Wells R W, Blennerhassett M G
Gastrointestinal Diseases Research Unit, Queen's University, Hotel Dieu Hospital, Kingston, Ontario K7L 5G2, Canada.
Gut. 2005 Dec;54(12):1699-706. doi: 10.1136/gut.2005.066563. Epub 2005 Jul 13.
The altered motility of the inflamed intestine derives in part from changes to the contractility of the intestinal smooth muscle cell. While modifications to the muscarinic receptor system are identified, changes to 5-hydroxytryptamine (5-HT; serotonin) receptors that also mediate contraction are less well studied.
In the trinitrobenzene sulphonic acid model of rat colitis, we used receptor antagonists to identify changes in receptor utilisation that accompany the selective reversal of the impaired contractile response to acetylcholine (ACh) and 5-HT during colitis (day 4 (D4)) and following resolution of inflammation (day 36 (D36)).
In isolated circular smooth muscle cells, challenged with ACh, the muscarinic 3 receptor (M3R) antagonists 4-DAMP and pF-HSD each showed a 50% decrease in antagonism on D4 while the M2R antagonist methoctramine more than doubled its potency, showing a decreased role of M3R and an increased role of M2R, respectively. These changes were fully reversed by D36. In contrast, the 5-HT2 receptor (5-HT2R) antagonist ketanserin was sharply decreased in effectiveness on D4, with a further decrease by D36, when the contribution of 5-HT(2A)R was only 22% of control. There were no changes in response to the 5-HT4R antagonist SDZ-205-557 at any time. Western blotting identified decreased expression of 5-HT(2A)R on D36 versus controls, further supporting the conclusion that the persistence of the impaired response to 5-HT was due to decreased expression of the excitatory 5-HT(2A)R.
Thus the lasting decrease in receptor expression and resulting impairment of the contractile response will compromise the capacity for an appropriate response to 5-HT, which may contribute to the intestinal dysfunction seen in post-enteritis syndromes.
炎症肠道的运动改变部分源于肠道平滑肌细胞收缩性的变化。虽然已确定毒蕈碱受体系统发生了改变,但对同样介导收缩的5-羟色胺(5-HT;血清素)受体的变化研究较少。
在大鼠结肠炎的三硝基苯磺酸模型中,我们使用受体拮抗剂来确定在结肠炎期间(第4天(D4))以及炎症消退后(第36天(D36)),伴随着对乙酰胆碱(ACh)和5-HT受损收缩反应的选择性逆转,受体利用情况的变化。
在分离的环形平滑肌细胞中,用ACh刺激时,毒蕈碱3受体(M3R)拮抗剂4-DAMP和pF-HSD在D4时的拮抗作用均降低了50%,而M2R拮抗剂美索曲明的效力增加了一倍多,分别显示M3R的作用降低和M2R的作用增加。这些变化在D36时完全逆转。相比之下,5-HT2受体(5-HT2R)拮抗剂酮色林在D4时的有效性急剧下降,到D36时进一步下降,此时5-HT(2A)R的贡献仅为对照的22%。在任何时候,对5-HT4R拮抗剂SDZ-205-557的反应均无变化。蛋白质印迹法显示,与对照相比,D36时5-HT(2A)R的表达降低,进一步支持了对5-HT反应受损持续存在是由于兴奋性5-HT(2A)R表达降低这一结论。
因此,受体表达的持续下降以及由此导致的收缩反应受损将损害对5-HT作出适当反应的能力,这可能导致肠炎后综合征中出现的肠道功能障碍。