Background: Enterochromaffin cells (EC) synthesize and release 5-HT and ATP to trigger or modulate gut neural reflexes and transmit information about visceral/pain sensation. Alterations in 5-HT signaling mechanisms may contribute to the pathogenesis of IBD or IBS, but the pharmacologic or molecular mechanisms modulating Ca2+-dependent 5-HT release are not understood. Previous studies indicated that purinergic signaling via ATP and ADP is an important mechanism in modulation of 5-HT release. However, EC cells also respond to UTP and UDP suggesting uridine triphosphate receptor and signaling pathways are involved as well. We tested the hypothesis that UTP is a regulator of 5-HT release in human EC cells. Methods: UTP signaling mechanisms were studied in BON cells, a human EC model, using Fluo-4/Ca(2+)imaging, patch-clamp, pharmacological analysis, immunohistochemistry, western blots and qPCR. 5-HT release was monitored in BON or EC isolated from human gut surgical specimens (hEC). Results: UTP, UTP gamma S, UDP or ATP induced Ca(2+)oscillations in BON. UTP evoked a biphasic concentration-dependent Ca(2+)response. Cells responded in the order of UTP, ATP > UTP gamma S > UDP >> MRS2768, BzATP, alpha,beta-MeATP > MRS2365, MRS2690, and NF546. Different proportions of cells activated by UTP and ATP also responded to UTP gamma S (P2Y(4), 50% cells), UDP (P2Y(6), 30%), UTP gamma S and UDP (14%) or MRS2768 (<3%). UTP Ca(2+)responses were blocked with inhibitors of PLC, IP3R, SERCA Ca(2+)pump, La(3+)sensitive Ca(2+)channels or chelation of intracellular free Ca2+ by BAPTA/AM. Inhibitors of L-type, TRPC, ryanodine-Ca(2+)pools, PI3-Kinase, PKC or SRC-Kinase had no effect. UTP stimulated voltage-sensitive Ca(2+)currents (I-Ca), V-m-depolarization and inhibited I-K (not I-A) currents. An I(Kv)7.2/7.3 K+ channel blocker XE-991 mimicked UTP-induced V-m-depolarization and blocked UTP-responses. XE-991 blocked I-K and UTP caused further reduction. La3+ or PLC inhibitors blocked UTP depolarization; PKC inhibitors, thapsigargin or zero Ca(2+)buffer did not. UTP stimulated 5-HT release in hEC expressing TPH1, 5-HT, P2Y(4)/P2Y(6)R. Zero-Ca(2+)buffer augmented Ca(2+)responses and 5-HT release. Conclusion: UTP activates a predominant P2Y(4)R pathway to trigger Ca(2+)oscillations via internal Ca(2+)mobilization through a PLC/IP3/IP3R/SERCA Ca(2+)signaling pathway to stimulate 5-HT release; Ca(2+)influx is inhibitory. UTP-induced Vm-depolarization depends on PLC signaling and an unidentified K channel (which appears independent of Ca(2+)oscillations or Ica/VOCC). UTP-gated signaling pathways triggered by activation of P2Y(4)R stimulate 5-HT release.