A Novel Antibody Targeting the Second Extracellular Loop of the Serotonin 5-HT2A Receptor Inhibits Platelet Function

Serotonin (5-hydroxytriptamine or 5-HT) is known to be a weak platelet agonist, and is involved in thrombus formation. While 5-HT cannot induce platelet aggregation on its own, when secreted from the alpha granules, it binds to its G-protein Coupled Receptor (GPCR; i.e., 5HT_2AR), thereby acting to amplify platelet functional responses (e.g., aggregation). Thus, 5HT_2AR-mediated responses are more involved in the secondary amplification of platelet aggregation in the growing thrombus. Therefore, even though 5-HT can be seen as a weak inducer of platelet activation, it is an important amplifier of aggregation triggered by agonists such as ADP, collagen, and epinephrine, thereby enhancing thrombogenesis. The 5HT_2AR/5HT_2A signaling pathway is of clinical interest to the scientific and medical communities as it has been implicated in the genesis of several forms of cardiovascular disorders. However, efforts to develop antagonists for 5HT_2AR as therapeutic agents in cardiovascular diseases have thus far failed due to these reagents having deleterious side-effects, and/or to lack of selectivity, amongst other reasons. In light of research efforts that identified that the 5HT_2AR ligand binding domain resides in the second extracellular loop (EL2; amino acids P²⁰⁹-N²³³), we developed an antibody, i.e., referred to as 5HT_2ARAb, against the EL2 region, and characterized its pharmacological activity in the context of platelets. Thus, we utilized platelets from healthy human donors, as well as C57BL/6J mice (10-12 weeks old) to analyze the inhibitory effects of the 5HT_2ARAb on platelet activation in vitro, ex vivo, and on thrombogenesis in vivo as well as on 5HT_2AR ligand binding. Our results indicate that the 5HT_2ARAb inhibits 5-HT-enhanced platelet activation in vitro and ex vivo, but has no apparent effects on that which is agonist-induced. The 5HT_2ARAb was also found to prolong the thrombus occlusion time, and it did so without modulating the tail bleeding time, in mice unlike the P2Y12 antagonist clopidogrel and the 5HT_2AR antagonist ketanserin. Moreover, it was found that the 5HT_2ARAb does so by directly antagonizing the platelet 5HT_2AR. Our findings document that the custom-made 5HT_2ARAb exhibits platelet function blocking activity and protects against thrombogenesis without impairing normal hemostasis.