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(Arteriosclerosis, Thrombosis, and Vascular Biology. 1999;19:762-766.)
© 1999 American Heart Association, Inc.

Original Contributions

Increased Serotonin Receptor Density and Platelet GPIIb/IIIa Activation Among Smokers

Jerome H. Markovitz; Lelland Tolbert; Suzan E. Winders

From the Division of Preventive Medicine, Department of Medicine (J.H.M., S.E.W.), and the Department of Psychiatry, Division of Neuroscience (L.T.), University of Alabama at Birmingham.

Correspondence to Jerome Markovitz, MD, MPH, University of Alabama at Birmingham, 1717 Eleventh Ave S, Room 733, Birmingham, AL 35205 USA. E-mail jmarkovitz{at}dopm.uab.edu

Abstract—This study sought to determine whether depressive symptoms and/or platelet serotonin receptor (5HT_2A) density are associated with increased platelet activation (PA) found among smokers. Flow cytometric detection of PA was used to study 36 smokers and 16 nonsmokers, aged 18 to 48 years. Subjects were tested at baseline and after either smoking 2 cigarettes (smokers) or a similar resting interval (nonsmokers). Assessment of PA included both platelet secretion and fibrinogen receptor (GPIIb/IIIa) binding. Platelet 5HT_2A receptor binding and saturation were tested using [³H]LSD, and depressive symptoms were measured using the Beck Depression Inventory. Platelet 5HT_2A receptor density was increased among smokers versus nonsmokers (82.7±67.7 versus 40.0±20.2 fmol/mg protein; P<0.005), and there was a dose-dependent relationship between receptor density and packs/d among smokers. Baseline wound-induced GPIIb/IIIa binding at 1 minute and GPIIb/IIIa binding in response to collagen stimulation in vitro was increased among smokers (P<0.05); there were no changes in PA among smokers after smoking, and platelet secretion was not elevated among smokers. Depressive symptoms were associated with 5HT_2A receptor density among nonsmokers (P<0.005), but no such relationship was evident among smokers; PA was unrelated to 5HT_2A receptor density in either group. The findings indicate that smoking is associated with increased platelet serotonin receptor density and with increased GPIIb/IIIa receptor binding, although these 2 factors are not related to each other or to depressive symptoms among smokers. Serotonergic dysfunction may be an important factor in the development of cardiovascular disease among smokers.

Key Words: smoking • platelet activation • thrombosis • serotonin receptors • depression

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