Serotonin Signaling in Diverticular Disease

Costedio, Meagan; Coates, Matthew; Danielson, Amy; Buttolph, Thomas R.; Blaszyk, Hagen; Mawe, Gary M.; Hyman, Neil

doi:10.1007/s11605-008-0536-5

Cited by 94 publications

(49 citation statements)

References 27 publications

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“…Taken together, our results seem to be consistent with findings of Costedio et al [7]. Increased serotonin release in the gut would likely be reflected by increased circulating levels of the hormone.…”

Section: Discussionsupporting

confidence: 93%

“…These authors suggested that increased hormone release may contribute to diverticulosis pathogenesis by altering colonic motility. On the contrary, Costedio et al [7] did not find any differences in serotonin mucosal content and release between patients with diverticulosis and healthy subjects. In turn, they reported impaired reuptake of the hormone caused by decreased expression of serotonin-selective reuptake transporters (SERT) in the actively inflamed tissue from patients with diverticulitis and a similar tendency in adjacent regions.…”

Section: Discussionmentioning

confidence: 85%

“…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.…”

Section: Discussionmentioning

confidence: 98%

“…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.…”

Section: Introductionmentioning

confidence: 99%

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

2012

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AbstractNeurotransmitters might participate in the development of diverticular disease. We measured fasting and postprandial serotonin levels in colonic diverticulosis patients and healthy volunteers. We demonstrated significantly lower maximal concentrations of serotonin in patients than the controls (respectively 109.8±61.4 and 251.3±44.1 ng/ml, p<0.001) as well as lower serotonin minimal values (respectively 38.4±21.8 and 124.6±41.4 ng/ml, p<0.001) and areas under time-course curves (respectively 288.8±139.8 and 739±167.4 ng/ml, p<0.001); significant difference between alternating pattern and normal bowel habit concerning fasting serotonin level, the hormone response to test meal (p=0.041) as well as minimal serotonin level (p=0.044). Bowel habit was also related to peak serotonin values following a test meal with 38.5 ng/ml in constipation, 139.5 ng/ml in diarrhea, 122.4 ng/ml in alternating pattern and 249 ng/ml in subjects with normal bowel habit (p=0.040) as well as AUC with 120.8 ng/ml in constipation, 416 ng/ml in diarrhea, 298 ng/ml in alternating pattern and 684 ng/ml in subjects with normal bowel habit (p=0.043). We demonstrated substantial differences in fasting serum serotonin levels as well as the hormone response to a test meal between colonic diverticulosis patients and healthy individuals, which seemed to be associated with abnormal bowel habits rather than presence of diverticula.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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

2012

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“…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. 109 Additionally, decreased nitric oxide activity in the longitudinal muscle of diverticular colon could account for decreased relaxation and increased muscle spasm in this condition.…”

Section: Evolution Of Medical Therapy Resulting From New Insights Intmentioning

confidence: 99%

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

Tursi

Papagrigoriadis

2009

Aliment Pharmacol Ther

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Sigmoid Diverticulitis

Morris

Regenbogen

Hardiman

et al. 2014

JAMA

154

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IMPORTANCE Diverticulitis is a common disease. Recent changes in understanding its natural history have substantially modified treatment paradigms.OBJECTIVE To review the etiology and natural history of diverticulitis and recent changes in treatment guidelines. EVIDENCE REVIEWWe searched the MEDLINE and Cochrane databases for English-language articles pertaining to diagnosis and management of diverticulitis published between January 1, 2000, and March 31, 2013. Search terms applied to 4 thematic topics: pathophysiology, natural history, medical management, and indications for surgery. We excluded small case series and articles based on data accrued prior to 2000. We hand searched the bibliographies of included studies, yielding a total of 186 articles for full review. We graded the level of evidence and classified recommendations by size of treatment effect, according to the guidelines from the American Heart Association Task Force on Practice Guidelines.FINDINGS Eighty articles met criteria for analysis. The pathophysiology of diverticulitis is associated with altered gut motility, increased luminal pressure, and a disordered colonic microenvironment. Several studies examined histologic commonalities with inflammatory bowel disease and irritable bowel syndrome but were focused on associative rather than causal pathways. The natural history of uncomplicated diverticulitis is often benign. For example, in a cohort study of 2366 of 3165 patients hospitalized for acute diverticulitis and followed up for 8.9 years, only 13.3% of patients had a recurrence and 3.9%, a second recurrence. In contrast to what was previously thought, the risk of septic peritonitis is reduced and not increased with each recurrence. Patient-reported outcomes studies show 20% to 35% of patients managed nonoperatively progress to chronic abdominal pain compared with 5% to 25% of patients treated operatively. Randomized trials and cohort studies have shown that antibiotics and fiber were not as beneficial as previously thought and that mesalamine might be useful. Surgical therapy for chronic disease is not always warranted. CONCLUSIONS AND RELEVANCERecent studies demonstrate a lesser role for aggressive antibiotic or surgical intervention for chronic or recurrent diverticulitis than was previously thought necessary.

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Serotonin Signaling in Diverticular Disease

Cited by 94 publications

References 27 publications

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

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

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

Sigmoid Diverticulitis

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