Department of Colorectal Surgery, Kings College Hospital, London, UK.
Int J Colorectal Dis. 2012 Dec;27(12):1597-605. doi: 10.1007/s00384-012-1515-6. Epub 2012 Jun 29.
Neurotransmitter imbalance is hypothesised as a pathogenetic mechanism in several bowel conditions. We previously reported increased 5-HT in the sigmoid mucosa of colon resected for complicated diverticular disease (DD). We aimed to identify if abnormal 5-HT expression is associated with symptoms of uncomplicated DD.
This was a prospective, comparative study and follow-up survey of symptoms. We examined the differences in 5-HT between DD patients and controls, as well as the presence of bowel symptoms at time of endoscopy and also 2 years later. Sigmoid biopsies were collected at colonoscopy. Immunohistochemical staining for 5-HT cells was performed.
Eighty-seven patients were recruited, 37 (42.5 %) DD and 50 (57.5 %) controls. No patients underwent surgery. There was no significant difference in total mean number of 5-HT-positive cells in DD compared to controls or between patients and controls with abdominal symptoms. Forty-one patients (47.1 %) responded to questionnaires at median 57.8 months from biopsy. Eighteen (43.9 %) were DD and 23(56.1 %) controls. 5-HT counts showed no significant association to symptom persistence.
Although 5-HT expression has previously been found to be increased in complicated DD in whole bowel-resected specimens, the same is not confirmed on colonic mucosal biopsies. This raises the suggestion that 5-HT may be involved in the development of acute complications but may not be involved in the pathogenesis of chronic symptoms.
神经递质失衡被假设为几种肠道疾病的发病机制。我们之前报道过，在因复杂憩室病（DD）而行结肠切除术的乙状结肠黏膜中，5-HT 增加。我们旨在确定异常 5-HT 表达是否与单纯 DD 的症状相关。
这是一项前瞻性、对照研究和症状随访调查。我们比较了 DD 患者和对照组之间的 5-HT 差异，以及内镜检查时和 2 年后的肠道症状存在情况。在结肠镜检查时采集乙状结肠活检。进行 5-HT 细胞的免疫组织化学染色。
共招募了 87 名患者，37 名（42.5%）为 DD，50 名（57.5%）为对照组。没有患者接受手术。DD 患者与对照组之间或有腹部症状的患者与对照组之间的 5-HT 阳性细胞总数没有显著差异。41 名患者（47.1%）在活检后中位数 57.8 个月时对问卷做出了回应。其中 18 名（43.9%）为 DD，23 名（56.1%）为对照组。5-HT 计数与症状持续时间无显著相关性。
尽管先前在全肠切除标本中发现复杂 DD 中 5-HT 表达增加，但在结肠黏膜活检中并未得到证实。这提出了一种可能性，即 5-HT 可能参与急性并发症的发生，但可能不参与慢性症状的发病机制。
