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1.
Toxicology ; 467: 153098, 2022 02 15.
Article in English | MEDLINE | ID: mdl-35026344

ABSTRACT

Molybdenum, lithium, and tungsten are constituents of many products, and exposure to these elements potentially occurs at work. Therefore it is important to determine at what levels they are toxic, and thus we set out to review their pulmonary toxicity, genotoxicity, and carcinogenicity. After pulmonary exposure, molybdenum and tungsten are increased in multiple tissues; data on the distribution of lithium are limited. Excretion of all three elements is both via faeces and urine. Molybdenum trioxide exerted pulmonary toxicity in a 2-year inhalation study in rats and mice with a lowest-observed-adverse-effect concentration (LOAEC) of 6.6 mg Mo/m3. Lithium chloride had a LOAEC of 1.9 mg Li/m3 after subacute inhalation in rabbits. Tungsten oxide nanoparticles resulted in a no-observed-adverse-effect concentration (NOAEC) of 5 mg/m3 after inhalation in hamsters. In another study, tungsten blue oxide had a LOAEC of 63 mg W/m3 in rats. Concerning genotoxicity, for molybdenum, the in vivo genotoxicity after inhalation remains unknown; however, there was some evidence of carcinogenicity of molybdenum trioxide. The data on the genotoxicity of lithium are equivocal, and one carcinogenicity study was negative. Tungsten seems to have a genotoxic potential, but the data on carcinogenicity are equivocal. In conclusion, for all three elements, dose descriptors for inhalation toxicity were identified, and the potential for genotoxicity and carcinogenicity was assessed.


Subject(s)
Cell Transformation, Neoplastic/chemically induced , Lithium Chloride/toxicity , Lung/drug effects , Molybdenum/toxicity , Neoplasms/chemically induced , Oxides/toxicity , Tungsten/toxicity , Animals , Body Burden , Carcinogenicity Tests , Cell Transformation, Neoplastic/genetics , Cell Transformation, Neoplastic/metabolism , Cell Transformation, Neoplastic/pathology , Dose-Response Relationship, Drug , Humans , Inhalation Exposure , Lithium Chloride/pharmacokinetics , Lung/metabolism , Lung/pathology , Metal Nanoparticles , Molybdenum/pharmacokinetics , Mutagenicity Tests , Neoplasms/genetics , Neoplasms/metabolism , Neoplasms/pathology , Oxides/pharmacokinetics , Risk Assessment , Tungsten/pharmacokinetics
2.
Fluids Barriers CNS ; 18(1): 57, 2021 Dec 07.
Article in English | MEDLINE | ID: mdl-34876168

ABSTRACT

BACKGROUND: Little is known about the extent of drug entry into developing brain, when administered to pregnant and lactating women. Lithium is commonly prescribed for bipolar disorder. Here we studied transfer of lithium given to dams, into blood, brain and cerebrospinal fluid (CSF) in embryonic and postnatal animals as well as adults. METHODS: Lithium chloride in a clinically relevant dose (3.2 mg/kg body weight) was injected intraperitoneally into pregnant (E15-18) and lactating dams (birth-P16/17) or directly into postnatal pups (P0-P16/17). Acute treatment involved a single injection; long-term treatment involved twice daily injections for the duration of the experiment. Following terminal anaesthesia blood plasma, CSF and brains were collected. Lithium levels and brain distribution were measured using Laser Ablation Inductively Coupled Plasma-Mass Spectrometry and total lithium levels were confirmed by Inductively Coupled Plasma-Mass Spectrometry. RESULTS: Lithium was detected in blood, CSF and brain of all fetal and postnatal pups following lithium treatment of dams. Its concentration in pups' blood was consistently below that in maternal blood (30-35%) indicating significant protection by the placenta and breast tissue. However, much of the lithium that reached the fetus entered its brain. Levels of lithium in plasma fluctuated in different treatment groups but its concentration in CSF was stable at all ages, in agreement with known stable levels of endogenous ions in CSF. There was no significant increase of lithium transfer into CSF following application of Na+/K+ ATPase inhibitor (digoxin) in vivo, indicating that lithium transfer across choroid plexus epithelium is not likely to be via the Na+/K+ ATPase mechanism, at least early in development. Comparison with passive permeability markers suggested that in acute experiments lithium permeability was less than expected for diffusion but similar in long-term experiments at P2. CONCLUSIONS: Information obtained on the distribution of lithium in developing brain provides a basis for studying possible deleterious effects on brain development and behaviour in offspring of mothers undergoing lithium therapy.


Subject(s)
Antimanic Agents/pharmacokinetics , Blood , Brain , Cerebrospinal Fluid , Lithium Chloride/pharmacokinetics , Maternal-Fetal Exchange , Milk, Human , Animals , Animals, Newborn , Animals, Suckling , Antimanic Agents/administration & dosage , Antimanic Agents/blood , Antimanic Agents/cerebrospinal fluid , Choroid Plexus , Embryo, Mammalian , Female , Lactation , Lithium Chloride/administration & dosage , Lithium Chloride/blood , Lithium Chloride/cerebrospinal fluid , Pregnancy , Rats , Rats, Sprague-Dawley
3.
Physiol Res ; 70(4): 655-659, 2021 08 31.
Article in English | MEDLINE | ID: mdl-34062068

ABSTRACT

Lithium is used in the treatment of bipolar disorder. We previously demonstrated that two types of transporters mediate the tubular reabsorption of lithium in rats, and suggested that sodium-dependent phosphate transporters play a role in lithium reabsorption with high affinity. In the present study, we examined sex differences in lithium reabsorption in rats. When lithium chloride was infused at 60 µg/min, creatinine clearance and the renal clearance of lithium were lower, and the plasma concentration of lithium was higher in female rats. These values reflected the higher fractional reabsorption of lithium in female rats. In rats infused with lithium chloride at 6 µg/min, the pharmacokinetic parameters of lithium examined were all similar in both sexes. The fractional reabsorption of lithium was decreased by foscarnet, a representative inhibitor of sodium-dependent phosphate transporters, in male and female rats when lithium chloride was infused at the low rate. Among the candidate transporters mediating lithium reabsorption examined herein, the mRNA expression of only PiT2, a sodium-dependent phosphate transporter, exhibited sexual dimorphism. The present results demonstrated sex differences in the tubular reabsorption of lithium with low affinity in rats.


Subject(s)
Kidney Tubules/metabolism , Lithium Chloride/metabolism , Renal Reabsorption , Sodium-Phosphate Cotransporter Proteins/metabolism , Animals , Female , Infusions, Intravenous , Lithium Chloride/administration & dosage , Lithium Chloride/pharmacokinetics , Male , Rats, Wistar , Sex Characteristics , Sex Factors , Sodium-Phosphate Cotransporter Proteins/genetics
4.
Pharmacology ; 106(7-8): 446-450, 2021.
Article in English | MEDLINE | ID: mdl-33979799

ABSTRACT

Lithium, administered to patients of bipolar disorders, is mainly excreted into urine, and tubular reabsorption at the proximal tubule is involved in the renal handling of lithium. In this study, we examined the renal excretion of lithium in rats with Fanconi syndrome, characterized by defects of transports of various compounds at the proximal tubules, induced by maleic acid. After maleic acid was intravenously injected, mannitol and lithium chloride were infused in turn. Using samples of plasma and bladder urine during the mannitol infusion, renal parameters were determined. Pharmacokinetic parameters of lithium were obtained using samples during the lithium chloride infusion. Maleic acid decreased creatinine clearance and increased the fractional excretion of glucose and phosphate, suggesting the induction of Fanconi syndrome. In rats with Fanconi syndrome, plasma concentration of lithium was increased, and its renal clearance was decreased. No effect on the fractional excretion of lithium was exhibited. This study represents that the tubular reabsorption of lithium was impaired to the same degree with glomerular filtration in rats with experimental Fanconi syndrome and that the dysfunction of the tubular reabsorption of glucose and phosphate was more severe. It is possible that Fanconi syndrome inhibited the reabsorption of lithium at the proximal tubule and facilitated the reabsorption of lithium from the loop of Henle to the collecting duct.


Subject(s)
Antimanic Agents/pharmacokinetics , Fanconi Syndrome/physiopathology , Kidney Tubules, Proximal/physiopathology , Lithium Chloride/pharmacokinetics , Animals , Creatinine/metabolism , Disease Models, Animal , Glucose/metabolism , Injections, Intravenous , Male , Maleates , Phosphates/metabolism , Rats , Rats, Wistar
5.
Physiol Res ; 69(4): 645-651, 2020 08 31.
Article in English | MEDLINE | ID: mdl-32584131

ABSTRACT

Lithium is mainly excreted into urine, and a large fraction of lithium filtered through glomeruli is reabsorbed in the proximal tubule. However, the mechanisms responsible for lithium reabsorption remain unclear. We previously reported that the reabsorption of lithium was biphasic in rats, and that foscarnet inhibited lithium reabsorption with a high affinity type. We herein evaluated the effects of acetazolamide and foscarnet on the renal excretion of lithium in rats treated with lithium chloride at 2 doses. In rats intravenously injected with a bolus of 25 mg/kg lithium chloride, acetazolamide facilitated the urinary excretion of lithium, and increased the fractional excretion of lithium from 0.446 to 0.953, near the theoretically maximum value. At a dose of 2.5 mg/kg lithium chloride, the fractional excretion of lithium was 0.241 in control rats, 0.420 in rats administered acetazolamide, and 0.976 in rats administered acetazolamide and foscarnet. These results showed the potent inhibition of lithium reabsorption by acetazolamide and foscarnet in rats. And, it was exhibited that the effects of acetazolamide on lithium reabsorption differed with the dosages of lithium administered.


Subject(s)
Acetazolamide/pharmacology , Foscarnet/pharmacology , Kidney Tubules, Proximal/drug effects , Lithium Chloride/pharmacology , Renal Reabsorption/drug effects , Animals , Antiviral Agents/pharmacology , Disease Models, Animal , Diuretics/pharmacology , Drug Interactions , Kidney Tubules, Proximal/metabolism , Lithium Chloride/antagonists & inhibitors , Lithium Chloride/pharmacokinetics , Male , Rats , Rats, Wistar
6.
Biopharm Drug Dispos ; 39(9): 448-451, 2018 Nov.
Article in English | MEDLINE | ID: mdl-30393876

ABSTRACT

Lithium, administered to patients with bipolar disorders, is mainly excreted in the urine, and tubular reabsorption is involved. This study characterized the renal excretion of lithium in rats subjected to renal ischemia for 60 min or 90 min. After intravenous injection of lithium chloride at 25 mg/kg, the pharmacokinetic parameters of lithium were determined. In sham-operated rats, the renal clearance of lithium was calculated to be 1.49 ml/min/kg, and its ratio to creatinine clearance (fractional excretion) was 43.4%. Renal ischemia inhibited the renal excretion of lithium, and did not affect its fractional excretion. The urinary pH of rats with renal ischemia for 90 min was significantly higher than those of the other groups, and the linear regression with the fractional excretion of lithium in rats with renal ischemia showed a moderate correlation (r = 0.650, p = 0.00193). This study demonstrated the effect of renal ischemia on the renal excretion of lithium in rats. It was suggested that not only glomerular filtration but also the reabsorption of lithium was impaired by renal ischemia.


Subject(s)
Antimanic Agents/pharmacokinetics , Ischemia/complications , Kidney/metabolism , Lithium Chloride/pharmacokinetics , Animals , Disease Models, Animal , Hydrogen-Ion Concentration , Injections, Intravenous , Kidney/blood supply , Linear Models , Male , Rats , Rats, Wistar , Time Factors
7.
Equine Vet J ; 50(4): 537-543, 2018 Jul.
Article in English | MEDLINE | ID: mdl-29112289

ABSTRACT

BACKGROUND: Pharmacokinetics of lithium chloride (LiCl) administered as a bolus, once i.v. have not been determined in horses. There is no point-of-care test to measure lithium (Li+ ) concentrations in horses in order to monitor therapeutic levels and avoid toxicity. OBJECTIVES: To determine the pharmacokinetics of LiCl in healthy adult horses and to compare agreement between two methods of plasma Li+ concentration measurement: spectrophotometric enzymatic assay (SEA) and inductively coupled plasma mass spectrometry (ICP-MS). STUDY DESIGN: Nonrandomised, single exposure with repeated measures over time. METHODS: Lithium chloride was administered (0.15 mmol/kg bwt) as an i.v. bolus to eight healthy adult horses. Blood samples were collected pre-administration and at multiple times until 48 h post-administration. Samples were analysed by two methods (SEA and ICP-MS) to determine plasma Li+ concentrations. Pharmacokinetics were determined based on the reference ICP-MS data. RESULTS: Adverse side effects were not observed. The SEA showed linearity, R2 = 0.9752; intraday coefficient of variation, 2.5%; and recovery, 96.3%. Both noncompartmental and compartmental analyses (traditional two-stage and nonlinear mixed-effects [NLME] modelling) were performed. Geometric mean values of noncompartmental parameters were plasma Li+ concentration at time zero, 2.19 mmol/L; terminal elimination half-life, 25.68 h; area under the plasma concentration-time curve from time zero to the limit of quantification, 550 mmol/L min; clearance, 0.273 mL/min/kg; mean residence time, 31.22 h; and volume of distribution at steady state, 511 mL/kg. Results of the traditional two-stage analysis showed good agreement with the NLME modelling approach. Bland-Altman analyses demonstrated poor agreement between the SEA and ICP-MS methods (95% limits of agreement = 0.14 ± 0.13 mmol/L). MAIN LIMITATIONS: Clinical effects of LiCl have not been investigated. CONCLUSIONS: The LiCl i.v. bolus displayed pharmacokinetics similar to those reported in other species. The SEA displayed acceptable precision but did not agree well with the reference method (ICP-MS). The Summary is available in Spanish - see Supporting Information.


Subject(s)
Adjuvants, Immunologic/pharmacokinetics , Horses/blood , Lithium Chloride/pharmacokinetics , Adjuvants, Immunologic/blood , Animals , Female , Lithium Chloride/blood , Male
8.
Eur Neuropsychopharmacol ; 27(8): 744-750, 2017 08.
Article in English | MEDLINE | ID: mdl-28666638

ABSTRACT

Lithium (Li) and valproate (VPA) are used in the treatment of bipolar disorder (BD), with narrow therapeutic window requiring periodic control of serum levels. This prevents intoxication, lack of efficacy due to low serum concentrations, and allows monitoring adherence. We aimed at evaluating the bioequivalence of salivary and blood levels of LI or VPA in a sample of adult BD patients. Secondarily, lithium bioequivalence was evaluated across different patients' lifespans. BD patients treated with either Li or VPA underwent contemporary standard serum and salivary measurements. Blood levels of both drugs were taken according to standard procedures. Li salivary levels were performed by an adapted potentiometric method on the AVL9180 electrolyte analyzer. VPA salivary levels were taken with an immune-assay method with turbidimetric inhibition. A total of 50 patients (38 on Li, 12 on VPA) were enrolled. Blood-saliva bioequivalence for VPA was not found due to a high variability in salivary measures. Li measures resulted in a high correlation (r=0.767, p<0.001), showing no partial correlation with age (r=0.147, p=0.380). Li salivary test is a reliable method of measuring Li availability and is equivalent to serum levels. Potential advantages of Li salivary testing are its non-invasive nature and the possibility of doing the test during the usual appointment with the psychiatrist.


Subject(s)
Antidepressive Agents , Bipolar Disorder/drug therapy , Bipolar Disorder/metabolism , Lithium Chloride , Saliva/chemistry , Valproic Acid , Adult , Antidepressive Agents/metabolism , Antidepressive Agents/pharmacokinetics , Antidepressive Agents/therapeutic use , Female , Humans , Lithium Chloride/metabolism , Lithium Chloride/pharmacokinetics , Lithium Chloride/therapeutic use , Male , Middle Aged , Psychiatric Status Rating Scales , Therapeutic Equivalency , Valproic Acid/metabolism , Valproic Acid/pharmacokinetics , Valproic Acid/therapeutic use
9.
Sci Rep ; 7: 45204, 2017 03 24.
Article in English | MEDLINE | ID: mdl-28338064

ABSTRACT

By virtue of its excellent bioactivity and osteoconductivity, calcium phosphate cement (CPC) has been applied extensively in bone engineering. Doping a trace element into CPC can change physical characteristics and enhance osteogenesis. The trace element lithium has been demonstrated to stimulate the proliferation and differentiation of osteoblasts. We investigated the fracture-healing effect of osteoporotic defects with lithium-doped calcium phosphate cement (Li/CPC) and the underlying mechanism. Li/CPC bodies immersed in simulated body fluid converted gradually to hydroxyapatite. Li/CPC extracts stimulated the proliferation and differentiation of osteoblasts upon release of lithium ions (Li+) at 25.35 ± 0.12 to 50.74 ± 0.13 mg/l through activation of the Wnt/ß-catenin pathway in vitro. We also examined the effect of locally administered Li+ on defects in rat tibia between CPC and Li/CPC in vivo. Micro-computed tomography and histological staining showed that Li/CPC had better osteogenesis by increasing bone mass and promoting repair in defects compared with CPC (P < 0.05). Li/CPC also showed better osteoconductivity and osseointegration. These findings suggest that local release of Li+ from Li/CPC may accelerate bone regeneration from injury through activation of the Wnt/ß-catenin pathway in osteoporosis.


Subject(s)
Bone Cements/pharmacology , Bone Regeneration , Durapatite/pharmacology , Lithium Chloride/pharmacology , Osteoporotic Fractures/therapy , Wnt Signaling Pathway , Animals , Bone Cements/chemistry , Bone Cements/therapeutic use , Cell Line , Drug Liberation , Durapatite/therapeutic use , Female , Lithium Chloride/pharmacokinetics , Lithium Chloride/therapeutic use , Mice , Osteoblasts/cytology , Osteoblasts/drug effects , Osteoblasts/metabolism , Osteogenesis , Rats , Rats, Sprague-Dawley
10.
Pharmacology ; 99(5-6): 236-239, 2017.
Article in English | MEDLINE | ID: mdl-28147361

ABSTRACT

AIMS: Lithium is administered for treating bipolar disorders and is mainly excreted into urine. Nonsteroidal anti-inflammatory drugs inhibit this process. In this study, we examined the enantioselective effect of flurbiprofen on the disposition of lithium in rats. METHODS: Pharmacokinetic experiments with lithium were performed. RESULTS: Until 60 min after the intravenous administration of lithium chloride at 30 mg/kg as a bolus, 17.8% of lithium injected was recovered into the urine. Its renal clearance was calculated to be 1.62 mL/min/kg. Neither creatinine clearance (Ccr) nor pharmacokinetics of lithium was affected by the simultaneous injection of (R)-flurbiprofen at 20 mg/kg. (S)-flurbiprofen impaired the renal function and interfered with the urinary excretion of lithium. The ratio of renal clearance of lithium to Ccr was decreased by the (S)-enantiomer. CONCLUSION: This study clarified that the (S)-flurbiprofen but not (R)-flurbiprofen inhibited the renal excretion of lithium in rats.


Subject(s)
Flurbiprofen/pharmacology , Lithium Chloride/pharmacokinetics , Animals , Lithium Chloride/blood , Lithium Chloride/urine , Male , Rats , Stereoisomerism
12.
Drug Metab Pers Ther ; 30(1): 65-7, 2015 Mar.
Article in English | MEDLINE | ID: mdl-25803094

ABSTRACT

BACKGROUND: Lithium, which is often used for the treatment of bipolar disorders, is mainly recovered into urine after being orally administered. Due to the fact that it is completely absorbed via the gastrointestinal tract, it remains unknown whether biliary excretion is involved in the lithium disposition. In this study, we examined biliary excretion of lithium in rats and compared these with renal excretion. MATERIALS AND METHODS: After the injection of lithium chloride to femoral vein, plasma levels and excretion into urine and bile of lithium were evaluated. RESULTS: After its intravenous administration as a bolus, the plasma concentration of lithium decreased time-dependently. Until 60 min, 6.47% and 0.694% of injected lithium were excreted into urine and bile, respectively. The biliary clearance of lithium was calculated to be 0.0779 mL/min/kg, and this was 11.3% of the renal clearance. CONCLUSIONS: These findings suggest the low ability of the liver to eliminate lithium from plasma in comparison with the kidney in rats.


Subject(s)
Antimanic Agents/pharmacokinetics , Hepatobiliary Elimination/physiology , Lithium Chloride/pharmacokinetics , Animals , Antimanic Agents/blood , Antimanic Agents/urine , Injections, Intravenous , Lithium Chloride/blood , Lithium Chloride/urine , Male , Rats, Wistar , Renal Elimination/physiology
13.
J Anim Sci ; 93(2): 562-9, 2015 Feb.
Article in English | MEDLINE | ID: mdl-25548209

ABSTRACT

Lithium chloride (LiCl) is widely used for inducing conditioned taste aversion (CTA) so that livestock will reduce or avoid ingestion of toxic plants and graze groundcover mingled with valuable crops. However, pharmacokinetic studies of LiCl at effective CTA doses are lacking. With this aim, 6 Murciano-Grandina dairy does during late lactation and 6 dry Manchega dairy ewes were orally dosed with 200 and 225 mg LiCl/kg BW, respectively. Does were placed in metabolism cages whereas ewes were group fed in pens. Lithium was measured over 168 (does) and 192 h (ewes) at predefined intervals in plasma, urine, feces, and milk using flame atomic absorption spectroscopy. Plasma Li concentrations reached a maximum at 4 h in does (13.4 ± 1.35 mg Li/L) and 12 h in ewes (17.7 ± 0.8 mg Li/L). The calculated plasma half-lives were 40.3 ± 3.8 and 30.9 ± 2.1 h for does and ewes, respectively. In goats, all Li administered was recovered at 96 h (92 ± 4% in urine, 6.5 ± 1.3% in feces, and 2.8 ± 0.4% in milk); however, the estimated clearance time in feces was 11 and 9 d for does and ewes, respectively. Additionally, maximum Li excretion in doe milk was 15.6 ± 0.5 mg/L, which was approximately half of the calculated effective dose for a 5-kg BW sucking kid. In conclusion, Li kinetics in goats and sheep were similar to cattle and elimination took longer than in monogastric species. The low concentration of Li in feces, urine, and milk, as well as the complete elimination of Li from the body after 1.5 wk allows us to conclude that LiCl is safe and suitable for inducing CTA in ruminants.


Subject(s)
Food Preferences/drug effects , Lithium Chloride/pharmacokinetics , Ruminants/metabolism , Taste/drug effects , Animals , Cattle , Feces/chemistry , Female , Goats , Kinetics , Lactation/metabolism , Lithium/blood , Lithium/metabolism , Lithium/urine , Lithium Chloride/administration & dosage , Lithium Chloride/pharmacology , Milk/chemistry , Sheep, Domestic , Spectrophotometry, Atomic , Time Factors
14.
Pharmacol Res ; 87: 94-8, 2014 Sep.
Article in English | MEDLINE | ID: mdl-24997387

ABSTRACT

Lithium, used for the treatment of bipolar disorders, is reabsorbed via sodium-transport system in the proximal tubule. This step causes intra-/inter-individual difference of lithium disposition, and it has not been unclear which transporter contributes. In this study, we examined effect of foscarnet and parathyroid hormone (PTH), inactivators for sodium-phosphate cotransporter, and phlorizin, a typical inhibitor for sodium-glucose cotransporter, on the disposition of lithium in rats. Their intravenous administration stimulated urinary excretion of phosphate or glucose. After the intravenous injection of lithium chloride as a bolus, plasma concentration of lithium decreased time-dependently. The renal clearance of lithium was calculated to be 0.740 ml/min/kg in control rats, and this was 26.7% of creatinine clearance. Foscarnet and PTH significantly increased the renal clearance of lithium and its ratio to creatinine clearance, suggesting that they prevented the reabsorption of lithium. No effect of phlorizin on the renal handling of lithium was recognized. In control rats, the renal clearance of lithium showed a strong correlation with the renal excretion rate of phosphate, compared with creatinine clearance. These findings suggest that sodium-phosphate cotransporter reabsorbs lithium in the rat kidney. Furthermore, its contribution was estimated to be more than 65.9% in the lithium reabsorption. And, this study raised the possibility that therapeutic outcome of lithium is related with the functional expression of sodium-phosphate cotransporter in the kidney.


Subject(s)
Kidney/metabolism , Lithium Chloride/pharmacokinetics , Sodium-Phosphate Cotransporter Proteins/metabolism , Animals , Blood Glucose/analysis , Foscarnet/pharmacology , Glycosuria , Lithium Chloride/blood , Lithium Chloride/pharmacology , Male , Parathyroid Hormone/pharmacology , Phlorhizin/pharmacology , Phosphates/blood , Phosphates/urine , Rats, Wistar
15.
Biol Pharm Bull ; 36(11): 1829-34, 2013.
Article in English | MEDLINE | ID: mdl-24189427

ABSTRACT

To clarify whether peripheral inflammation has a remote effect on the central nervous system, the electrolyte disposition between the circulating blood and central nervous system was evaluated in rats with carrageenan-induced acute peripheral inflammation (API). λ-Carrageenan was subcutaneously injected in the hind paw of the rat, and lithium was utilized as a surrogate marker of sodium. When the plasma and cerebrospinal fluid (CSF) concentrations of lithium were examined following lithium being intravenously administered, it was revealed that the CSF concentration of lithium in API rats is reduced compared to that in normal rats, while the plasma concentration profile of lithium in API rats is indistinguishable from that in normal rats. The pharmacokinetic analysis showed that the lithium disposition from the plasma to CSF markedly decreased by 35.8% in API rats compared to that in normal rats. On the other hand, when lithium was immediately administered into the lateral ventricle, its elimination profiles in CSF were not different between normal and API rats. It is therefore probable that the lithium disposition from the plasma to CSF alters in API rats, reflecting the entry process of electrolytes from the circulating blood to brain tissue being suppressed in response to peripheral inflammation.


Subject(s)
Electrolytes/cerebrospinal fluid , Inflammation/metabolism , Lithium Chloride/pharmacokinetics , Animals , Carrageenan , Inflammation/chemically induced , Lithium Chloride/blood , Lithium Chloride/cerebrospinal fluid , Male , Orosomucoid/metabolism , Rats , Rats, Wistar
16.
Med Intensiva ; 36(6): 434-44, 2012.
Article in Spanish | MEDLINE | ID: mdl-22743144

ABSTRACT

The pulmonary artery catheter has been a key tool for monitoring hemodynamic status in the intensive care unit for nearly 40 years. During this period of time, it has been the hemodynamic monitoring technique most commonly used for the diagnosis of many clinical situations, allowing clinicians to understand the underlying cardiovascular physiopathology, and helping to guide treatment interventions. However, in recent years, the usefulness of pulmonary artery catheterization has been questioned. Technological advances have introduced new and less invasive hemodynamic monitoring techniques. This review provides a systematic update on the hemodynamic variables offered by cardiac output monitoring devices, taking into consideration their clinical usefulness and their inherent limitations, with a view to using the supplied information in an efficient way.


Subject(s)
Critical Care/methods , Hemodynamics , Monitoring, Physiologic/methods , Blood Flow Velocity , Cardiography, Impedance , Catheterization, Central Venous , Catheterization, Swan-Ganz , Echocardiography, Doppler , Echocardiography, Transesophageal , Humans , Lithium Chloride/blood , Lithium Chloride/pharmacokinetics , Oximetry , Oxygen/blood , Pulmonary Wedge Pressure , Thermodilution/instrumentation , Vascular Access Devices
17.
Neurosci Lett ; 521(1): 62-6, 2012 Jul 11.
Article in English | MEDLINE | ID: mdl-22659074

ABSTRACT

Lithium is licensed for the treatment of bipolar disorders and also discussed in relation to neuroprotective properties. Although the drug has a small therapeutic window, its uptake and passage into the brain are poorly understood. We administered lithium to rats, following an acute (3 mmol/kg, i.p.) or chronic (3 mmol/kg/day, p.o.) regime. Lithium levels were assessed in serum, brain homogenate, cerebrospinal fluid (CSF) and, by means of microdialysis, in the extracellular space (ECS) of the brain 2, 6 and 24h post injection or after 3 weeks of chronic administration. Lithium is detected in brain ECS within minutes of administration and reaches maximum levels in brain extracellular fluid after 30 min. In the early phase after lithium administration (2 and 6h), serum levels of lithium do not differ significantly from those assessed in CSF and brain homogenate. Afterwards, however, accumulation in brain tissue occurs. As a consequence, after 24h and 3 weeks, lithium levels in brain homogenate (i.e., intracellular levels) are significantly higher than in CSF or dialysates (i.e., extracellular levels). In conclusion, lithium rapidly reaches the brain, but after prolonged treatment, brain intracellular levels are high and poorly represented by plasma or CSF measurements.


Subject(s)
Antimanic Agents/pharmacokinetics , Brain/metabolism , Lithium Chloride/pharmacokinetics , Animals , Antimanic Agents/administration & dosage , Dose-Response Relationship, Drug , Lithium Chloride/administration & dosage , Microdialysis , Rats , Rats, Sprague-Dawley
18.
Pharmacopsychiatry ; 45(1): 1-6, 2012 Jan.
Article in English | MEDLINE | ID: mdl-21989601

ABSTRACT

INTRODUCTION: The aim of this prospective study was to investigate the influence of lithium serum levels on subclinical psychopathological features during the euthymic interval in patients with an affective disorder. METHODS: The study included 54 patients with a recurrent affective disorder undergoing a continuous prophylactic lithium treatment (31 unipolar, 23 bipolar). The observation period lasted for 2 years and included 332 visits. Visits consisted of a detailed interview, a continuous measurement of lithium levels and the collection of validated scales including HAMD, YMRS, CGI, VAMS and the SCL-90R. Several correlations between lithium serum levels and different psychopathological features during the euthymic interval were calculated on an individual patient basis and on a group basis to reveal generally occurring correlations. RESULTS: No generally occurring significant correlations between lithium serum levels and specific psychopathological features were found. Only on a single patient level, 32 significant correlations between lithium level and specific psychopathological features were found, partly indicating a negative and partly indicating a positive influence of higher lithium levels on psychopathological symptoms. Nevertheless, in the group analyses no significant correlations were found. DISCUSSION: Higher lithium levels were not associated with an improved psychopathological status, but they were not associated with a worse status (due to a higher burden of side effects) either. According to the literature there is currently no strong evidence to treat patients with a higher lithium level. It is recommended to start with a lower level and to continue with individual adjustments in accordance to prophylactic efficacy and tolerability.


Subject(s)
Affective Disorders, Psychotic/blood , Affective Disorders, Psychotic/psychology , Antimanic Agents/therapeutic use , Drug Monitoring , Lithium Chloride/therapeutic use , Lithium/blood , Adult , Affect/drug effects , Affective Disorders, Psychotic/physiopathology , Affective Disorders, Psychotic/prevention & control , Aged , Antimanic Agents/adverse effects , Antimanic Agents/pharmacokinetics , Female , Germany , Hospitals, University , Humans , Lithium Chloride/adverse effects , Lithium Chloride/pharmacokinetics , Male , Medical Records , Middle Aged , Outpatient Clinics, Hospital , Prospective Studies , Psychiatric Status Rating Scales , Secondary Prevention , Young Adult
19.
Hum Psychopharmacol ; 26(4-5): 358-63, 2011.
Article in English | MEDLINE | ID: mdl-21721043

ABSTRACT

OBJECTIVES: Vascular endothelial growth factor (VEGF) is thought to be involved in the pathophysiology of mood disorders and the target of antidepressants. The aim of this study was to elucidate molecular effects of lithium on VEGF expression by using leukocytes of healthy subjects and patients with bipolar disorder. METHODS: Eight healthy male subjects participated in the first study. Lithium was prescribed for 2 weeks, enough to reach therapeutic serum concentration. Leukocyte counts and serum lithium concentrations were determined at baseline, at 1- and 2-week medication, and at 2 weeks after stopping medication. VEGF mRNA levels were also examined in nine lithium-treated bipolar patients and healthy controls in the second study. RESULTS: In the first study, leukocyte counts were significantly increased at 2 weeks compared with those at baseline and were normalized after 2 weeks. VEGF mRNA levels were significantly decreased at 2 weeks and after 2 weeks compared with those at baseline. Consistent with the first study, VEGF mRNA levels were significantly decreased in the lithium-treated bipolar patients compared with healthy controls. CONCLUSIONS: Our investigation suggests that VEGF mRNA expression may be useful as a peripheral marker of the effects of lithium.


Subject(s)
Antimanic Agents/therapeutic use , Bipolar Disorder/drug therapy , Down-Regulation/drug effects , Leukocytes/drug effects , Lithium/therapeutic use , Vascular Endothelial Growth Factor A/metabolism , Adult , Antimanic Agents/blood , Antimanic Agents/pharmacokinetics , Antimanic Agents/pharmacology , Biomarkers/blood , Bipolar Disorder/blood , Bipolar Disorder/immunology , Bipolar Disorder/metabolism , Diagnostic and Statistical Manual of Mental Disorders , Female , Humans , Leukocyte Count , Leukocytes/immunology , Leukocytes/metabolism , Lithium/blood , Lithium/pharmacokinetics , Lithium/pharmacology , Lithium Chloride/blood , Lithium Chloride/pharmacokinetics , Lithium Chloride/pharmacology , Lithium Chloride/therapeutic use , Male , Middle Aged , RNA, Messenger/metabolism , Vascular Endothelial Growth Factor A/genetics
20.
Eur J Pharmacol ; 666(1-3): 93-9, 2011 Sep.
Article in English | MEDLINE | ID: mdl-21651904

ABSTRACT

After 60 years, lithium is still the mainstay in the treatment of mood disorders and widely used in clinic. In addition to its mood stabilizer effects, lithium also shows some anticonvulsant properties. Similar to lithium, agmatine also plays a protective role in the CNS against seizures and has been reported to enhance the effect of different antiepileptic agents. Moreover, both agmatine and lithium have modulatory effects on α(2)-adrenoceptors. So, we designed this study: 1) to investigate whether agmatine and lithium show an additive effect against clonic seizures induced by pentylenetetrazole; 2) to assess whether this additive effect is mediated through the α(2)-adrenoceptor or not. In our study, acute administration of a single effective dose of lithium chloride (30 mg/kg, i.p.) increased the seizure threshold. Pre-treatment with low and, per se, non-effective doses of agmatine (1 and 3mg/kg) potentiated a sub-effective dose of lithium (10mg/kg). Interestingly, the anticonvulsant effects of these effective combinations of lithium and agmatine were prevented by pre-treatment with low and non-effective doses of yohimbine [α(2)-adrenoceptor antagonist] (0.1 and 0.5mg/kg). On the other hand, clonidine [α(2)-adrenoceptor agonist] augmented the anticonvulsant effect of a sub-effective combination of lithium (5mg/kg i.p.) and agmatine (1mg/kg) at relatively low doses (0.1 and 0.25mg/kg). In summary, our findings demonstrate that agmatine and lithium chloride exhibit additive anticonvulsant properties which seem to be mediated through α(2)-adrenoceptor.


Subject(s)
Agmatine/pharmacology , Anticonvulsants/pharmacology , Lithium Chloride/pharmacology , Pentylenetetrazole/pharmacology , Receptors, Adrenergic, alpha-2/metabolism , Seizures/chemically induced , Seizures/metabolism , Agmatine/pharmacokinetics , Agmatine/therapeutic use , Animals , Anticonvulsants/pharmacokinetics , Anticonvulsants/therapeutic use , Dose-Response Relationship, Drug , Drug Synergism , Lithium Chloride/pharmacokinetics , Lithium Chloride/therapeutic use , Male , Mice , Seizures/drug therapy , Yohimbine/pharmacology
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