Serotonin: a platelet hormone modulating cardiovascular disease
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Serotonin: a platelet hormone modulating cardiovascular disease Marina Rieder1,2 · Nadine Gauchel1,2 · Christoph Bode1,2 · Daniel Duerschmied1,2 Accepted: 30 October 2020 © The Author(s) 2020
Abstract Cardiovascular diseases and depression are significant health burdens and increasing evidence suggests a causal relationship between them. The incidence of depression among patients suffering from cardiovascular disease is markedly elevated, and depression itself is an established cardiovascular risk factor. Serotonin 5-hydroxytryptamin (5-HT), a biogenic amine acting as a neurotransmitter and a peripheral hormone, is involved in the pathogenesis of both, cardiovascular disease and depression. Novel cardiovascular functions of 5-HT have recently been described and will be summarized in this review. 5-HT has a broad spectrum of functions in the cardiovascular system, yet the clinical or experimental data are partly conflicting. There is further research needed to characterize the clinical effects of 5-HT in particular tissues to enable targeted pharmacological therapies. Keywords Serotonin · 5-hydroxytryptamin · Platelets · Cardiovascular disease
Highlights • Depression and cardiovascular diseases are significant
health burdens.
• Serotonin, acting as a neurotransmitter and a biogenic
amine is involved in the pathogenesis of depression and cardiovascular disease. • Novel cardiovascular functions of serotonin have recently been described. • This review focuses on the role of serotonin in atherosclerosis, myocardial infarction, heart failure, thrombosis and arterial hypertension.
Serotonin Serotonin 5-hydroxytryptamin (5-HT) was discovered more than 70 years ago and first described as a vasoconstrictor [1]. Since then, multiple functions of 5-HT emerged, all conducted via signaling through one of the so far 15 known distinct 5-HT receptors [2, 3] or by covalent binding to different effector proteins, named “serotonylation” [4]. In regard of cardiovascular diseases, the receptor subtypes 5-HT1B, 5-HT2A, 5-HT2B, 5-HT4 and 5-HT7 are of particular interest. 5-HT1B, 5-HT2A, 5-HT2B and 5-HT7 are expressed on smooth muscle and endothelial cells of arteries and veins, regulating vascular tone. 5-HT2A is additionally located on platelets and involved in activation and aggregation, and it can also be found on cardiomyocytes and fibroblasts. 5-HT4, expressed in cardiac atria and ventricle conducts positive inotropic and lusitropic effects but may also trigger arrhythmias (reviewed in [5]).
Marina Rieder and Nadine Gauchel have contributed equally. * Nadine Gauchel nadine.gauchel@universitaets‑herzzentrum.de 1
Department of Cardiology and Angiology I, Faculty of Medicine, Heart Center Freiburg University, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany
Department of Medicine III (Interdisciplinary Medical Intensive Care), Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
2
Serotonin synthesis 5-HT is derived from the essential amino acid l-tryptophan [6]. The bi
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