]. …”

Plasma serotonin level in left-sided colonic diverticulosis: A pilot study

“…We measured serum level of the hormone, which represents circulating serotonin together with its platelet-stored pool. Since increased serotonin release suggested by Barenjee et al [6] as well as its hindered reuptake suggested by Costedio et al [7] ought rater result in increased plasma concentrations, significantly lower serotonin levels in the sera of symptomatic diverticulosis patients might imply decreased platelet pool of the hormone. Platelets, similarly to enterocytes, utilize SERT for the hormone uptake.…”

“…Barenjee et al [6] examined paired samples of the bowel, with and without diverticula, and demonstrated higher content of serotonin expressing cells as well as higher serotonin content in the latter. These authors suggested that increased hormone release may contribute to diverticulosis pathogenesis by altering colonic motility.…”

“…Serotonin (5-hydroksytryptamine, 5-HT) is a signaling molecule targeting enterocytes, smooth muscles and enteric neurons, the impaired signaling of which has been implicated in the pathogenesis of irritable bowel syndrome (IBS) [5]. However, studies concerning the role of serotonin in diverticular disease are limited to two conflicting papers [6,7], while the issue of blood serotonin levels has not been addressed yet. Our objective was to evaluate serotonin serum levels in a fasting and a fed state in patients with uncomplicated, symptomatic, left-sided diverticulosis as compared to healthy subjects.…”