Acute CINV is associated with which neurotransmitter?

Acute chemotherapy-induced nausea and vomiting (CINV) is primarily associated with serotonin, specifically 5-HT3 (5-hydroxytryptamine type 3) receptors. During and shortly after chemotherapy, the release of serotonin from the enterochromaffin cells in the gastrointestinal tract is heightened, which in turn stimulates the vagus nerve and activates central pathways that lead to vomiting. Medications that block these 5-HT3 receptors, such as ondansetron, are commonly used to prevent and manage this type of nausea and vomiting.

In contrast, while norepinephrine, dopamine, and histamine play roles in different aspects of the body’s response to various stimuli, they are not the primary neurotransmitters linked to the acute phase of CINV. Norepinephrine is more involved in the body's stress response, dopamine is linked to motion sickness and other forms of nausea, and histamine plays a role in allergies and gastric acid secretion rather than directly influencing acute CINV. Understanding the specific involvement of serotonin allows for targeted prevention and treatment strategies in managing symptoms for patients undergoing chemotherapy.