Serotonin (5-hydroxytryptamine, 5-HT) is an endogenous autacoid that can modulate activity in visceral sensory nerves. It produces complex physiologic actions within the cardiopulmonary system by interacting with both vascular and airway smooth-muscle 5-HT receptors (51). Although the role of 5-HT in humoral control of airway tone is not known, several interactions between this monoamine and the lung have been described. 5-HT is actively transported by the pulmonary endothelial cells where it is metabolized by monoamine oxidase, perhaps accounting for an affinity site on the outer layer of the mitochondria (112). Radio autographic localization has confirmed that pulmonary endothelial cells are the site of 5-HT uptake (112).
Effects of 5-HT on airways5-HT is believed to have direct, complex indirect, or both actions on smooth muscle and nervous structures (51). The airway responses to 5-HT appear to be a summation of ongoing excitatory and inhibitory signals triggered or modified by this monoamine. A contractile response has been reported in airway muscle preparations from guinea pig, cat, dog, horse, cow, sheep, and calf (1,12,30,44,83,89, 108,117). No response is observed in the trachea and bronchus of rat, rabbit, and pig (27, 29), whereas a relaxation caused by 5-HT can be observed in goat trachea (28). Both in vivo and in vitro airway responses to 5-HT are often not as intense as to histamine or cholinergic agonists, may show tachyphylaxis, and may be partially or completely inhibited by pretreatment with atropine (62).5-HT causes constriction of both central and peripheral airways when given to vagotomized cats (34). However, the net effect of 5-HT infusion depends on the dose infused. Small amounts can induce air expulsion, while larger doses induce air retention because ofthe constriction ofthe large airways. Bronchoconstriction of large airways as well as of peripheral airways was observed in dogs during 5-HT perfusion by mechanical studies (38).The significance of 5-HT as a bronchoconstrictor in man remains to be determined. Experiments with tracheal muscle strips and bronchial spirals have shown that 5-HT causes weak contractions (10% of maximum) (37), although it can cause both constriction and relaxation of bronchioles and bronchi, depending on the concentration used (25,77,82). 5-HT causes relaxation when tone is induced in isolated human bronchial muscle preparations, an effect not blocked by 5-HT antagonists. In contrast, pulmonary vascular preparations always contract in 1