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Serotonin transporter variant drives preventable gastrointestinal abnormalities in development and function
Kara Gross Margolis, Zhishan Li, Korey Stevanovic, Virginia Saurman, Narek Israelyan, George M. Anderson, Isaac Snyder, Jeremy Veenstra-VanderWeele, Randy D. Blakely, Michael D. Gershon
Kara Gross Margolis, Zhishan Li, Korey Stevanovic, Virginia Saurman, Narek Israelyan, George M. Anderson, Isaac Snyder, Jeremy Veenstra-VanderWeele, Randy D. Blakely, Michael D. Gershon
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Research Article Gastroenterology

Serotonin transporter variant drives preventable gastrointestinal abnormalities in development and function

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Abstract

Autism spectrum disorder (ASD) is an increasingly common behavioral condition that frequently presents with gastrointestinal (GI) disturbances. It is not clear, however, how gut dysfunction relates to core ASD features. Multiple, rare hyperfunctional coding variants of the serotonin (5-HT) transporter (SERT, encoded by SLC6A4) have been identified in ASD. Expression of the most common SERT variant (Ala56) in mice increases 5-HT clearance and causes ASD-like behaviors. Here, we demonstrated that Ala56-expressing mice display GI defects that resemble those seen in mice lacking neuronal 5-HT. These defects included enteric nervous system hypoplasia, slow GI transit, diminished peristaltic reflex activity, and proliferation of crypt epithelial cells. An opposite phenotype was seen in SERT-deficient mice and in progeny of WT dams given the SERT antagonist fluoxetine. The reciprocal phenotypes that resulted from increased or decreased SERT activity support the idea that 5-HT signaling regulates enteric neuronal development and can, when disturbed, cause long-lasting abnormalities of GI function. Administration of a 5-HT4 agonist to Ala56 mice during development prevented Ala56-associated GI perturbations, suggesting that excessive SERT activity leads to inadequate 5-HT4–mediated neurogenesis. We propose that deficient 5-HT signaling during development may contribute to GI and behavioral features of ASD. The consequences of therapies targeting SERT during pregnancy warrant further evaluation.

Authors

Kara Gross Margolis, Zhishan Li, Korey Stevanovic, Virginia Saurman, Narek Israelyan, George M. Anderson, Isaac Snyder, Jeremy Veenstra-VanderWeele, Randy D. Blakely, Michael D. Gershon

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Figure 2

Numbers of total and late-born enteric neurons are greater in SERTKO than in WT mice.

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Numbers of total and late-born enteric neurons are greater in SERTKO tha...
n = 6. (A–D) Submucosal plexus, small intestine: (A) Total neurons. (B) Dopaminergic neurons (TH-immunoreactive). (C) CGRP-immunoreactive neurons. (D) Dopaminergic and CGRP-expressing neurons as a proportion of total neurons. (E–G) Myenteric plexus: (E) Total neurons, small intestine. (F) GABAergic neurons, small intestine. (G) GABAergic neurons as a proportion of total neurons. (H and I) Submucosal ANNA-1–immunoreactive neurons (blue): H shows WT; I shows SERTKO. (J and K) Myenteric ANNA-1–immunoreactive neurons (green; red in background is due to GABA immunoreactivity): J shows WT; K shows SERTKO. (L and M) Submucosal CGRP-immunoreactive neurons (red [arrow]). The blue is due to ANNA-1 immunoreactivity in nerve cell bodies; note that CGRP-immunoreactive cells contain coincident ANNA-1 immunoreactivity. The green fibers are immunostained with Abs to TH. L shows WT; M shows SERTKO. (N and O) Myenteric GABA-immunoreactive neurons (red [arrows]): N shows WT; O shows SERTKO. (P and Q) Submucosal TH-immunoreactive neurons (green [arrows]). The blue is due to ANNA-1 immunoreactivity in nerve cell bodies; note that TH-immunoreactive cells contain coincident ANNA-1 immunoreactivity. The red fibers that are also visible are immunostained with Abs to CGRP. P shows WT; Q shows SERTKO. (R and S) Myenteric plexus doubly immunostained to reveal GABA (red [arrows]) and ANNA-1 (green) immunoreactivities. Note that all GABA-immunoreactive cell bodies, but none of the fiber tracts, display coincident ANNA-1 immunoreactivity. R shows WT; S shows SERTKO. These are the same fields illustrated in N and O, but the merged image is shown to display GABA and ANNA-1 immunoreactivities simultaneously. Scale bars: 50 μm.

Copyright © 2025 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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