What is the role of endogenous gut serotonin in the control of gastrointestinal motility?

In recent years, there have been dramatic changes in our understanding of the role of endogenous 5-Hydroxytryptamine (5-HT or serotonin) in the control of gastrointestinal (GI) motility. Whilst it is well accepted that there are numerous types of 5-HT receptors expressed on enteric neurons and that exogenous 5-HT potently stimulates GI-motility, understanding the role of endogenous 5-HT in GI-motility has been substantially more difficult to resolve. Recent studies found 5-HT₃ and 5-HT₄ antagonists have the same effects on peristalsis in colon preparations depleted of endogenous 5-HT. Then, recent work revealed that in mice with genetic mutations to prevent the synthesis of endogenous 5-HT from enterochromaffin EC) cells did not block major neurogenic motor patterns in the gut wall and did not reduce GI-transit in conscious animals, raising doubts about early hypotheses that endogenous 5-HT was critical for neurogenic GI-motility patterns. Indeed, functional evidence now suggests that 5-HT₃ and 5-HT4 receptors on enteric nerves display constitutive activity. In summary, recent findings demonstrate that endogenous 5-HT released from the mucosa or enteric neurons is not required for the generation of major neurogenic motor patterns, at least in the large intestine, but that it likely acts as a modulator of contractile frequency. This review will discuss how and why our understanding of endogenous 5-HT has dramatically changed in the past few years.