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Pathophysiological relevance of serotonin
1Division of Pharmacotherapy, Faculty of Medicine, University of Amsterdam, The Netherlands.
Journal of Cardiovascular Pharmacology
|January 1, 1987
Summary
Serotonin plays a complex role in cardiovascular health, with established pathological links in conditions like carcinoid syndrome and migraine. Its contribution to hypertension is debated, but 5-HT2 receptor blockade may benefit specific patient groups.
Area of Science:
- Cardiovascular Pathophysiology
- Neuropharmacology
- Vascular Biology
Background:
- Serotonin (5-hydroxytryptamine) is widely distributed and interacts with numerous 5-HT receptors, suggesting significant physiological roles.
- While its physiological impact on microcirculation and regional blood flow is modest, serotonin has a clear pathological role in specific conditions.
Purpose of the Study:
- To elucidate the pathophysiological role of serotonin in cardiovascular disease.
- To examine serotonin's involvement in various disorders with associated cardiovascular events.
- To assess the therapeutic potential of targeting serotonergic mechanisms in cardiovascular conditions.
Main Methods:
- Review of existing literature on serotonin's distribution, receptor subtypes, and physiological/pathological roles.
- Analysis of evidence linking serotonin to conditions such as carcinoid syndrome, migraine, peripheral vascular disease, and hypertension.
- Discussion of the potential contribution of central and peripheral serotonergic mechanisms to cardiovascular pathophysiology.
Main Results:
- Serotonin's role is modest in normal microcirculation and regional blood flow but significant in carcinoid syndrome, migraine, and peripheral vascular disease.
- Evidence for serotonin's contribution to Raynaud's phenomenon and other vasospastic disorders is under investigation.
- Peripheral serotonin's role in essential hypertension is unlikely, but it may exacerbate vascular damage in hypertensive patients, especially those with atherosclerosis, via platelet aggregation.
- Central serotonergic mechanisms may contribute to hypertensive disease.
Conclusions:
- Serotonin exhibits a dual role, with established pathological significance in certain vascular disorders and a potential ancillary role in hypertension-related vascular damage.
- Pharmacological blockade of 5-HT2 receptors presents a potential therapeutic strategy for specific patient populations, particularly older individuals with atherosclerosis and hypertension.
- Further research is needed to fully delineate the complex interactions between serotonin and cardiovascular pathophysiology.