Study On The Changes Of 5-HT And MR In IBS And Correlation With The Disease And Syndrome In TCM

Irritable bowel syndrome (IBS) is one of the chronic functional gastrointestinal disorders. The mechanism of IBS is generally unknown and the conventional therapy couldn't work well. Recently, most people considered IBS was caused by neuroendocrine-immune network imbalance. Serotonin (5-HT) and melatonin (MT) is one of the most important factors in the neuroendocrine-immune network. Recently many researchers have demonstrated that 5-HT played a part in IBS. Some scholars proposed that MT also participated in IBS, and considered there was a reverse feedback regulation balance system between 5-HT and MT in the regulation of gastrointestinal motility. Although there are some distinct advantages in using the methods of traditional Chinese medicine (TCM) treating the patients, there aren't any reports about the distribution characteristic of MT and ( receptor) MR in the mucosal of colon and correlation with the disease and syndrome in TCM.Objective:The expression of 5-HT and MR in colon mucosa from IBS patients and the correlation with the disease and syndrome in TCM were studied in our research.Methods:23 diarrhea-predominant IBS(D-IBS),20 constipation-predominant IBS(C-IBS) (according to Romeâ…¡) and 20 control participated in the protocol. There wasn't age and sex variability within the three groups. 43 patients suffered from IBS filled the investigation table with relative factors, and they would be passed a judgment on symptoms and signs by a uniform standard. According to the table the patients was divided into 21 asthenia syndromes, 14 sthenia syndromes and 8 asthenia and sthenia syndromes. All patients were not found pathology changes in colon mucous membranes through colonoscopy and pathology. To investigate the changes of 5-HT and MR in ileocecal junction (ICJ) and the sigmoid colon of patients, the tissue of biopsies of the ICJ and the sigmoid colon were tested by Streptavidi/Peroxidase(SP) immunohistochemistry. The pathology microscope image analysis system (JEDA801D) was applied for the positive area and the optical density(OD) scale. The data was analysed by SPSS10.0 and Excel 2003.Results:1. 5-HT positive expression 5-HT positive cell diffused distribution in mucous membrane proper and submucous layer. Significant increase of 5-HT positive area and OD scale were found in the ileocecal junction biopsies from IBS patients compared to controls (P<0.01). Simultaneously in the sigmoid colon biopsies from IBS patients, the markedly increased 5-HT positive area and OD scale compared to that of controls (P<0.05). 5-HT positive area and OD scale in the ileocecal junction from IBS patients showed a significant increase(P<0.05) comparing to that in the sigmoid colon from the same group(P<0.01).2.MR positive expression There were more MR in mucous layer than submucous layer. Significant increase of MR positive area and OD scale were found in the ileocecal junction and the sigmoid colon biopsies from D-IBS patients compared to controls (P<0.05) and from controls than C-IBS (P<0.05). MR positive area in the ileocecal junction from IBS patients showed a significant increase comparing to that in the sigmoid colon from the same group(P<0.05), but the difference of OD scale between the ileocecal junction and the sigmoid colon biopsies from the same IBS group was not significant(P>0.05).3.5-HT and MR positive expression in differentiation of symptoms and signs of TCM Significant decrease of MR positive area and OD scale were found in the ileocecal junction and the sigmoid colon biopsies from sthenia syndrome and asthenia and sthenia syndrome patients compared to asthenia syndrome (P<0.05). The difference of MR positive area and OD scale in the ileocecal junction and the sigmoid colon biopsies between sthenia syndrome and asthenia and sthenia syndrome was not significant(P>0.05). The difference of 5-HT positive area and OD scale in the ileocecal junction and the sigmoid colon biopsies among asthenia syndrome, sthenia syndrome and asthenia and sthenia syndrome was not significant(P>0.05).Conclusions:1.The expression of 5-HT is high in IBS. This confirms that 5-HT play a part in IBS in certain ways.2.The expression of MR is high in D-IBS and is low in C-IBS. This demonstrations that MR has some influence to gastrointestinal motility .3.MR expression is high in asthenia syndromes which hint MT is low expression in asthenia syndromes patients. MR may be correlated with the disease and syndrome of TCM. It may be used as a diadynamic criteria of asthenia syndrome.