The 5HTTLPR polymorphlism, psychopathologic symptoms, and platelet [H-3-] paroxetine binding in bulimic syndromes

Background: A short (s) allele in the promoter region of the 5-hydroxytryptamine (5-HT) transporter gene (5HTTLPR) has been associated with low transcription of the 5-HT transporter protein, and with clinical manifestations including impulsivity, affective disorder, and bulimia nervosa. Methods: We studied implications of the 5HTTLPR s allele for eating symptoms, psychopathologic traits, and platelet [H-3-] paroxetine binding in 59 women with bulimia spectrum syndromes. Results: Compared with those without it, carriers of the s allele of 5HTTLPR showed significantly more affective instability, behavioral impulsivity, inter- personal insecurity, comorbid borderline personality disorder (BPD), and lower density (B-max) of paroxetine-binding sites. Conclusions: Our results suggest that proneness to impulsivity, affective dysregulation, and reduced central 5-HT reuptake may (in part) be codetermined by the 5HTTLPR polymorphism. However, given inconsistent 5HTTLPR expression in different populations, we speculate that we may be observing a phenotype (i.e., eating disorder)-dependent manifestation. (C) 2004 by Wiley Periodicals, Inc.