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AIM: To investigate the expression of serotonin receptor subtypes in the colon of patients with slow transit constipation (STC), and explore its role in the pathogenesis of STC. METHODS: Using Envision immunohistochemical staining, we detected the expression and distribution of 5-HT1A receptor, 5-HT3 receptor and 5-HT4 receptor in the colon of 20 STC patients and 20 controls. IMS computer analysis system was used for semi-quantitative analysis. RESULTS: 5-HT1A receptor was positively scattered in submucosa and muscular layer. The positive score in myenteric plexus had no significant difference between two groups (P = 0.548). 5-HT3 receptor was also positively scattered in submucosa and muscular layer. The positive score in myenteric plexus was significantly lower in STC group than that in the controls (65.2 ± 15.9 vs 94.3 ± 20.1, P < 0.01). 5-HT4 receptor was positively scattered in mucosa, submucosa and muscular layer. In mucosa and myenteric plexus, the positive scores in STC group were significantly lower than those in the controls (57.8 ± 10.9 vs 78.5 ± 12.9, P < 0.01; 77.5 ± 19.9 vs 119.2 ± 26.9, P < 0.01). In STC patients, we didn’t find any correlation between the expression level of 5-HT3 receptor and the remained marks at the 5 day of colonic transit study. However, there was a negative correlation between the expression level of 5-HT4 receptor and the remained marks at the 5 day of colonic transit study (r = -0.782, P < 0.01). CONCLUSION: The expression levels of 5-HT3 and 5-HT4 receptors are decreased in the colon of STC patients, which may contribute to the pathogenesis of STC.

Expression of serotonin receptor subtypes and its significance in the colon of patients with slow transit constipation