5-hydroxytryptamine, as an essential signaling molecule in organisms, triggers multiple signals in the intestine and nervous system and is implicated in a wide range of physiological functions through activating specific 5-HT receptors (
Mawe and Hoffman, 2013). Intestine-derived 5-HT can convey signals from the intestine to intrinsic or extrinsic neurons, modulating intestinal peristalsis and motility, secretion, and the absorption of nutrients through 5-HTR signaling, vasodilatation, and platelet function (
Hu et al., 2023;
Liu et al., 2023). Additionally, 5-HT participates in the regulation of diarrhea by affecting intestinal inflammation. The inhibition of serotonin transporter (
SERT) expression in the intestine is a sign of inflammation induced by an enteric source of 5-HT, which leads to the secretion-enhancing effect promoted by 5-HT in the mucosa and promotes colon inflammation induced by 2,4,6-trinitrobenzenesulfonic acid (TNBS) or the deletion of the anti-inflammatory factor interleukin-10 (IL-10) (
Gershon, 2013). This is due to the lack of SERT, which increases the release of 5-HT from enterochromaffin cells, promoting intestinal inflammation, therefore 5-HT is unmistakably proinflammatory (
Liu et al., 2021). Notably, inflammation can raise the concentration of 5-HT in the serum and gastrointestinal tract wall of piglets, which is further accompanied by diarrhea (
Bulc et al., 2022;
Yang et al., 2022a;
Wang et al., 2023). Trp hydroxylase (TPH), the rate-limiting enzyme in the biosynthesis of 5-HT, contains two isoforms, of which TPH1 is mainly expressed by specialized gut endocrine cells (
Jones et al., 2020). Typically, an elevated 5-HT level is associated with the upregulation of TPH1 in the small intestinal mucosa, implying that TPH1 plays an important role in this physiological process. Thus, inhibiting TPH1 is an attractive strategy to curb inflammation and attenuate diarrhea (
Chojnacki et al., 2021;
Zhai et al., 2023). Previous studies have found that the increasing 5-HT content activates the innate immune system by binding to 5-HTR, eventually bringing adaptive immunity to bear and mediating the full force of inflammation in the bowel (
Faba et al., 2022;
Liu et al., 2023). These subtle changes in immune activation may contribute to the diarrhea caused by 5-HT. Unlike
TPH1,
TPH2 is primarily expressed in neurons of the raphe nuclei of the brain stem and a subset of neurons in the enteric nervous system (
Jones et al., 2020). Interestingly, the deletion of TPH2 seems to increase the severity of inflammation, emphasizing the immune protective effect of neuronal 5-HT. Studies have found that the 5-HT produced by TPH2 can protect the enteric nervous system from the neurotoxic effects of inflammation (
Gershon, 2012). This suggests that 5-HT plays both offence and defense in the intestine, depending on the site of 5-HT synthesis (
Najjar et al., 2023). However, there is no direct evidence to show the mitigating effect of TPH2 on diarrhea, and this area of study should be investigated using more targeted techniques. Although the relationship between endogenous Trp metabolism and diarrhea has not yet been reported, the changes in endogenous Trp metabolites and the corresponding enzymes in the inflammatory responses function as indicators of diarrhea.