Serotonin transporter that cotransports serotonin with one Na(+) ion in exchange for one K(+) ion and possibly one proton in an overall electroneutral transport cycle. Transports serotonin across the plasma membrane from the extracellular compartment to the cytosol thus limiting serotonin intercellular signaling (PubMed:10407194, PubMed:12869649, PubMed:21730057, PubMed:27049939, PubMed:27756841, PubMed:34851672). Essential for serotonin homeostasis in the central nervous system. In the developing somatosensory cortex, acts in glutamatergic neurons to control serotonin uptake and its trophic functions accounting for proper spatial organization of cortical neurons and elaboration of sensory circuits. In the mature cortex, acts primarily in brainstem raphe neurons to mediate serotonin uptake from the synaptic cleft back into the pre-synaptic terminal thus terminating serotonin signaling at the synapse (By similarity). Modulates mucosal serotonin levels in the gastrointestinal tract through uptake and clearance of serotonin in enterocytes. Required for enteric neurogenesis and gastrointestinal reflexes (By similarity). Regulates blood serotonin levels by ensuring rapid high affinity uptake of serotonin from plasma to platelets, where it is further stored in dense granules via vesicular monoamine transporters and then released upon stimulation (PubMed:17506858, PubMed:18317590). Mechanistically, the transport cycle starts with an outward-open conformation having Na1(+) and Cl(-) sites occupied. The binding of a second extracellular Na2(+) ion and serotonin substrate leads to structural changes to outward-occluded to inward-occluded to inward-open, where the Na2(+) ion and serotonin are released into the cytosol. Binding of intracellular K(+) ion induces conformational transitions to inward-occluded to outward-open and completes the cycle by releasing K(+) possibly together with a proton bound to Asp-98 into the extracellular compartment. Na1(+) and Cl(-) ions remain bound throughout the transport cycle (PubMed:10407194, PubMed:12869649, PubMed:21730057, PubMed:27049939, PubMed:27756841, PubMed:34851672). Additionally, displays serotonin-induced channel-like conductance for monovalent cations, mainly Na(+) ions. The channel activity is uncoupled from the transport cycle and may contribute to the membrane resting potential or excitability (By similarity)

OMIMResearchGenerating clinical summary…
MultiplemechanismAD/ARLOEUF 0.182 OMIM phenotypes
Clinical SummaryHTT
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Gene-Disease Validity (ClinGen)
Huntington disease · ADDefinitive

Definitive — sufficient evidence for diagnostic panels

Population Constraint (gnomAD)
Highly constrained gene — heterozygous loss-of-function variants are very rare in the population (pLI 1.00). One damaged copy is likely sufficient to cause disease.
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Clinical Trials
12 active or recruiting trials — potential therapeutic options may be available
Some data sources returned errors (1)

ncbi: Error: NCBI fetch failed: 429 https://eutils.ncbi.nlm.nih.gov/entrez/eutils/esearch.fcgi

Population Genetics & Constraint

gnomAD v4 — loss-of-function & missense intolerance

LoF intolerant — likely haploinsufficient
LoF Constraint?
0.18LOEUF
pLI 1.000
Z-score 10.27
OE 0.12 (0.080.18)
Highly constrained

Highly LoF-intolerant (top ~10% of genes)

Missense Constraint?
2.78Z-score
OE missense 0.81 (0.780.85)
1404 obs / 1729.3 exp
Mild constraint

Moderately missense-constrained (top ~2.5%)

Observed / Expected Ratios?
LoF OE?0.12 (0.080.18)
00.351.4
Missense OE?0.81 (0.780.85)
00.61.4
Synonymous OE?1.10
01.21.6
LoF obs/exp: 19 / 158.6Missense obs/exp: 1404 / 1729.3Syn Z: -2.04

This gene — mechanism propensity

DN
0.3992th %ile
GOF
0.3788th %ile
LOF
0.72top 10%

This gene has evidence for multiple mechanisms of pathogenicity (loss-of-function and gain-of-function). Both the Badonyi & Marsh prediction and the broader genomic evidence point to loss-of-function as the predominant mechanism. Different variants in this gene may act through different mechanisms — interpret in context of the specific variant.

LOFprediction above median · LOEUF 0.18
GOF1 literature citation

Literature Evidence

GOFThat Hdh inactivation does not mimic adult HD neuropathology suggests that the human disease involves a gain of function.1

Predictions from Badonyi M, Marsh JA. PLoS ONE. 2024;19(8):e0307312. Mechanism ranking also informed by gnomAD constraint, ClinVar, and ClinGen data.

References

  1. 1.PMID 7618107

ClinVar Variant Classifications

0 submitted variants in ClinVar

Protein Context — Lollipop Plot

HTT · protein map & ClinVar variants

Showing all ClinVar variants across the protein. Search a specific variant to highlight its position.

Clinical Trials

Active and recruiting trials from ClinicalTrials.gov

Huntington Disease

A Randomised Controlled Trial, Of N-Acetyl Cysteine (NAC), for Premanifest Huntingtin Gene Expansion Carriers

RECRUITING
NCT05509153Phase PHASE2Western Sydney Local Health DistrictStarted 2024-06-01
NACPlacebo
Huntington Disease

Frequency of Selected Single Nucleotide Polymorphisms in Huntington Disease Gene Expansion Carriers

RECRUITING
NCT06667414Hoffmann-La RocheStarted 2024-09-02
Premature Ejaculation

Therapeutic Outcomes of Selective Serotonin Reuptake Inhibitors and Phosphodiesterase-5 Inhibitors Combination Therapy Versus Monotherapy

NOT YET RECRUITING
NCT07057011Phase NASouth Valley UniversityStarted 2025-07-01
Paroxetine 20 Mg Oral Tablet
Preterm BirthMother-Infant InteractionInfant Development

Continuous Delivery Room Skin-to-skin-study for Moderate and Late Preterm Infants

RECRUITING
NCT05975203Phase NAUniversity of CologneStarted 2023-08-04
skin-to-skin contact
Invasive PreNatal Diagnosis in a Context of Family History of Single-gene Disorders, IncludingSickle Cell DiseaseCystic Fibrosis

Development of Non-Invasive Prenatal Diagnosis for Single Gene Disorders

RECRUITING
NCT06147414Assistance Publique - Hôpitaux de ParisStarted 2024-10-23
Blood sample
Parkinson DiseaseNervous System DisorderNeurodegenerative Diseases

Molecular and Functional Imaging in Monogenic PD.

RECRUITING
NCT05518617University of ExeterStarted 2022-07-01
Positron Emission Tomography (PET) scan using DASB tracer
PregnancyPostpartumChildbirth

HIIT vs MICT During Pregnancy and Health and Birth Outcomes in Mothers and Children

RECRUITING
NCT05009433Phase NAGdansk University of Physical Education and SportStarted 2021-06-24
High intensity interval training program for pregnant womenModerate intensity continuous training program for pregnant womenStandard obstetric care with extended education on healthy lifestyle
Parkinson DiseaseParkinson'sParkinson's Disease

Serotonin Release in Premotor and Motor PD

RECRUITING
NCT05516732University of ExeterStarted 2022-07-01
Positron Emission Tomography (PET) scan using CIMBI-36 tracerMagnetic Resonance Imaging (MRI) ScanPositron Emission Tomography (PET) scan using DASB tracer
Huntington Disease

Gene Therapy Development and Validation for Huntington's Disease Fibro TG-HD

RECRUITING
NCT06444217Phase NAUniversity Hospital, AngersStarted 2024-09-23
skin biopsy
Huntington's Disease

HDClarity: a Multi-site Cerebrospinal Fluid Collection Initiative to Facilitate Therapeutic Development for Huntington's Disease

RECRUITING
NCT02855476University College, LondonStarted 2017-01-01
Huntington Disease

Study of BDNF Pathway Biomarkers in the Cerebrospinal Fluid in Patients With Huntington's Disease

RECRUITING
NCT04012411Phase NAUniversity Hospital, MontpellierStarted 2020-03-03
Brain MRILumbar PunctionBlood sample
Depression

Intern Health Study

ENROLLING BY INVITATION
NCT01809080University of MichiganStarted 2007-05