Skip to main content

Hyperserotonemia in Autism: 5HT-Regulating Proteins

  • Reference work entry
Comprehensive Guide to Autism

Abstract

Serotonin (5-hydroxytryptamine, 5HT) is a biologically active molecule with many physiological functions in the mammalian organism. 5HT is present both in the brain (central 5HT compartment) and peripheral tissues (peripheral 5HT compartment), in which its synthesis, degradation, and action are regulated by specific enzymes, transporters, and receptors called 5HT-regulating proteins.

Several lines of evidence indicate the involvement of serotonin in the development of autism. First, serotonin regulates many essential functions which are often disturbed in autistic subjects. Second, brain imaging studies have suggested alterations of 5HT synthesis in the brains of autistic children. Third, drugs targeting 5HT-regulating elements efficiently alleviate certain autistic symptoms. Fourth, autism is considered a neurodevelopmental disorder and serotonin has an important role in brain development. Finally, elevated 5HT levels in blood, called hyperserotonemia, have been consistently found in about 30 % of patients.

The mechanisms that lead to increased blood 5HT concentrations, the relationship between high blood 5HT levels and 5HT dysfunction in the central nervous system, and the role of hyperserotonemia in the development of autism are still not understood, but they seem to involve alterations in 5HT-regulating proteins. According to one theory, alterations in peripheral 5HT-regulating proteins can lead to increased 5HT concentrations in the peripheral compartment. During brain development, these high 5HT levels present in blood could reach the central 5HT compartment, inhibit development of 5HT neurons, and lead to the anatomical and functional alterations of the brain, characteristic for autism. According to another theory, alterations in the 5HT elements occur simultaneously in both compartments; those in the central compartment affect early brain development resulting in autistic behavioral symptoms, while those in the peripheral compartment are reflected as hyperserotonemia.

Most research on the dysregulation of the 5HT system in hyperserotonemia and autism has focused on the peripheral 5HT-regulating proteins which influence the level of 5HT synthesis in the intestine, 5HT release from the intestine into blood plasma, 5HT uptake from blood plasma into platelets, 5HT release from platelets, and 5HT degradation in liver and lungs. The research conducted so far indicates increased 5HT metabolism (i.e., synthesis and degradation), increased accumulation (uptake) of 5HT into platelets, and decreased functionality of 5HT receptors (5HT2A) present on the platelet membrane. Fewer studies have been conducted on the central 5HT-regulating proteins, yet they indicate alterations in the central compartment as well. Central 5HT disturbances, although obvious, are far less clear and may involve malfunction of 5HT as both a developmental factor and neurotransmitter.

Further research on large, uniform, and diagnostically clearly defined samples should facilitate the identification of the biochemical correlates of autism, including the role of 5HT-regulating proteins.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 1,199.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 1,299.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Abramson RK, Wright HH, Carpenter R, et al. Elevated blood serotonin in autistic probands and their first-degree relatives. J Autism Dev Disord. 1989;19:397–407.

    Article  PubMed  Google Scholar 

  • Anderson GM. Monoamines in autism: an update of neurochemical research on a pervasive developmental disorder. Med Biol. 1987;65:67–74.

    PubMed  Google Scholar 

  • Anderson GM, Minderaa RB, van Benthem PP, et al. Platelet imipramine binding in autistic subjects. Psychiatry Res. 1984;11:133–41.

    Article  PubMed  Google Scholar 

  • Anderson GM, Horne WC, Chatterjee D, et al. The hyperserotonemia of autism. Ann N Y Acad Sci. 1990;600:331.

    Article  PubMed  Google Scholar 

  • Anderson GM, Gutknecht L, Cohen DJ, et al. Serotonin transporter promoter variants in autism: functional effects and relationship to platelet hyperserotonemia. Mol Psychiatry. 2002;7:831–6.

    Article  PubMed  Google Scholar 

  • Berger M, Gray JA, Roth BL. The expanded biology of serotonin. Annu Rev Med. 2009;60:355–66.

    Article  PubMed  Google Scholar 

  • Betancur C, Corbex M, Spielewoy C, et al. Serotonin transporter gene polymorphisms and hyperserotonemia in autistic disorder. Mol Psychiatry. 2002;7:67–71.

    Article  PubMed  Google Scholar 

  • Billett EE. Monoamine oxidase (MAO) in human peripheral tissues. Neurotoxicology. 2004;25:139–48.

    Article  PubMed  Google Scholar 

  • Boullin DJ, Bhagavan HN, Coleman M, et al. Platelet monoamine oxidase in children with infantile autism. Med Biol. 1975;53:210–3.

    PubMed  Google Scholar 

  • Brzezinski A. Melatonin in humans. N Engl J Med. 1997;336:186–95.

    Article  PubMed  Google Scholar 

  • Bursztejn C, Ferrari P, Dreux C, et al. Metabolism of serotonin in autism in children. Encéphale. 1988;14:413–9.

    PubMed  Google Scholar 

  • Campbell M, Friedman E, DeVito E. Blood serotonin in psychotic and brain damaged children. J Autism Child Schizophr. 1974;4:33–41.

    Article  PubMed  Google Scholar 

  • Chen K, Wu HF, Shih JC. The deduced amino acid sequences of human platelet and frontal cortex monoamine oxidase B are identical. J Neurochem. 1993;61:187–90.

    Article  PubMed  Google Scholar 

  • Chugani DC. Serotonin in autism and pediatric epilepsies. Ment Retard Dev Disabil Res. 2004;10:112–6.

    Article  Google Scholar 

  • Cohen DJ, Young JG. Platelet monoamine oxidase in early childhood autism. Arch Gen Psychiatry. 1977;34:534–7.

    Article  PubMed  Google Scholar 

  • Cook EH, Leventhal BL, Heller W, et al. Autistic children and their first-degree relatives: relationships between serotonin and norepinephrine levels and intelligence. J Neuropsychiatry Clin Neurosci. 1990;2:268–74.

    PubMed  Google Scholar 

  • Cook EH, Arora RC, Anderson GM, et al. Platelet serotonin studies in hyperserotonemic relatives of children with autistic disorder. Life Sci. 1993;52:2005–15.

    Article  PubMed  Google Scholar 

  • Cook EH, Fletcher KE, Wainwright M, et al. Primary structure of the human platelet serotonin 5-HT2A receptor: identify with frontal cortex serotonin 5-HT2A receptor. J Neurochem. 1994;63:465–9.

    Article  PubMed  Google Scholar 

  • Cote F, Fligny C, Bayard E, et al. Maternal serotonin is crucial for murine embryonic development. Proc Natl Acad Sci USA. 2007;104:329–34.

    Article  PubMed  Google Scholar 

  • Coutinho AM, Oliveira G, Morgadinho T, et al. Variants of the serotonin transporter gene (SLC6A4) significantly contribute to hyperserotonemia in autism. Mol Psychiatry. 2004;9:264–71.

    Article  PubMed  Google Scholar 

  • Coutinho AM, Sousa I, Martins M, et al. Evidence for epistasis between SLC6A4 and ITGB3 in autism etiology and in the determination of platelet serotonin levels. Hum Genet. 2007;121:243–56.

    Article  PubMed  Google Scholar 

  • Croonenberghs J, Delmeire L, Verkerk R, et al. Peripheral markers of serotonergic and noradrenergic function in post-pubertal, Caucasian males with autistic disorder. Neuropsychopharmacology. 2000;22:275–83.

    Article  PubMed  Google Scholar 

  • Cuccaro ML, Wright HH, Abramson RK, et al. Whole-blood serotonin and cognitive functioning in autistic individuals and their first-degree relatives. J Neuropsychiatry Clin Neurosci. 1993;5:94–101.

    PubMed  Google Scholar 

  • Deutch AY, Roth RH. Pharmacology and biochemistry of synaptic transmission: classic transmitters. In: Byrne JH, Roberts JL, editors. From molecules to networks an introduction to cellular and molecular neuroscience. Burlington: Academic; 2004. p. 245–78.

    Chapter  Google Scholar 

  • Filinger EJ, Garcia-Cotto MA, Vila S. Possible relationship between pervasive developmental disorders and platelet monoamine oxidase activity. Braz J Med Biol Res. 1987;20:161–4.

    PubMed  Google Scholar 

  • Gejman PV, Owen MJ, Sanders AR. Psychiatric genetics. In: Tasman A, Kay J, Lieberman J, editors. Psychiatry. 2nd ed. West Sussex: Wiley; 2003. p. 234–53.

    Google Scholar 

  • Gershon MD. Roles played by 5-hydroxytryptamine in the physiology of the bowel. Aliment Pharmacol Ther. 1999;13:15–30.

    Article  PubMed  Google Scholar 

  • Goldberg J, Anderson GM, Zwaigenbaum L, et al. Cortical serotonin type-2 receptor density in parents of children with autism spectrum disorders. J Autism Dev Disord. 2009;39:97–104.

    Article  PubMed  Google Scholar 

  • Green AR. Neuropharmacology of 5-hydroxytryptamine. Br J Pharmacol. 2006;147:S145–52.

    Article  PubMed  Google Scholar 

  • Hanley HG, Stahl SM, Freedman DX. Hyperserotonemia and amine metabolites in autistic and retarded children. Arch Gen Psychiatry. 1977;34:521–31.

    Article  PubMed  Google Scholar 

  • Happé F, Ronald A, Plomin R. Time to give up on a single explanation for autism. Nat Neurosci. 2006;9:1218–20.

    Article  PubMed  Google Scholar 

  • Hérault J, Petit E, Martineau J, et al. Serotonin and autism: biochemical and molecular biology features. Psychiatry Res. 1996;65:33–43.

    Article  PubMed  Google Scholar 

  • Hoshino Y, Yamamoto T, Kaneko M, et al. Blood serotonin and free tryptophan concentration in autistic children. Neuropsychobiology. 1984;11:22–7.

    Article  PubMed  Google Scholar 

  • Hranilovic D, Bujas-Petkovic Z, Vragovic R, et al. Hyperserotonemia in adults with autistic disorder. J Autism Dev Disord. 2007;37:1934–40.

    Article  PubMed  Google Scholar 

  • Hranilovic D, Novak R, Babic M, et al. Hyperserotonemia in autism: the potential role of 5HT-related gene variants. Coll Antropol. 2008;32:75–80.

    PubMed  Google Scholar 

  • Hranilovic D, Bujas-Petkovic Z, Tomicic M, et al. Hyperserotonemia in autism: activity of 5HT-associated platelet proteins. J Neural Transm. 2009;116:493–501.

    Article  PubMed  Google Scholar 

  • Janusonis S. Serotonergic paradoxes of autism replicated in a simple mathematical model. Med Hypotheses. 2005;64:742–50.

    Article  PubMed  Google Scholar 

  • Janusonis S, Anderson GM, Shifrovich I, et al. Ontogeny of brain and blood serotonin levels in 5-HT receptor knockout mice: potential relevance to the neurobiology of autism. J Neurochem. 2006;99:1019–31.

    Article  PubMed  Google Scholar 

  • Katsui T, Okuda M, Usuda S, et al. Kinetics of 3 H-serotonin uptake by platelets in infantile autism and developmental language disorder (including five pairs of twins). J Autism Dev Disord. 1986;16:69–76.

    Article  PubMed  Google Scholar 

  • Kolevzon A, Newcorn JH, Kryzak L, et al. Relationship between whole blood serotonin and repetitive behaviors in autism. Psychiatry Res. 2010;175:274–6.

    Article  PubMed  Google Scholar 

  • Kuperman S, Beeghly JH, Burns TL, et al. Serotonin relationships of autistic probands and their first-degree relatives. J Am Acad Child Psychiatry. 1985;24:186–90.

    Article  PubMed  Google Scholar 

  • Kuperman S, Beeghly JH, Burns TL, et al. Association of serotonin concentration to behavior and IQ in autistic children. J Autism Dev Disord. 1987;17:133–40.

    Article  PubMed  Google Scholar 

  • Lam KSL, Aman MG, Arnold LE. Neurochemical correlates of autistic disorder: a review of the literature. Res Dev Disabil. 2006;27:254–89.

    Article  PubMed  Google Scholar 

  • Launay JM, Ferrari P, Haimart M. Serotonin metabolism and other biochemical parameters in infantile autism: a controlled study of 22 autistic children. Neuropsychobiology. 1988;20:1–11.

    Article  PubMed  Google Scholar 

  • Leboyer M, Philippe A, Bouvard M, et al. Whole blood serotonin and plasma beta-endorphin in autistic probands and their first-degree relatives. Biol Psychiatry. 1999;45:158–63.

    Article  PubMed  Google Scholar 

  • Lesch KP, Wolozin BL, Murphy DL, et al. Primary structure of the human platelet serotonin uptake site: identity with the brain serotonin transporter. J Neurochem. 1993;60:2319–22.

    Article  PubMed  Google Scholar 

  • Leventhal BL, Cook EH, Morford M, et al. Relationships of whole blood serotonin and plasma norepinephrine within families. J Autism Dev Disord. 1990;20:499–511.

    Article  PubMed  Google Scholar 

  • Makkonen I, Riikonen R, Kokki H, et al. Serotonin and dopamine transporter binding in children with autism determined by SPECT. Dev Med Child Neurol. 2008;50:593–7.

    Article  PubMed  Google Scholar 

  • Marazziti D, Muratori F, Cesari A, et al. Increased density of the platelet serotonin transporter in autism. Pharmacopsychiatry. 2000;33:165–8.

    Article  PubMed  Google Scholar 

  • Martineau J, Barthélémy C, Jouve J, et al. Monoamines (serotonin and catecholamines) and their derivatives in infantile autism: age-related changes and drug effects. Dev Med Child Neurol. 1992;34:593–603.

    Article  PubMed  Google Scholar 

  • McBride PA, Anderson GM, Hertzig ME, et al. Serotonergic responsivity in male young adults with autistic disorder. Results of a pilot study. Arch Gen Psychiatry. 1989;46:213–21.

    Article  PubMed  Google Scholar 

  • McDougle CJ, Naylor ST, Cohen DJ, et al. Effects of tryptophan depletion in drug-free adults with autistic disorder. Arch Gen Psychiatry. 1996;53:993–1000.

    Article  PubMed  Google Scholar 

  • McDougle CJ, Stigler KA, Erickson CA, et al. Pharmacology of autism. Clin Neurosci Res. 2006;6:179–88.

    Article  Google Scholar 

  • Minderaa RB, Anderson GM, Volkmar FR, et al. Urinary 5-hydroxyindoleacetic acid and whole blood serotonin and tryptophan in autistic and normal subjects. Biol Psychiatry. 1987;22:933–40.

    Article  PubMed  Google Scholar 

  • Mulder EJ, Anderson GM, Kema IP, et al. Platelet serotonin levels in pervasive developmental disorders and mental retardation: diagnostic group differences, within-group distribution, and behavioral correlates. J Am Acad Child Adolesc Psychiatry. 2004;43:491–9.

    Article  PubMed  Google Scholar 

  • Mulder EJ, Anderson GM, Kemperman RFJ, et al. Urinary excretion of 5-hydroxyindoleacetic acid, serotonin and 6-sulphatoxymelatonin in normoserotonemic and hyperserotonemic autistic individuals. Neuropsychobiology. 2010;61:27–32.

    Article  PubMed  Google Scholar 

  • Murphy DL, Andrews AM, Wichems CH, et al. Brain serotonin neurotransmission: an overview and update with an emphasis on serotonin subsystem heterogeneity, multiple receptors, interactions with other neurotransmitter systems, and consequent implications for understanding the actions of serotonergic drugs. J Clin Psychiatry. 1998;59:4–12.

    PubMed  Google Scholar 

  • Murphy D, Daly E, Schmitz N, et al. Cortical serotonin 5-HT2A receptor binding and social communication in adults with Asperger’s syndrome: an in vivo SPECT study. Am J Psychiatry. 2006;163:934–6.

    Article  PubMed  Google Scholar 

  • Nakamura K, Sekine Y, Ouchi Y, et al. Brain serotonin and dopamine transporter bindings in adults with high-functioning autism. Arch Gen Psychiatry. 2010;67:59–68.

    Article  PubMed  Google Scholar 

  • Owley T, Leventhal BL, Cook EH. Childhood disorders: the autism spectrum disorders. In: Tasman A, Kay J, Lieberman J, editors. Psychiatry. 2nd ed. West Sussex: Wiley; 2003. p. 757–74.

    Google Scholar 

  • Perry BD, Cook EH, Leventhal BL, et al. Platelet 5-HT2 serotonin receptor binding sites in autistic children and their first-degree relatives. Biol Psychiatry. 1991;30:121–30.

    Article  PubMed  Google Scholar 

  • Persico AM, Pascucci T, Puglisi-Allegra S, et al. Serotonin transporter gene promoter variants do not explain the hyperserotoninemia in autistic children. Mol Psychiatry. 2002;7:795–800.

    Article  PubMed  Google Scholar 

  • Piven J, Gayle J, Chase GA, et al. A family history study of neuropsychiatric disorders in the adult siblings of autistic individuals. J Am Acad Child Adolesc Psychiatry. 1990;29:177–83.

    Article  PubMed  Google Scholar 

  • Puri RN, Colman RW. ADP-induced platelet activation. Crit Rev Biochem Mol Biol. 1997;32:437–502.

    Article  PubMed  Google Scholar 

  • Racke K, Reimann A, Schwörer H, et al. Regulation of 5-HT release from enterochromaffin cells. Behav Brain Res. 1995;73:83–7.

    Article  Google Scholar 

  • Roth JA, Young JG, Cohen DJ. Platelet monoamine oxidase activity in children and adolescents. Life Sci. 1976;18:919–24.

    Article  PubMed  Google Scholar 

  • Rotman A, Caplan R, Szekely GA. Platelet uptake of serotonin in psychotic children. Psychopharmacology. 1980;67:245–8.

    Article  PubMed  Google Scholar 

  • Safai-Kutti S, Denfors I, Kutti J, et al. In vitro platelet function in infantile autism. Folia Haematol Int Mag Klin Morphol Blutforsch. 1988;115:897–901.

    PubMed  Google Scholar 

  • Schain RJ, Freedman DX. Studies on 5-hydroxyindole metabolism in autistic and other mentally retarded children. J Pediatr. 1961;58:315–20.

    Article  PubMed  Google Scholar 

  • Schwörer H, Ramadori G. Autoreceptors can modulate 5-hydroxytryptamine release from porcine and human small intestine in vitro. Naunyn Schmiedeberg’s Arch Pharmacol. 1998;357:548–52.

    Article  Google Scholar 

  • Stolz JF. Uptake and storage of serotonin by platelets. In: Vanhoutte PM, editor. Serotonin and the cardiovascular system. New York: Raven; 1985. p. 38–42.

    Google Scholar 

  • Takahashi S, Kanai H, Miyamoto Y. Monoamine oxidase activity in blood platelets from autistic children. Psychiatry Clin Neurosci. 1977;31:597–603.

    Article  Google Scholar 

  • Walther DJ, Bader M. A unique central tryptophan hydroxylase isoform. Biochem Pharmacol. 2003;66:1673–80.

    Article  PubMed  Google Scholar 

  • Weiss LA, Abney M, Cook EH, et al. Sex-specific genetic architecture of whole blood serotonin levels. Am J Hum Genet. 2005;76:33–41.

    Article  PubMed  Google Scholar 

  • Weizman A, Gonen N, Tyano S, et al. Platelet [3 H] imipramine binding in autism and schizophrenia. Psychopharmacology. 1987;91:101–3.

    Article  PubMed  Google Scholar 

  • Whitaker-Azmitia PM. Serotonin and brain development: role in human developmental diseases. Brain Res Bull. 2001;56:479–85.

    Article  PubMed  Google Scholar 

  • Whitaker-Azmitia PM. Behavioral and cellular consequences of increasing serotonergic activity during brain development: a role in autism? Int J Dev Neurosci. 2005;23:75–83.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Dubravka Hranilovic .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer Science+Business Media New York

About this entry

Cite this entry

Hranilovic, D., Blazevic, S. (2014). Hyperserotonemia in Autism: 5HT-Regulating Proteins. In: Patel, V., Preedy, V., Martin, C. (eds) Comprehensive Guide to Autism. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-4788-7_34

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-4788-7_34

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-4787-0

  • Online ISBN: 978-1-4614-4788-7

  • eBook Packages: Behavioral Science

Publish with us

Policies and ethics