Placental biogenic amine transporters: in vivo function, regulation and pathobiological significance.

The biogenic amine transporters are part of a large family of plasma membrane transporters. These carriers mediate the re-uptake of neurotransmitters from the synaptic cleft and plasma compartments. Re-uptake process is inhibited by drugs like cocaine, fluoxetine and tricyclic antidepressants. There are specific transporters for norepinephrine, epinephrine, dopamine and serotonin. The placenta expresses the norepinephrine and serotonin transporters, which is unusual as they are otherwise expressed predominantly in neuronal tissue. Fetal catecholamine clearance rate is higher than under any other physiological conditions and is mediated in large measure by the placental transporters. The high intrauterine catecholamine secretion and clearance rates are part of the unique fetal neuroendocrine milieu. They condition the fetus to a high capacity for catecholamine secretion in the early postnatal period when elevated sympathoadrenal system activity is vital for postnatal survival. Because of the prominent catecholamine clearance rate, the fetus is vulnerable to the adverse effects of re-uptake inhibitors. Understanding the mechanisms of expression and regulation of placental biogenic amine transporters is important to the pathobiology of fetal conditions associated with elevated catecholamine levels or intrauterine exposure to uptake inhibitors like cocaine.