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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 4

Intestinal motility is abnormally slow in SERT Ala56 mice.

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Intestinal motility is abnormally slow in SERT Ala56 mice.
Intestinal mo...
Intestinal motility was abnormally slow in SERT Ala56 mice (n = 30–36/group; 2 trials). (A) Total GI transit time (GIT) measured in vivo. (B) Gastric emptying. (C) Time to eject a bead from the rectum (colonic motility). (D) Small intestinal transit after a bolus injection of 5-HT. (E and F) WT (E) and SERT Ala56 (F) mice. Typical spatiotemporal maps showing CMMCs (arrows) in isolated preparations of colon (n = 3–4 per group). The ordinate represents time, and the abscissa represents oral-to-anal distance. The width of the gut (mm), indicative of contractions, was pseudocolored. (G) CMMC frequency. (H) CMMC velocity. (I) CMMC length of propagation. Student’s unpaired t test was used to compare groups. For the box-and-whisker plot, the boxes represent the first and third quartiles, the whiskers are 95% confidence interval, and the lines within the boxes are median values.

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

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