Serum Serotonin Differentiates Between Disease Activity States in Crohn's Patients. Issue 10 (26th August 2020)

• Record Type: Journal Article
• Authors: Manzella, Christopher R; Jayawardena, Dulari; Pagani, Wilfredo; Li, Ye; Alrefai, Waddah A; Bauer, Jessica; Jung, Barbara; Weber, Christopher R; Gill, Ravinder K
• Is Part Of: Inflammatory bowel diseases. Volume 26:Issue 10(2020)
• Page Start: 1607
• Page End: 1618
• Publication Date: 2020-08-26
• Subjects: serotonin -- 5-hydroxytryptamine -- serotonin transporter -- SERT -- tryptophan -- kynurenine; Inflammatory bowel diseases -- Periodicals; Colitis, Ulcerative -- Periodicals; Crohn Disease -- Periodicals; Inflammatory Bowel Diseases -- Periodicals; 616.344
• DOI: 10.1093/ibd/izaa208
• Languages: English
• ISSNs: 1078-0998

Abstract

Abstract: Background: Diagnosis and monitoring of inflammatory bowel diseases (IBDs) utilize invasive methods including endoscopy and tissue biopsy, with blood tests being less specific for IBDs. Substantial evidence has implicated involvement of the neurohormone serotonin (5-hydroxytryptamine, 5-HT) in the pathophysiology of IBDs. The current study investigated whether serum 5-HT is elevated in patients with active ulcerative colitis (UC) or Crohn's disease (CD). Methods: Serum samples were obtained from a German cohort of 96 CD and UC patients with active disease, refractory disease, or remission of disease based upon their disease activity index (DAI) and disease history. High pressure liquid chromatography with tandemmass spectrometry was used to measure 5-HT, tryptophan (TRP), and kynurenine (KYN) levels in the serum samples, and Luminex Multiplex ELISA was used to measure cytokine levels. Intestinal mucosal biopsies were obtained from a separate cohort of healthy and CD patients, and the immunoreactivity of the serotonin transporter (SERT) was determined. Results: There was no statistically significant difference in TRP or KYN levels between disease categories in either UC or CD. Interestingly, 5-HT levels were significantly elevated in patients with active CD but not active UC when compared with the levels in remission or refractory disease. Serum 5-HT was superior to C-reactive protein and circulating cytokines in differentiating between disease categories in CD. Additionally, SERT immunoreactivity was decreased in the ileum and colon of patients with CD compared to healthy controls. Conclusion: We have shown that the serum 5-HT can differentiate between active disease and refractory disease or remission among CD patients, emphasizing the potential suitability of serum 5-HT as an auxiliary measure in diagnosing active CD. Abstract : Serum serotonin levels discriminate active disease from refractory disease or disease in remission in Crohn's disease but not in ulcerative colitis. C-reactive protein, tryptophan, kynurenine, and cytokines poorly discriminate between disease states. Serotonin transporter immunofluorescence was decreased in Crohn's disease.