| Background:Irritable bowel syndrome (IBS) is a functional GI disorder characterized by abdominal pain and altered bowel habits in the absence of demonstrable organic pathology, classified as constipation predominant IBS (IBS-C), diarrhea predominant IBS (IBS-D) and alter predominant IBS (IBS-A) three subtype by clinical feature. But the causes and the mechanism remain poorly defined. In the past decade, there were a great deal of documents demonstrated that the facts of intestinal altered motility, neuroendocrine, immunity and surroundings played an important role in the mechanism of IBS. The gastrointestinal peptide hormones not only play a role as neurotransmitters and hormones, but also are concerned with the neuroimmunologicalmechanism of IBS. The hormones were divided into two subtypes as excitable and suppressive neurotransmitters, the mostly excitability were acetylcholine (Ach) and substance P (SP), the others were nitric oxide (NO), vasoactive intestinal peptide (VIP), calcitionin gene related peptide (CGRP) and so on. Both of the active substances interacted, influenced each other and cooperated to bring modulated function into full play. SP acted as an excitable neurotansmitter, was to be respected more and more for it's action in the mechanism of IBS. Even so that it's significance was not be confirmed, yet. In view of this we designed our research to study the expression of SP of colon tissue and relationship between the changes and clinical features in the patients with IBS and to find out the role of SP during the process of IBS.Aims:To investigate the change of substance P in the colon tissues and elucidate their possible roles in the pathogenesis of IBS.Materials and methods:44 patients with IBS, in them 32 patients are IBS-D and 12 cases are IBS-C, and 10 controls were acted as an object of study, the biopsies were carried out from the ascending colon and descendingcolon by electrofibrical enteroendoscopy. The samples were stained with SP by stret avidin-biotin complex (SABC) immunohisto-chemistry method and histology respectively, observed under microscopy with net in the lens. The yellow stained pellets were considered as SP positive stain and scored according to the density and intensity of the SP stain.Results:The scores of SP were that IBS-D 6.00 ± 0.68 , IBS-C 5.20 ± 0.58 and controls 2.91 ± 0.88 respectively, the IBSs have remarkable statistical significance matched the controls(p<0.01), the same result was made by IBS-Ds compared with IBS-Cs(p<0.01).The SP positive stain was seen among colon muscle fibers, mucous substratum of colon and circumference of glands. The gland cell contained plentiful of plasm, the exocytosis action is obvious contigeous to the SP.The scores of SP in the patients with mild diarrhea was 5.88 ± 0.64, the severe diarrheas was 6.52 ± 0.60. It was marked statistical significant that two group compared to each other (p<0.01).The scores of SP in the patients with mild abdomen pain was 5.17 ± 0.65, the moderates was 5.99 ± 0.54 and the severe abdomenpains was 6.39 ± 0.56. There was obvious statistical significance between the groups with abdomen pain and the controls, the same as to between the group of mild and the moderate. However, there was no significance between the group of moderate and severity (p>0.05).The SP scores of the male patients with IBS was 5.88 ± 0.44, the female patients was 5.75 ± 0.92. There was no obvious difference between the two groups (p>0.05).Conclusions:1. The level of SP in colon tissue was markedly increased in density and degree of immunostaining compared with those of in the controls.2. The level of SP was increasing along with the degree of diarrhea.3. The SP level was increasing in different ranges which was varied with the degree of abdomen pain aggravated, however, there was no difference among groups of moderate and severe abdomen pain.4. The level of SP had no difference in gender in patients with IBS.Accordingly, SP plays a very important role in the pathogenesis of IBS, is one of mostly causes that induced th...
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