rs6311

 

Chromosome 13
Position 46897343
Gene HTR2A

CT (GA)

46.546.5%

CC (GG)

32.432.4%

TT (AA)

21.121.1%

Breakdown:

rs6311 is a SNP linked to the HTR2A gene. It is significantly associated with Depression.

Individuals carrying haplotypes with minor allele T (A) experience greater depressive symptoms [Ref].

T (A) allele: 

Children homozygous for the T (A) allele had significantly more severe depression symptoms than those with C/T (GA) or T/T (AA) genotypes (P=0.025).

The T (A) allele was associated with Chronic fatigue syndrome (CFS) [Ref].

T (A) allele was associated with increased risk for irritable bowel syndrome [Ref].

 

C (G) allele:

CC (GG)-homozygotes reported more anger (p=0.004) and aggression-related behavior (p=0.011) [Ref].

C (G) allele was associated with a risk for Rheumatoid arthritis (RA) [Ref].

 

 

Research articles:

[PMID 15364038] may effect promoter activity (in the presence of a SV40 enhancer, promoter activity was significantly higher with the A allele than a G allele, but only in cell lines expressing endogenous HTR2A)

[PMID 18079067] -1438 A allele creates a consensus binding site for Th1/E47, a transcription factor implicated in development of the nervous system

[PMID 19560507] Interaction of serotonin-related genes affects short-term antidepressant response in major depressive disorder

[PMID 19590397] 5-HTR1A, 5-HTR2A, 5-HTR6, TPH1 and TPH2 polymorphisms and major depression

[PMID 19690620] Polymorphisms of serotonin receptor 2A and 2C genes and COMT in relation to obesity and type 2 diabetes

[PMID 19647026] Analysis of serotonin receptor 2A gene (HTR2A): association study with autism spectrum disorder in the Indian population and investigation of the gene expression in peripheral blood leukocytes

[PMID 20198576] Association between the -1438A/G polymorphism of the serotonin 2A receptor gene and late-onset psoriasis in a Thai population

[PMID 17440930] Polymorphisms in the serotonin receptor gene HTR2A are associated with quantitative traits in panic disorder.

[PMID 20589614] No relationship found between -1438A/G polymorphism of the serotonin 2A receptor gene (rs6311) and major depression susceptibility in a northeastern Thai population

[PMID 20827275] Influence of HTR2A polymorphisms and parental rearing on personality traits in healthy Japanese subjects

[PMID 20941551] Functional Genomics of Serotonin Receptor 2A (HTR2A): Interaction of Polymorphism, Methylation, Expression and Disease Association

[PMID 22046326] ‘Smoking Genes’: A Genetic Association Study

[PMID 16642436] Variation in the gene encoding the serotonin 2A receptor is associated with outcome of antidepressant treatment.

[PMID 16876316] Association study of sporadic Parkinson’s disease genetic risk factors in patients from Russia by APEX technology.

[PMID 17241828] Association studies of serotonin system candidate genes in early-onset obsessive-compulsive disorder.

[PMID 17590256] 5-HT2A SNPs and the Temperament and Character Inventory.

[PMID 18081710] Multivariate permutation analysis associates multiple polymorphisms with subphenotypes of major depression.

[PMID 18191318] Association study between obsessive-compulsive disorder and serotonergic candidate genes.

[PMID 18196244] Polymorphisms of the serotonin-2A receptor and catechol-O-methyltransferase genes: a study on fibromyalgia susceptibility.

[PMID 18439448] Stress, genes and the biology of suicidal behavior.

[PMID 18797395] Association between the A-1438G polymorphism of the serotonin 2A receptor gene and nonimpulsive suicide attempts.

[PMID 18826444] Serotonergic genes and amygdala activity in response to negative affective facial stimuli in Korean women.

[PMID 19328219] Differential role of serotonergic polymorphisms in alcohol and heroin dependence.

[PMID 19359258] Cohort profile: risk patterns and processes for psychopathology emerging during adolescence: the ROOTS project.

[PMID 19545856] Sensorimotor gating depends on polymorphisms of the serotonin-2A receptor and catechol-O-methyltransferase, but not on neuregulin-1 Arg38Gln genotype: a replication study.

[PMID 19911060] Persistence criteria for susceptibility genes for schizophrenia: a discussion from an evolutionary viewpoint.

[PMID 19937159] HTR2A is associated with SSRI response in major depressive disorder in a Japanese cohort.

[PMID 20008943] Association of FKBP5 polymorphisms with suicidal events in the Treatment of Resistant Depression in Adolescents (TORDIA) study.

[PMID 20191112] The Genetics of Anorexia Nervosa: Current Findings and Future Perspectives.

[PMID 20421848] Interactions between functional serotonergic polymorphisms and demographic factors influence personality traits in healthy Spanish Caucasians.

[PMID 20580209] Seasonality and winter-type seasonal depression are associated with the rs731779 polymorphism of the serotonin-2A receptor gene.

[PMID 21136126] Temperament profiles, 5-HT2A genotype, and response to treatment with SSRIs in major depression.

[PMID 21162693] Pharmacogenetics and antipsychotics: therapeutic efficacy and side effects prediction.

[PMID 21172166] Pharmacogenetics of antidepressant response.

[PMID 21741447] Interaction between two HTR2A polymorphisms and gender is associated with treatment response in MDD.

[PMID 21874579] Pilot study on HTR2A promoter polymorphism, -1438G/A (rs6311) and a nearby copy number variation showed association with onset and severity in early onset obsessive-compulsive disorder.

[PMID 23221997] TPH1, MAOA, serotonin receptor 2A and 2C genes in citalopram response: possible effect in melancholic and psychotic depression

[PMID 23872233] The relationship between the presence of ADHD and certain candidate gene polymorphisms in a Turkish sample

[PMID 23857836] Association between 5HT2A polymorphism and selective serotonin re-uptake inhibitor (SSRI)-induced sexual desire disorder (SDD) among Malaysian women

[PMID 23318131] Association of serotonin-1A and -2A receptor promoter polymorphisms with depressive symptoms, functional recovery, and pain in patients 6 months after lumbar disc surgery

[PMID 22717018] Escitalopram reduces attentional performance in anxious older adults with high-expression genetic variants at serotonin 2A and 1B receptors

[PMID 24355137] The association of 5-HTR2A-1438A/G, COMTVal158Met, MAOA-LPR, DATVNTR and 5-HTTVNTR gene polymorphisms and borderline personality disorder in female heroin-dependent Chinese subjects

[PMID 23547754] Genetics of serotonin receptors and depression: state of the art.

[PMID 23733030] Pharmacogenetics in major depression: a comprehensive meta-analysis.

[PMID 24968012] Serotonin 2A Receptor Gene (HTR2A) Regulatory Variants: Possible Association with Severity of Depression Symptoms in Children with Autism Spectrum Disorder

[PMID 25174699] Serotonin Receptor Gene (5HT-2A) Polymorphism is Associated with Provoked Vestibulodynia and Comorbid Symptoms of Pain

[PMID 25069264] [Haplotype analysis of serotonin 2A receptor gene polymorphisms and smoking behavior] [PMID 25758572] 5-Hydroxytryptamine (serotonin) 2A receptor gene polymorphism is associated with schizophrenia

[PMID 24021217] Common selective serotonin reuptake inhibitor side effects in older adults associated with genetic polymorphisms in the serotonin transporter and receptors: data from a randomized controlled trial

[PMID 26051731] Association study between 5-HT2A and NET gene polymorphisms and recurrent major depression disorder in Chinese han population

[PMID 29120849] Genetic analysis of impulsive personality traits: Examination of a priori candidates and genome-wide variation.

 

EXPRESSION CONTROL

Clinical Tips

 

Activation of 5HT2A receptors is on the whole bad.  The more receptors we have, the more likely they’ll activate, so it’s better to have fewer receptors. 5HT2A receptors are commonly found in platelets, the heart, joints, immune cells (monocytes), the vagus nerve (R) and brain (hypothalamus, brain stem, prefrontal) (R).

Activation of 5HT2A receptors can contribute to many problems, including anxiety, depression, fatigue, OCD, sleep problems, etc. However, some good effects include lowered heart rate and blood pressure and reduced inflammatory effects.

Negative effects:

Activation of 5HT2A receptors contributes to:

  • Anxiety and neuroticism.  In particular, it increases glutamate release and neuronal excitation (R).
  • Increased TGF-beta (R) – this effect is reversed by NAC and lipoic acid (R).
  • Decreased glutathione (R)
  • Reduced BDNF. When activated, these receptors decrease BDNF production (R).  This is the mechanism by which psychological stress reduces BDNF(R).
  • Increased arachidonic acid, which can be inflammatory (R).
  • Suicide and depression. Suicidal and otherwise depressed patients have had more 5-HT2A receptors than normal patients (R). Blocking these receptors is a mechanism of antipsychotics and can help depression (R). This receptor may to some extent account for the difference in the outcome of anti-depressant/SSRI treatment (minor alleles generally more likely to benefit) (R). 5HT2A receptors are in high concentration in the default mode network [DMN], which is overactive in depression (R).  This brain network is implicated in self-related thinking and mind wandering.
  • Chronic Fatigue Syndrome. One study has linked abnormal 5-HT2A polymorphisms which may enhance receptor activity with Chronic Fatigue Syndrome (R).  It’s possible that by activating the 5HT2A receptors, fatigue occurs because orexin neurons are shut off.  Antipsychotics that block 5HT2A receptors were found to activate orexin neurons (R).
  • Insomnia and sleep problems (R).
  • IBS. People with genes who produced more 5HT2A receptors were more likely to have IBS (T allele for ) (R).  When I took LSD (strong 5HT2A activator), it caused serious GI issues, which fits with this.
  • Decreases Slow Wave Sleep (along with 5HT6….. 5-HT1A, 5-HT1B, and 5-HT7 MAOA and serotonin transporters have been implicated in the control of REM sleep) (R).
  • OCD. Higher numbers of 5HT2A receptors in the caudate nuclei are associated with OCD (R). Blocking the 5-HT2 receptor has been shown to enhance therapeutic responses to SSRIs in patients with major depression and treatment-refractory obsessive“compulsive disorder (OCD) (R).
  • Pain. These receptors are found in the spinal cord regions that control pain (R). Activation of 5-HT2A receptors potentiates pain produced by inflammatory mediators (R).
  • Autism. These blockers may also be effective in ameliorating some symptoms associated with autism and other pervasive developmental disorders (R).  Autistic people have more 5HT2A receptors (in platelets) (R).
  • Tourette’s (R) and head twitch response (R).
  • Increased prolactin, cortisol and renin (activation of the 5-HT2A in the hypothalamus) (R).
  • Decreased blood flow to the heart (R), skin (R) and other places.  5HT2A causes your blood vessels to narrow (vasoconstriction of smooth muscle cells) (R). Decreased blood flow can contribute to people feeling colder.
  • Increased platelet clumping (R), which can worsen blood flow and cause heart disease.

Benefits

Activators of 5HT2A (R):

  • Lower heart rate and lower blood pressure (mediated by the vagus nerve) (R, R2).
  • Reduce inflammatory effects in several tissues including the heart and gut (especially against TNF-induced inflammation).
  • Enhance dopamine in the areas responsible for a higher level of thinking (PFC), which enhances memory and plays a role in attention and learning.
  • Reduce pressure in the eye,
  • Increase oxytocin and ACTH (activation of the 5-HT2A in the hypothalamus).

The lower heart rate and blood pressure are produced via the inhibition of Rostral Ventrolateral Medulla (RVLM) in the brainstem, which controls the baroreflex (R).

The baroreflex controls blood pressure and people with chronic fatigue often have low blood pressure.  These effects could, in part, be mediated by the 5HT2A receptors. Other effects could be as a result of lower orexin activation, as orexin neurons from the hypothalamus stimulate the RVLM (R).

The RVLM is the primary regulator of the fight or flight nervous system, sending excitatory signals to the sympathetic preganglionic neurons in the spinal cord, via reticulospinal tract (R).

In animals, the 5-HT2A receptors increase body heat by causing vasoconstriction in skin (mediated by brainstem) (R).

A haplotype consisting of 4 SNPs in the HTR2A gene has been associated with risk for rheumatoid arthritis [PMID 18006541]; the 4 SNPs being:

  • rs6311
  • rs6313
  • rs1328674
  • rs6314

A SNP in the HTR2A gene, rs7997012 and another gene (GRIK4) may also influence the odds of success upon treatment with the antidepressant citalopram, potentially differently in patients of different ethnic backgrounds.[PMID 17671280]

Activation of 5HT2A receptors can contribute to many problems, including anxiety, depression, fatigue, OCD, sleep problems, etc. However, some good effects include lowered heart rate and blood pressure and reduced inflammatory effects.

  • Inositol – reduces 5HT2A receptor function (R),
  • Meditation,
  • Zinc (R),
  • Feverfew (R)
  • Ginkgo (R)

Inositol and fluoxetine reduce 5HT2A receptor function at the receptor-G protein level.  In addition mI, and at high concentrations fluoxetine and imipramine, also reduces muscarinic acetylcholine receptors (R).

5HT2A receptors are in high concentration in the default mode network [DMN], which is overactive in depression (R).  

This brain network is implicated in self-related thinking and mind wandering. Meditation leads to a reduced activity in the default mode network (R), which can help some of the negative effects of the 5HT2A receptors on depression.

The negative effects of the 5HT2A receptors seem to work through activating GSK3 (R) and stimulating calcium release inside cells. Therefore, GSK3 inhibitors such as lithium might help.  

Magnesium can help with calcium release. 5-HT2A has sialic acid in it, which is bound to by lectins.  Lectins probably modify the receptor in some negative way in people who are susceptible.

  • SSRIs,
  • Sialic Acid?
  • MDMA (R) -in recent MDMA users, post-synaptic 5-HT(2A) receptor densities were significantly lower in all cortical areas studied,

Lithium inhibits GSK3b (R), which can help regulate this gene, but it also decreases brain inositol (R). Some studies show St Johns Wort decreases 5HT2A receptors (R).

Other studies report a 50-percent increase in 5-HT2A receptors after six months of use of St. Johns Wort so it looks like to benefit is limited in time.(R).  

 

Decrease activity ↓
  • Olanzapine (R)
  • Sarpogrelate (R R)
  • Aripiprazole (R)
  • N,N-Dimethyltryptamine (R)
  • Paliperidone Palmitate (R)
  • Ritanserin (R)
  • Tryptamine (R)
  • Ziprasidone (R)
  • Cyproheptadine (R)
  • Spiperone (R)
  • Norclozapine (R)
  • Lithium Chloride
  • (+)-JQ1 compound (R)
  • Perphenazine GABA ester (R)
  • Quetiapine Fumarate (R)

 

Increase activity
  • Risperidone (R)
  • Progesterone (R)
  • Palmitic Acid (R)

Non human studies:

  • Dopamine (R) ,(R), (R)
  • Calcium (R) , (R) , (R)
  • Cypermethrin (R) , (R)
  • Estradiol 3-benzoate (R)
  • Chlorpyrifos (R)
  • Zalcitabine (R)
  • Diazinon (R)
  • Freund’s Adjuvant (R)
  • Nanotubes, Carbon (R)
  • Nitrofen (R)
  • Ozone (R)
  • Nicotine (R)
  • Dietary Fats (R)
  • Yohimbine (R)
  • Dexamethasone (R)
  • PCB 180 (R)
  • Propylthiouracil (R)

 

Can work both ways

Non human studies:

  • Ketanserin (R)
  • Corticosterone  (R)
  • Tramadol  (R)
  • Phencyclidine  (R)
  • Tobacco Smoke Pollution (R)
  • Pertussis Toxin (R)
  • Iodopravadoline (R)
  • Colforsin  (R)
  • Streptozocin  (R)