Crosstalk of vascular 5-HT1 receptors with other receptors: Clinical implications

Blood vessels may either constrict or dilate in response to 5-HT, the response being dependent on the species, the vascular bed studied and the condition (healthy or diseased) of the subject studied. Vasoconstriction may be mediated by 5-HT2A, but, in a variable proportion, also by 5-HT1B receptors. The expression and function of 5-HT1B receptors is likely to be increased in disease states such as hypertension, cerebrovascular disease and variant angina pectoris. Contractile responses mediated by 5-HT1B receptors may be increased in blood vessels with damaged endothelium, but may also be augmented in the presence of low concentrations of other vasoconstrictors such as thromboxane A2, endothelin-1, prostaglandin F2α, angiotensin II, histamine, noradrenaline, phenylephrine or KCl. Such an augmentation, however, is not a generalized phenomenon, since it does not occur in all vascular beds and is not always induced by all substances mentioned above. Whereas the augmentation seems to depend on increased levels of the second messengers involved, the exact mechanism is not yet completely clear. The augmentation of 5-HT1B receptor-mediated contractions may be of relevance in pathophysiological conditions such as variant angina and preeclampsia, where the development of 5-HT1B receptors seems to be expedited. Further, augmentation of 5-HT1B receptor-mediated contractions may be an important determinant in the case of chest symptoms experienced as a side effect of antimigraine drugs.