Lithium: a modulator of cyclic AMP-dependent events in lymphocytes?

Lithium and hormesis: Enhancement of adaptive responses and biological performance via hormetic mechanisms

Biomedical and consumer interest in the health-promoting properties of pure single entities of known or unknown chemical constituents and mixtures has never been greater. Since its "rediscovery" in the 1950s, lithium is an example of such a constituent that represents an array of scientific and public health challenges and medical potentials that may now be understood best when seen through the lens of the dose-response paradigm known as hormesis. The present paper represents the first review of the capacity of lithium to induce hormetic dose responses in a broad range of biological models, organ systems, and endpoints. Of significance is that the numerous hormetic findings occur with extensive concentration/dose response evaluations with the optimal dosing being similar across multiple organ systems. The particular focus of these hormetic dose-response findings was targeted to research with a broad spectrum of stem cell types and neuroprotective effects. These findings suggest that lithium may have critically valuable systemic effects with respect to those therapeutically treated with lithium as well as for exposures that may be achieved via dietary intervention.

Review of lithium effects on immune cells

One of the remarkable discoveries in the field of psychopharmacology from late 1940s is Lithium (Li) that reminds of old but still gold. It continues to be a distinctive mood stabilizer that matches various standards recommended for mood stabilizers. Apart from this Li is also known to affect immune cell functions. Lithium response and regulations of different immune cells in bipolar patients, related immune disorders are not well defined. Here, we provide an overview of literature with regard to Li's effects on different immune cells. However, the use of Li is currently limited to bipolar disorders and there is no empirical evidence for immune cell disorders. The objective of this article is to provide the evaluations of Li responses towards the different immune cells based on the existing studies. Further, more studies are needed to understand the mechanistic basis and heterogeneous responses of Li's effect in bipolar, also unravel relative immune disorders.

Biphasic dose-dependent effect of lithium chloride on survival of human hormone-dependent breast cancer cells (MCF-7)

Lithium, the first element of Group I in the periodic system, is used to treat bipolar psychiatric disorders. Lithium chloride (LiCl) is a selective inhibitor of glycogen synthase kinase-3β (GSK-3β), a serine/threonine kinase that regulates many cellular processes, in addition to its role in the regulation of glycogen synthase. GSK-3β is emerged as a promising drug target for various neurological diseases, type-2 diabetes, cancer, and inflammation. Several works have demonstrated that lithium can either inhibit or stimulate growth of normal and cancer cells. Hence, the present study is focused to analyze the underlying mechanisms that dictate the biphasic oncogenic properties of LiCl. In the current study, we have investigated the dose-dependent effects of LiCl on human breast cancer cells (MCF-7) by assessing the consequences on cytotoxicity and protein expressions of signaling molecules crucial for the maintenance of cell survival. The results showed breast cancer cells respond in a diverse manner to LiCl, i.e., at lower concentrations (1, 5, and 10 mM), LiCl induces cell survival by inhibiting apoptosis through regulation of GSK-3β, caspase-2, Bax, and cleaved caspase-7 and by activating anti-apoptotic proteins (Akt, β-catenin, Bcl-2, and cyclin D1). In contrast, at high concentrations (50 and 100 mM), it induces apoptosis by reversing these effects. Moreover, LiCl also alters the sodium and potassium levels thereby altering the membrane potential of MCF-7 cells. Thus it is inferred that LiCl exerts a dose-dependent biphasic effect on breast cancer cells (MCF-7) by altering the apoptotic/anti-apoptotic balance.

Review of lithium effects on brain and blood

Clinicians have long used lithium to treat manic depression. They have also observed that lithium causes granulocytosis and lymphopenia while it enhances immunological activities of monocytes and lymphocytes. In fact, clinicians have long used lithium to treat granulocytopenia resulting from radiation and chemotherapy, to boost immunoglobulins after vaccination, and to enhance natural killer activity. Recent studies revealed a mechanism that ties together these disparate effects of lithium. Lithium acts through multiple pathways to inhibit glycogen synthetase kinase-3beta (GSK3 beta). This enzyme phosphorylates and inhibits nuclear factors that turn on cell growth and protection programs, including the nuclear factor of activated T cells (NFAT) and WNT/beta-catenin. In animals, lithium upregulates neurotrophins, including brain-derived neurotrophic factor (BDNF), nerve growth factor, neurotrophin-3 (NT3), as well as receptors to these growth factors in brain. Lithium also stimulates proliferation of stem cells, including bone marrow and neural stem cells in the subventricular zone, striatum, and forebrain. The stimulation of endogenous neural stem cells may explain why lithium increases brain cell density and volume in patients with bipolar disorders. Lithium also increases brain concentrations of the neuronal markers n-acetyl-aspartate and myoinositol. Lithium also remarkably protects neurons against glutamate, seizures, and apoptosis due to a wide variety of neurotoxins. The effective dose range for lithium is 0.6-1.0 mM in serum and >1.5 mM may be toxic. Serum lithium levels of 1.5-2.0 mM may have mild and reversible toxic effects on kidney, liver, heart, and glands. Serum levels of >2 mM may be associated with neurological symptoms, including cerebellar dysfunction. Prolonged lithium intoxication >2 mM can cause permanent brain damage. Lithium has low mutagenic and carcinogenic risk. Lithium is still the most effective therapy for depression. It "cures" a third of the patients with manic depression, improves the lives of about a third, and is ineffective in about a third. Recent studies suggest that some anticonvulsants (i.e., valproate, carbamapazine, and lamotrigene) may be useful in patients that do not respond to lithium. Lithium has been reported to be beneficial in animal models of brain injury, stroke, Alzheimer's, Huntington's, and Parkinson's diseases, amyotrophic lateral sclerosis (ALS), spinal cord injury, and other conditions. Clinical trials assessing the effects of lithium are under way. A recent clinical trial suggests that lithium stops the progression of ALS.

Hormetic Dose-Response Relationships in Immunology: Occurrence, Quantitative Features of the Dose Response, Mechanistic Foundations, and Clinical Implications

This article provides an assessment of the occurrence of immune-system-related hormetic-like biphasic dose-response relationships. Such dose-response relationships are extensive, with over 90 different immune response-related endpoints reported, induced by over 70 endogenous agonists, over 100 drugs, and over 40 environmental contaminants. Such hormetic responses were reported in over 30 animal models, over a dozen mammalian and human cell lines. These findings demonstrate that immune-system-related hormetic-like biphasic dose-response relationships are common and highly generalizable according to model, endpoint, and chemical class. The quantitative features of the dose response are generally consistent with previously published examples of hormetic dose responses for other biological endpoints. These findings were generally recognized and explicitly discussed by the original authors, often with consideration given to possible mechanistic foundations as well as numerous clinical implications. Despite the recognition by individual authors of the hormetic nature of these observed responses, the overall widespread nature of immune-related hormetic responses has been only little appreciated, with a general lack of insight into the highly generalizable nature of this phenomenon as well as the complex regulatory networks affecting biological switching mechanisms that result in the hormetic responses.

Enzyme replacement and other biochemical approaches to the therapy of adenosine deaminase deficiency

Addition of adenosine deaminase (ADA) restored in vitro responses of lymphocytes from a patient with ADA deficiency and severe combined immunodeficiency (SCID). Enzyme replacement therapy, using red blood cells as a source of encapsulated human ADA, restored both T and B cell function in this patient. Ten other ADA--SCID patients have been treated with this form of enzyme replacement and five have responded to therapy. Lymphocytes from ADA--SCID patients treated with enzyme replacement become immunocompetent but remain enzyme deficient. Studies of these cells provide evidence supporting both cyclic AMP- and dATP-mediated immunosuppressive mechanisms in ADA--SCID. These observations suggest that inhibition of cyclic AMP synthesis and/or deoxycytidine (and possibly thymidine) supplementation may be useful new biochemical approaches to the therapy of ADA--SCID.

The maturing of hormesis as a credible dose-response model

Hormesis is a dose-response phenomenon that has received little recognition, credibility and acceptance as evidenced by its absence from major toxicological/risk assessment texts, governmental regulatory dose-response modeling for risk assessment, and non-visibility in major professional toxicological society national meetings. This paper traces the historical evolution of the hormetic dose-response hypothesis, why this model is not only credible but also more common than the widely accepted threshold model in direct comparative evaluation, and how the toxicological community made a critical error in rejecting hormesis, a rejection sustained over 70 years.

The immunoregulatory effects of antidepressants

There is some evidence that major depression is accompanied by activation of the inflammatory-response system (IRS). It has been hypothesized that increased production of proinflammatory cytokines may play a role in the etiology of major depression. If increased production of proinflammatory cytokines is at all involved in the etiology of depression, one would expect antidepressive treatments to have negative immunoregulatory effects. This paper reviews the effects of antidepressants, such as tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), heterocyclic antidepressants (HCAs), serotonin-noradrenaline reuptake inhibitors (SNRIs), lithium, l-5-hydroxytroptophan (L-5-HTP), reversible inhibitors of MAO-A (RIMA) on the production of proinflammatory cytokines, e.g. interferon-gamma (IFNgamma), and negative immunoregulatory cytokines and agents, e.g. interleukin-10 (IL-10). In depressed patients, prolonged treatment with antidepressants and mood stabilizers normalizes signs of activation of the IRS, such as increased serum IL-6 and acute phase protein concentrations. In vitro, it has been shown that various types of antidepressive drugs, including TCAs (imipramine; clomipramine); SSRIs (citalopram, fluoxetine, sertraline); lithium; SNRIs (venlafaxine); HCAs (trazodone); RIMAs (moclobemide) and L-5-HTP significantly suppress the ratio of IFNgamma/IL-10 production by peripheral blood immunocytes. These antidepressant drugs appear to have a common effect on the IRS, i.e. in vitro they increase the production of IL-10 by peripheral blood leukocytes. Thus, the results suggest that antidepressants have negative immunoregulatory effects. It may be speculated that antidepressants exert some of their antidepressant effects through their negative immunoregulatory capacities. Copyright 2001 John Wiley & Sons, Ltd.

Lithium ions Up-regulate mRNAs encoding dense-core vesicle proteins in nerve growth factor-differentiated PC12 cells

We recently reported that lithium ions induced an up-regulation of cysteine string protein (CSP) gene expression in nerve growth factor (NGF)-differentiated PC12 cells but not in undifferentiated cells. Concomitantly, expression of two other proteins of regulated secretory pathways, synaptophysin (SY) and SNAP-25, was unaffected by lithium. To assess further the specificity of this effect of lithium, we used cDNA arrays. Our data indicate that lithium ions increase the level of mRNA for proteins such as secretogranin II and vesicular monoamine transporter 1 that are preferentially associated with large densecore secretory vesicles (LDCVs) without affecting mRNAs for proteins predominantly affiliated with small synaptic-like vesicles, including the vesicular acetylcholine transporter and SY. This action of lithium is detected in NGF-differentiated PC12 cells but not in undifferentiated cells. These observations suggest that lithium ions modulate the turnover of LDCVs, and this may play a role in mediating the therapeutic action of lithium in manic-depressive illness.

Signalling pathways in the brain: cellular transduction of mood stabilisation in the treatment of manic-depressive illness

The long-term treatment of manic-depressive illness (MDI) likely involves the strategic regulation of signalling pathways and gene expression in critical neuronal circuits. Accumulated evidence has identified signalling pathways, in particular the family of protein kinase C (PKC) isozymes, as targets for the long-term action of lithium. Chronic lithium administration produces a reduction in the expression of PKC alpha and epsilon, as well as a major PKC substrate, MARCKS, which has been implicated in long-term neuroplastic events in the developing and adult brain. More recently, studies have demonstrated robust effects of lithium on another kinase system, GSK-3beta, and on neuroprotective/neurotrophic proteins in the brain. Given the key roles of these signalling cascades in the amplification and integration of signals in the central nervous system, these findings have clear implications not only for research into the neurobiology of MDI, but also for the future development of novel and innovative treatment strategies.

Comparison of adjuvants with respect to serum IgG antibody response in orally immunized chickens

We have previously shown that oral immunization with non-replicating antigens hardly induced serum IgG antibody response in chickens and addition of sodium fluoride (NaF) to the immunogen markedly improved their immunological states. In the present study, taurine, lithium and Quillaja saponin (Q-SAP) were compared with NaF with respect to their enhancement of serum IgG antibody response in chickens after oral immunization. The antibody titer of chickens which received Q-SAP as the mucosal adjuvant tended to be higher than that of chickens which received antigen plus NaF. Simultaneous administration of antigen with lithium or taurine elicited a higher antibody titer in chickens compared to those of chickens orally immunized with antigen alone, but the effect of these two adjuvants was less efficient compared with that of NaF. These results suggested that Q-SAP as well as NaF is useful as an oral adjuvant for chickens.

Cancer morbidity in psychiatric patients: influence of lithium carbonate treatment

The relationship between mental diseases and cancer development has been examined in a number of studies but the findings are still inconclusive and suffer from methodological problems. Studies conducted to examine the effect of lithium on malignant cells yielded inconsistent results. The study group included 609 patients treated by lithium carbonate and 2396 controls. A lower but non significant risk (RR = 0.79; CI = 0.17-3.60) to develop non-epithelial tumors was found among lithium carbonate treated psychiatric patients as compared to controls. A significantly (P = 0.05) inverse trend of cancer with lithium dose was observed. The risk of cancer development among each group of psychiatric patients was significantly lower than in the general population (RR = 0.68 for the lithium treated group versus 0.78 for controls). Mental patients have a lower cancer prevalence than the general population and lithium may have a protective effect.

Lithium-stimulated proliferation and alteration of phosphoinositide metabolites in MCF-7 human breast cancer cells

Lithium, which is used to treat bipolar psychiatric disorders, can stimulate proliferation of a number of cells in tissue culture. Proliferation of MCF-7 human breast cancer cells, which also respond to EGF and estrogens, was stimulated by LiCl (1-5 mM) within the concentration range that is encountered during human therapy with lithium. Stimulation of growth was specific for lithium; rubidium, potassium, and sodium showed no such effect. In the presence of antiestrogen, lithium stimulated the growth of hormone-dependent breast cancer cells MCF-7, ZR-75-1, and T47D but not hormone-independent MDA-MB-231 cells or an estrogen-independent clone of MCF-7 cells. Lithium-stimulated proliferation was limited by cytotoxicity which could be moderated by added potassium chloride (5-20 mM) in the medium. Each of the mitogens lithium, 17 beta-estradiol, and EGF increased the rate of uptake of myo-inositol into MCF-7 cells. Whether normalized to inositol lipids, to protein, or to DNA, steady-state levels of inositol phosphates were elevated by each of the mitogens including lithium, which inhibits the breakdown of inositol phosphates in the phosphoinositide signaling pathway. These data indicate that therapeutic concentrations of lithium can stimulate the proliferation of human breast cancer cells by a mechanism that may involve the phosphoinositide pathway.

Protective effect of lithium on the stress-induced depression of cell-mediated immunity in mice

The effect of lithium chloride (LiCl) administration on the stress-induced depression of cell-mediated immunity was studied in mice. Two models of stress-induced depression of immunity were used: (1) keeping the animals at a temperature of 4 degrees C twice for 24 h at a 24-h interval, and (2) keeping them in the dark for 96 h. Both kinds of stress significantly decreased the reactivity of cell donors in the graft-versus-host (GVH) reaction and recipients in the host-versus-graft (HVG) reaction. Treatment with LiCl of the cell donors in GVH reaction or the recipients in HVG reaction daily for three weeks before stress application completely abolished the immunosuppressive effect of "cooling" stress, but not "darkness" stress. The LiCl is thus shown as a potential immunomodulator protecting mice from some forms of the stress-induced depression of cell-mediated immunity.

Lithium-associated transient thyrotoxicosis in 4 Chinese women with autoimmune thyroiditis

Four Chinese female patients who suffered from manic-depressive disorder and underlying autoimmune thyroiditis developed transient episodes of thyrotoxicosis during maintenance lithium therapy. Endocrinologically speaking, three of them had "Hashitoxicosis", while the other had silent lymphocytic thyroiditis. Albeit rare among Western patients, such lithium-associated thyroid dysfunctions appeared to be more likely to occur in Hong Kong Chinese. They seemed to involve multiple aetiological factors, such as autoimmune thyroid disease, the toxic and immunomodulatory roles of lithium and perhaps genetic and dietary factors. Because of their self-limiting nature, the importance of avoiding unnecessary and potentially deleterious antithyroid treatment is emphasised.

Induction of the differentiation of HL-60 and WEHI-3B D+ leukemia cells by lithium chloride

The use of lithium chloride in manic-depressive patients and in patients receiving myelo-suppressive cancer chemotherapeutic agents is accompanied by a sustained leukocytosis due to an increase in granulocyte production. This property suggests that lithium chloride may have effects on hematopoietic differentiation. Treatment of cultured WEHI-3B D+ murine myelomonocytic and HL-60 human promyelocytic leukemia cells with millimolar concentrations of lithium chloride resulted in concentration-dependent increases in the number of differentiated myeloid cells, as determined by the ability of the cells to reduce nitroblue tetrazolium and by the binding of myeloid specific antibodies, and was associated with an inhibition of cellular proliferation. The effects of lithium chloride on growth and differentiation were antagonized by KCl, whereas NaCl had little effect. The induction of leukemic cell maturation by lithium chloride was markedly enhanced by the addition of low levels of retinoic acid. In contrast, other differentiation inducing agents (i.e. dimethyl sulfoxide and selenazofurin) had no effect on the degree of maturation induced by lithium. These findings suggest that the combination of lithium chloride and retinoic acid may have clinical utility in the treatment of leukemia through the induction of terminal differentiation.

Possible immunological effects of psychotropic medication

Psychoactive drugs provide an essential intervention in the care of organ transplant recipients, yet little is known of their effect on immunological function. Human and animal data on immunological effects of neuroleptic (e.g., haloperidol, phenothiazines) and antidepressant agents (e.g., tricyclic antidepressants, fluoxetine) lead to conflicting hypotheses. Lithium carbonate acts through the phosphoinositide system and has a bipolar effect on neuronal activity. Lithium is known to have immune-enhancing properties and is difficult to administer in the peritransplant period but nonetheless deserves study for possible beneficial effects on allograft function.

Effects of lithium on dimethyl sulfoxide induced differentiation of HL-60 promyelocytic leukemia cells

The human promyelocytic leukemia cell line, HL-60, was used to investigate the effects of lithium on dimethyl sulfoxide (DMSO)-induced granulocytic differentiation of these cells. Dose-response studies showed an optimal increase of cellular proliferation when cells were incubated with 5 mM lithium for 5 days (127 +/- 5% of DMSO only treated cells). This enhancement in growth was preceded by significantly increased [methyl-3H]thymidine incorporation (143 +/- 4% of DMSO only treated controls) after 2 days. However, no significant changes in the ability of cells to reduce NBT could be detected irrespective of whether the cells were incubated with 1.25% (v/v) DMSO only, or with DMSO plus non-toxic concentrations (less than or equal to 10 mM) lithium. From the results obtained it would appear as if the arrest of growth induced by DMSO and the stimulation of proliferation effected by lithium occurs along independent pathways and that lithium exerts its mitogenic effect prior to the onset of terminal differentiation initiated by DMSO.

Lithium mimics dexamethasone in stimulating DNA synthesis by WI-38 cells

Lithium interferes with the responses of neural and secretory cells to calcium-mobilizing agonists by blocking the generation of phospholipase C-dependent second messengers. However, the mechanism by which lithium stimulates the proliferation of other cells in response to agonists that do not activate phospholipase C remains obscure. We investigated the pathways that mediate the mitogenic action of lithium on WI-38 cells in a defined, serum-free medium. Lithium, like dexamethasone (Dex), potentiated DNA synthesis in response to the combination of insulin+epidermal growth factor (EGF) (+50%), but not in response to either growth factor alone or with Dex. As in the case of Dex, lithium could be added as late as 8 h following stimulation of quiescent cells by insulin+EGF without loss of potentiating activity. While DNA synthesis in control cultures was essentially complete by 24 h, lithium and Dex stimulated "late" DNA synthesis (24-30 h) 10-fold and 5-fold, respectively. The potentiating activity of Dex, but not that of lithium, was blocked by the specific glucocorticoid receptor antagonist, RU486. Both lithium and Dex stimulated log-phase growth, but only Dex increased saturation density. These data indicate that both lithium and Dex recruit into the cell cycle a subpopulation of cells with a longer mean prereplicative phase (G1). The effect of lithium on DNA synthesis in WI-38 cells may be mediated by the glucocorticoid response pathway at some point distal to activation of the glucocorticoid receptor, or by an independent mechanism that can be switched on late in G1.

Effective modulation of the haematopoietic toxicity associated with zidovudine exposure to murine and human haematopoietic progenitor stem cells in vitro with lithium chloride

The drug zidovudine (AZT), a synthetic thymidine analogue, has been used in the treatment of acquired immunodeficiency syndrome (AIDS). Clinical use of zidovudine has induced haematopoietic toxicity manifested by anaemia, neutropenia, frequent thrombocytopenia, and overall bone-marrow suppression. The monovalent cation lithium has been shown to be an effective agent capable of modulating several aspects of haematopoiesis such as the induction of neutrophilia, thrombopoiesis, and protection against suppression of haematopoietic progenitor stem cells following exposure to anticancer drugs and/or radiation in the treatment of malignant disease. We here report the results of studies designed to evaluate the effectiveness of lithium in reversing and/or protecting against either murine or human bone marrow derived haematopoietic progenitors, i.e. (CFU-GM, CFU-Meg, and BFU-E) when co-cultured in the presence of zidovudine in vitro. Lithium chloride (LiCl) reversed zidovudine toxicity to either murine or human derived CFU-GM and CFU-Meg that was optimal at a concentration of 1 mM (P less than 0.05). However, the addition of lithium failed to influence zidovudine toxicity toward either murine or human BFU-E. In summary, these results support the scant clinical studies that have described the presence of neutrophilia and/or thrombopoiesis in zidovudine-treated AIDS patients receiving lithium. In addition, these data further confirm the need for more detailed evaluation of lithium as an adjuvant agent to reduce the haematopoietic toxicity associated with the use of antiviral therapy in HIV-infected patients.

Control of proliferation of MCF-7 breast cancer cells in a commercial preparation of charcoal-stripped adult bovine serum

A commercial preparation of charcoal-stripped adult bovine serum was used to culture MCF-7 cells in estrogen-free media. Use of this stripped adult bovine serum represents an alternative to calf serum which is in more limited supply, and saves charcoal-stripping of serum in the laboratory, which can be a rate-limiting step in the preparation of materials for estrogen-free tissue culture. MCF-7 cell proliferation was controlled by estrogens, epidermal growth factor (EGF) and lithium chloride in adult bovine serum as well as in standard media prepared with charcoal-stripped calf serum, and approximately the same fold-increase in response to the tested agents was observed in the two sera. Although the growth rates were lower in media prepared with adult bovine serum, MCF-7 cells in both media exhibited the same sensitivities in dose-responses to these three mitogens. Levels of estrogen and progesterone receptors, and the magnitude of estrogen-dependent stimulation of the progesterone receptors, were similar in cells maintained in both sera. Therefore, a commercially stripped adult bovine serum can be used to replace calf serum in the study of estrogenic responses and the control of proliferation in MCF-7 breast cancer cells.

Kaposi sarcoma associated with human immunodeficiency virus infection

In the present study, 11 patients with epidemic Kaposi sarcoma were evaluated; 55% were in stage IV and 45% in stage II; in addition, 75% had systemic symptoms, 89% had low total and T-lymphocyte counts, and all of them had not only low T-helper lymphocyte counts but also T-helper/T-suppressor ratios. The majority of patients (89%) had low proliferative responses with phytohemagglutinin (PHA). Nine patients were treated with: alpha-2 interferon (five patients), zidovudine (two patients), doxorubicin and zidovudine (one patient), and radiotherapy (one patient). There were only five patients with stable disease, three treated with alpha-2 interferon, one with doxorubicin, and one with doxorubicin plus azidothymidine. Two patients (one with doxorubicin and one with doxorubicin plus zidovudine) needed lithium to increase leukocyte and platelet counts. In May 1989, 73% of patients were dead (median survival 8 +/- 2 months). It is concluded that: (1) it is important to select the patients who have the best chance to improve with treatment; (2) the response with alpha-2 interferon or monochemotherapy is low and there is no change in overall survival; (3) a low helper cell count, low T-helper/T-suppressor ratio, and low proliferative response with mitogens are features of poor prognosis; (4) toxicity with treatment was acceptable; and (5) lithium increased neutrophil and platelet counts.

Lithium counteracts histamine suppression of human T cell mitogenesis

Human T cell proliferative responses to concanavalin A (conA) were suppressed by approximately 50% by histamine (100 microM). In contrast, LiCl (1 or 3 mM) potentiated T cell responses by about 50%, but 10 mM LiCl had no significant effect on T cell proliferation. Histamine suppression was not significantly affected by the presence of potentiating concentrations of LiCl, whereas 10 mM LiCl completely abrogated histamine suppression.

Lithium enhances the proliferation of HL-60 promyelocytic leukemia cells

The effects of lithium, an agent used in the treatment of manic depression and to attenuate myelosuppression during chemotherapy, on HL-60 promyelocytic leukemia cells were investigated. By monitoring cell growth at varying concentrations (0-50 mM), as well as by following cell proliferation over 8 days, it was established that lithium stimulates HL-60 proliferation within a very narrow concentration range. Enhancement of growth was optimal at 5 mM, whereas concentrations above 10 mM were toxic. Time course studies revealed that the greatest increase in cell number occurred after 5-6 days in the presence of lithium. This was preceded by DNA synthesis reaching a maximum after 1-2 days. Viability of the cells decreased gradually after 3 days with 5 mM, but not with 2.5 mM. We suggest that HL-60 cells are a suitable model to further investigate possible mitogenic and cytotoxic effects of lithium in vitro.

Biological effects of lithium chloride on the insect trypanosomatid Herpetomonas samuelpessoai

Effects of lithium chloride on growth, differentiation and respiration of Herpetomonas samuelpessoai, cultivated in a synthetic medium were studied both at 28 and 37 degrees C. Low concentration of lithium chloride (15 mM) stimulated growth at 37 degrees C. In addition, the protozoon tolerated high concentrations (60-150 mM) of the salt at both incubation temperatures. In general, 15 mM lithium chloride increased and 150 mM decreased oxygen uptake when glucose, glutamic acid and proline were used as substrates. However, at 28 degrees C after incubation for 96 h, the highest concentration increased oxygen uptake in the presence of glucose. Sodium butyrate induced cell differentiation in H. samuelpessoai both at 28 and 37 degrees C. High concentration (150 mM) of lithium chloride inhibited cell differentiation of H. samuelpessoai induced by both controlled growth conditions and butyrate addition. The results obtained are described in this paper.

Lithium modulation of second messenger signal amplification in man: inhibition of phosphatidylinositol-specific phospholipase C and adenylate cyclase activity

The activity of phosphatidylinositol-specific phospholipase C was significantly reduced in platelets obtained from 20 euthymic manic-depressive patients on therapeutic lithium doses (mean blood level 0.85 mEq/l) compared to an age- and sex-matched group of 36 control subjects. The activities of prostaglandin E1-, aluminum/NaF-, and forskolin-stimulated platelet adenylate cyclase activity were also measured in a similar group of 16 lithium-treated and 22 control subjects. A marked reduction in both postreceptor (aluminum/NaF and forskolin) and receptor-stimulated (prostaglandin E1) platelet adenylate cyclase activity was observed in the lithium-treated group (mean blood level 0.81 mEq/l). These findings support the hypothesis that lithium's therapeutic mode of action in manic-depressive psychosis is mediated by the combined down-regulation of both principal second messenger systems, inositol phosphates and cyclic adenosine monophosphate, by reducing the activity of phosphatidylinositol-specific phospholipase C and adenylate cyclase.

Lithium potentiates antigen-dependent stimulation of lymphocytes only under suboptimal conditions

Immunization of hamsters with DNP-BSA in either Freund's complete or incomplete adjuvant led to the induction of antigen reactive lymph node cells. As assessed by in vitro lymphocyte stimulation assays, antigen in complete adjuvant was more effective than antigen in incomplete adjuvant in inducing immunity. Supplementing antigen-stimulated cultures from animals 14 days post-immunization with LiCl led to no enhancement of tritiated thymidine incorporation into cells from animals immunized with antigen in complete adjuvant, but did enhance antigen-dependent stimulation of cells from animals immunized with antigen + incomplete adjuvant. LiCl was, however, able to enhance stimulation of cells from animals immunized with antigen + complete adjuvant at 22 and 29 days post-immunization, when in vitro responsiveness was declining. Lymph node cells from animals optimally immunized antigen + complete adjuvant were fractionated by passage over Sephadex G-10 columns. Sephadex G-10 non-adherent cells, deficient in cells such as macrophages, exhibited a depressed responsiveness to antigen, compared to unfractionated cells, and responsiveness was not restored by LiCl. Stimulation of cells by antigen was found to be inhibited by supplementing the cultures with theophylline or dibutyryl cyclic AMP and this inhibition could be reversed by LiCl. Lithium would, therefore, appear to be able to influence lymphocyte adenylate cyclase. Thus, LiCl can exert an immunopharmacologic effect on in vitro antigen stimulation primarily when conditions are suboptimal, possibly through an influence on cyclic AMP metabolism.

Mechanism of lithium-induced augmentation of T-cell proliferation

The mechanism whereby lithium augments mitogen-stimulated T-cell proliferation was investigated. Lithium in a concentration of 5mM caused a significant increase in interleukin 2 (IL-2) production after phytohemagglutinin (PHA) stimulation. Lithium also caused an increase in interleukin 1 production from peripheral blood monocytes. Lithium did not influence the expression of IL-2 receptors on T-cells. However, lithium did result in increased proliferative response to IL-2 in an IL-2 responsive cell line. Thus, lithium influences the T-cell proliferation response to mitogens in several ways, by stimulation of lymphokine and monokine production as well as by augmenting the response of IL-2 responsive cells to IL-2.

Dissociation of neutrophil aggregation, adhesiveness, and Fc receptor activity

Neutrophils that bear receptors for the Fc portion of immunoglobulin G have been demonstrated to be more active in assays of adherence, aggregation, and chemotaxis compared to Fc receptor-negative cells. We examined the relationship of neutrophil Fc receptor activity and cell-cell adherence or aggregation induced by phorbol myristate acetate. In contrast to 1-isoproterenol, isobutyl-methyl-xanthine, and dibutyryl cAMP, each of which inhibited Fc receptor activity and neutrophil aggregation, theophylline significantly impaired aggregation without affecting Fc receptor activity. The selective beta-2 agonist, metaproterenol, and 8-Bromo cAMP failed to inhibit Fc receptor activity or neutrophil aggregation. Three known inducers of neutrophil intracellular cyclic AMP, PGE1, PGE2, and cholera toxin, also did not inhibit Fc receptor activity. Inhibition of Fc receptor activity by 95% in the presence of purified Fc fragments did not affect neutrophil aggregation. Similarly suppression of Fc receptor activity by purified Fc fragments did not inhibit neutrophil adhesion to nylon fiber columns. These data demonstrate that the Fc receptor does not mediate phorbol myristate acetate-induced cell-cell adhesion and is not necessary for optimal neutrophil adhesion to nylon fibers. Our results are consistent with the possibility that the reversible inhibitory activity of beta-adrenergic agonists on rosette formation may be a steric effect rather than a metabolic effect. These data tend to dissociate Fc receptor activity, neutrophil aggregation, and adhesion and support the hypothesis that the Fc receptor may be a marker of neutrophil heterogeneity rather than a component necessary for optimal neutrophil aggregation or adhesion.

Lithium ion reversibly inhibits inducer-stimulated adipose conversion of 3T3-L1 cells

Adipose conversion of 3T3-L1 cells by inducers (dexamethasone, 1-methyl-3-isobutylxanthine and insulin) was inhibited by LiCl at concentrations from 2 to 20 mM. The effect of LiCl was reversible and the inhibited cells were converted to adipocytes when stimulated after the removal of LiCl. Inhibition by LiCl of adipose conversion was accompanied with a blockage of the enhanced [3H]thymidine incorporation and cellular proliferation that occurred before the adipocyte phenotype was expressed. Of the cations tested, only Li+ had these effects.

Lithium and immune function

Lithium has potent antiviral and immunostimulating properties which are probably consequences of its actions on prostaglandin synthesis. Although lithium has considerable potential in the prophylaxis of some viral illnesses and other manifestations of defective immune function, it is, paradoxically, capable of activating autoimmune mechanisms in predisposed patients.

Lithium inhibits terminal differentiation of erythroleukemia cells. Evidence for a pre-commitment 'priming' event

Lithium has been found to be a novel inhibitor of the terminal differentiation of Friend murine erythroleukemia cells. A general method for the quantitative analysis of differentiation inhibitors has been developed and used to compare the site of inhibition by lithium with that by vanadate. Lithium inhibits the commitment to differentiation (K 1/2 approximately 10 mM) induced by DMSO (dimethylsulfoxide) at non-toxic concentrations that have only a small effect on the rate of proliferation. Inhibition is reversible and probably requires entry of Li+ into the cell, since it is blocked by high KCl in the medium. LiCl is most effective when present during the first 10 h of DMSO treatment, before commitment is initiated. Computer-assisted analysis of the kinetics of commitment demonstrate that inhibition by lithium is best described by including a lithium-sensitive 'priming' event, which occurs with high probability prior to commitment.

The AIDS virus as an opportunistic organism inducing a state of chronic relative cortisol excess: therapeutic implications

The AIDS virus is an opportunistic organism which requires a previously immunocompromised host for successful replication. We propose that the primary and as yet unlocalized lesion caused by the AIDS virus involves disruption of physiologically balanced responses to stressors, effectively creating a state of chronic relative cortisol excess. Such a state inhibits successful anti-pathogen strategies including those directed against the AIDS virus itself and leads to a self-sustaining downhill clinical course. Therapies based on this model are discussed.

Immunological response to stress in agoraphobia and panic attacks

The authors studied in vitro immune function as measured by lymphocytic proliferative response to mitogen stimulation in 36 patients with agoraphobia and panic attacks who were participating in a double-blind placebo-controlled psychopharmacological study of anxiety disorder. No significant difference in immune status was observed between panic patients and healthy controls.

Lithium-associated thyrotoxicosis

Primary hypothyroidism developed in a 57-year-old woman treated for eight years with lithium carbonate for manic-depressive illness, and nine months later she became thyrotoxic. Although autoimmune disease appeared to be responsible, lithium was suspected to play a contributory role in both phases of her illness. This is the first reported case of hyperthyroidism following hypothyroidism in a lithium-treated patient. The 24 reported cases of lithium-associated thyrotoxicosis and the possible mechanisms that may explain this poorly understood phenomenon are also reviewed.

Lithium ion inhibits nerve growth factor-induced neurite outgrowth and phosphorylation of nerve growth factor-modulated microtubule-associated proteins

LiCl (2.5-20 mM) reversibly suppressed nerve growth factor (NGF)-induced neurite outgrowth by cultured rat PC 12 pheochromocytoma cells. Similar concentrations of LiCl also reversibly blocked NGF-dependent regeneration of neurites by PC12 cells that had been primed by long-term pre-exposure to NGF and by cultured newborn mouse sympathetic neurons. In contrast, transcription-dependent responses of PC12 cells to NGF such as priming and induction of the NGF-inducible large external glycoprotein, occurred despite the presence of Li+. SDS PAGE analysis of total cellular phosphoproteins (labeled by 2-h exposure to 32P-orthophosphate) from neurite-bearing primed PC12 cells revealed that Li+ reversibly inhibited the phosphorylation of a band of Mr 64,000 that was barely detectable in NGF-untreated PC12 cells. However, Li+ did not appear to affect the labeling of other phosphoproteins in either NGF-primed or untreated PC12 cultures, nor did it affect the rapid increase in phosphorylation of several proteins that occurs when NGF is first added to unprimed cultures. Several criteria indicated that the NGF-inducible phosphoprotein of Mr 64,000 is a microtubule-associated protein (MAP). Of the NGF-inducible phosphorylated MAPs that have been detected in PC12 cells (Mr 64,000, 72,000, 80,000, and 320,000), several (Mr 64,000, 72,000, and 80,000) were found to be substantially less phosphorylated in the presence of Li+. Neither a phorbol ester tumor promotor nor permeant cAMP analogs reversed the inhibitory effects of Li+ on neurite outgrowth or on phosphorylation of the component of Mr 64,000. Microtubules are a major and required constituent of neurites, and MAPs may regulate the assembly and stability of neuritic microtubules. The observation that Li+ selectively inhibits NGF-induced neurite outgrowth and MAP phosphorylation suggests a possible causal relationship between these two events.

Conditioned taste aversion suppresses induction of delayed-type hypersensitivity immune reactions

Conditioned taste aversion was induced in mice by pairing saccharin drinking with an intraperitoneal injection of lithium chloride, a toxic but nonimmunosuppressive drug. Conditioned mice showed not only suppressed saccharin drinking but also a 75% reduction in the induction of delayed-type hypersensitivity immune responses to low doses of sheep erythrocytes. This effect was observed with doses of lithium chloride which had no effect of their own on immune functions. In addition, a reduction in water consumption was not responsible for the reduced immune response of conditioned mice since the immune responses of water deprived mice did not differ from those of nondeprived mice. Conditioned mice exposed to saccharin had higher plasma levels of glucocorticoids than nonconditioned mice, suggesting that the experience of being reexposed to a taste paired with lithium chloride was perceived as aversive. These data demonstrate that alterations in immune functions can be induced by a conditioned taste aversion procedure independently of any immunosuppressive drug.

Lithium therapy for mania and depression

The literature on lithium carbonate was reviewed for clues to the processes involved in mania. Lithium has proved effective therapeutically and prophylactically for mania and depressive disorders. Children and adolescents as well as adults tolerate lithium well. Side effects rarely are serious enough to necessitate having lithium therapy. Some success with schizophrenia and schizoaffective disorders has broadened the scope of lithium's therapeutic efficacy but also blunted the expectation for a direct relationship between lithium and the processes involved in mania. Research points to neurotransmitters as contributing to the etiology and symptom pattern of mania.

Evolution of oligoleukemia

Chronic lithium administration to 22 patients with oligoleukemia did not alleviate cytopenia or stimulate bone marrow proliferative activity. The authors identified, however, pretreatment characteristics discriminating two evolutionary endpoints of oligoleukemia (marrow failure, 10 patients; overt acute leukemia, 12 patients): higher marrow leukemic infiltrate, normal myeloid precursor proportion, platelet count, and female sex all favored eventual transition to overt leukemia which, in comparison with marrow failure, was associated with a significantly longer survival duration from symptoms. For patients developing overt leukemia, survival from diagnosis was inversely correlated with the degree of marrow leukemic infiltrate. The lack of lithium responsiveness in oligoleukemia is consistent with the concept of differentiated leukemia with abnormalities either at the level of a lithium-responsive adherent cell elaborating colony stimulating activity (CSA) or at the level of CSA-responsive CFUs.

Specificity of lithium (Li+) to enhance the production of colony stimulating factor (GM-CSF) from mitogen-stimulated lymphocytes in vitro

We report here studies demonstrating the ability of Li+ to increase GM-CSF production from both mitogen-induced spleen and thymus cells prepared as serum-free conditioned media (SF-SCCM, SF-TCCM). GM-CSF activity was both a mitogen and Li+ specific mediated event (P less than 0.001-0.001). Identical cultures prepared with either Na, K, Ca, or Mg did not induce GM-CSF activity as compared to Li. No GM-CSF activity was observed in the absence of mitogen. Furthermore, indomethacin (10(-6) M), a potent inhibitor of prostaglandin (PG) synthesis, produced an even greater enhancement in GM-CSF than control cultures prepared without indomethacin. These data indicate Li may enhance GM-CSF production by inhibiting the ability of PG to decrease GM-CSF production. CFU-Mk colony formation was not significantly influenced by any specific cation-induced mitogen (CM), suggesting Li's ability to stimulate megakaryocytopoiesis may be mediated via a more direct stem cell effect. Furthermore, Li-derived (CM) significantly reduced both CFU-E and BFU-E, while those CMs prepared in the presence of K and Ca significantly increased erythroid colony formation. These effects could be mediated via alterations in the production of BPA. These studies demonstrate the unique capacity of cations to influence the differentiation of committed hematopoietic stem cells possibly by modulating the production of such factors required for hematopoietic differentiation.

Lithium inhibits the cytolytic glucocorticoid effect on S49 mouse lymphoma cells

Cytolysis is the end point of receptor-mediated effects of glucocorticoids on S49 mouse lymphoma cells of wild-type. In the presence of 5 mM LiCl this effect of triamcinolone or dexamethasone was markedly delayed. The cytoprotective effect of Li+ against 10(-7) M triamcinolone acetonide was already manifest after 24 h of steroid incubation, and on the fifth day 50-fold more Li+-treated than control cells were viable. This effect of Li+ was not exerted through changes of the doubling time of the cells, and thus could not be ascribed to an overall reduction of protein- or RNA synthesis. Data on accumulation and effect of cyclic AMP indicated that the cytoprotective effect was independent on cyclic AMP. Furthermore Li+ did not affect the amount or affinity of glucocorticoid receptors in intact cells. By use of aqueous 2-phase partitioning and DNA-Sepharose binding of [3H]triamcinolone acetonide labelled cytosols we demonstrate that Li+ inhibits the in vitro salt-activation of the glucocorticoid-receptor complexes by 60-100%. The nuclear bound fraction of hormone-receptor complexes in intact cells at 37 degrees C was not affected by Li+. The data suggest that Li+ inhibits the cytolytic glucocorticoid effect by interacting with the hormone-receptor complexes.

Salivary and lacrimal secretions in patients on lithium therapy

Salivary and lacrimal secretion rates and salivary composition were examined in 22 manic-depressive patients on lithium therapy and in 21 matched, healthy controls. Serum immunoglobulins (IgG and IgA) were measured in these patients. Their oral health was examined and found to be unimpaired. Significantly lowered tear secretion was detected in the patients, while their salivary secretion rates were normal. The salivary concentrations of NA, K and IgA were significantly elevated in whole saliva. In parotid saliva, the concentrations of K and IgA were elevated, while Na was in the normal range. A significant correlation between serum and salivary lithium concentrations was found, indicating the usefulness of salivary measurements for monitoring. Informed consent of the patients was obtained after the nature of the procedures had been fully explained.

Circulating T-cell subpopulations in lithium-associated granulocytosis

Granulocytosis is a common feature in patients undergoing lithium therapy. With increasing evidence that T lymphocytes play a role in the control of granulopoiesis, we have investigated the effect of lithium administration on circulating levels of T helper and T suppressor cells, as identified by monoclonal antibodies, to determine whether lithium-induced granulocytosis is mediated through changes in peripheral blood T cell subsets. Lithium carbonate was administered to 10 subjects over a 2 week period. Differential leucocyte counts and T, B, T helper and T suppressor lymphocyte enumerations were performed prior to administration of lithium (Day 1) and on 2 occasions (Day 7 and 14) during ingestion of the drug. Ten healthy control subjects were similarly investigated. Small, but significant elevation (p less than 0.05) in neutrophil counts at 7 and 14 days were observed in subjects taking lithium, serum lithium levels at these times were 0.56 +/- 0.27 and 0.68 +/- 0.17 mmol/l, respectively; lymphocyte and monocyte levels were unaffected. The percentages and absolute numbers of circulating T, B, T helper and T suppressor lymphocytes were not significantly altered (p greater than 0.05) during lithium administration and did not differ significantly (p greater than 0.05) from those recorded for the control group. We were thus unable to demonstrate that short-term lithium administration induced changes in the circulating levels of T helper (OKT4+) or T suppressor (OKT8+) cells.

The effects of prostaglandins on the proliferation of cultured human T lymphocytes

The effects of PGE2 on cultured T lymphocytes (CTC) stimulated by either Con A, PHA, or lectin-free IL-2 were studied. PGE2, in a concentration ranging from 100 to 1 ng/ml, consistently and significantly inhibited the proliferation of CTC induced by either PHA or Con A. PGF2 alpha was essentially without effect. Although the degree of inhibition of PHA-treated CTC was increased with suboptimal amounts of PHA, significant inhibition still resulted with optimal PHA concentrations. PGE2, but not PGF2 alpha, was also effective in significantly inhibiting the proliferation of IL-2-treated CTC in a dose-related fashion; however, the addition of suboptimal amounts of IL-2 did not result in greater increases in the degree of inhibition by PGE2. Depleting the CTC of either OKT-4 or OKT-8 phenotypic cells did not abrogate this PGE2 inhibitory effect, indicating that PGE2 does not suppress the proliferative response solely by the activation of suppressor cells with the OKT-8 phenotype. PGE2 also was found to inhibit the production of IL-2 by fresh lymphocytes treated by either optimal or suboptimal amounts of PHA, however, this decrease in production by PGE2 was not necessarily associated with a decrease in the proliferation of these stimulated lymphocytes. Only with low PHA concentrations, where IL-2 production was markedly reduced and barely detectable, was lymphocyte proliferation appreciably reduced by PGE2. In additional experiments, LiCl was added to PGE2 containing cultures to determine whether LiCl could modulate the inhibitor effect of PGE2 of either PHA- or IL-2-stimulated CTC. In these studies, LiCl, in concentrations of 1-10 mM was found to lessen or completely abrogate the reduced PHA proliferative response induced by PGE2. This effect was more pronounced with suboptimal concentrations of PHA than with optimal PHA amounts. In contrast, the PGE2-induced inhibition of IL-2-stimulated CTC was not modified or altered by the addition of LiCl. Thus, these results suggest that LiCl acts at the level of IL-2 production instead of IL-2 action, and that PGE2 inhibits IL-2-induced proliferation of CTC by a different or additional mechanism than for PHA-treated cells. In conclusion, these results, taken as a whole, indicate that PGE2 suppresses the proliferation of stimulated CTC by at least two different mechanisms: 1) by reducing the production of IL-2 by stimulated lymphocytes; and 2) by directly acting on the responding CTC.(ABSTRACT TRUNCATED AT 400 WORDS)

Growth effect of lithium on mouse mammary epithelial cells in serum-free collagen gel culture

The effect of lithium on the growth of mammary epithelial cells from adult virgin and midpregnant BALB/c or BALB/cfC3H mice was tested in a serum-free collagen gel culture system. The serum-free medium consisted of a 1:1 mixture of Ham's F12 and Dulbecco's Modified Eagle's medium supplemented with insulin, transferrin, cholera toxin, epidermal growth factor (EGF), and bovine serum albumin fraction V (BSA V). A multifold increase in cell number occurred during 10-12 days of culture in this medium. In dose-response studies in which the concentration of each component of this serum-free medium was varied in turn, the addition of LiCL (10 mM) enhanced growth at most concentrations of each factor. However, LiCl could not enhance growth in the absence of insulin or BSA V, but could replace EGF. The optimal concentration of LiCl was 5-10 mM; higher concentrations (20-80 mM) were toxic. KCl (1-10 mM) when added to the serum-free medium slightly stimulated growth; the addition of NaCl to the medium had little effect on growth. LiCl did not enhance the growth of cells from spontaneous mammary tumors of BALB/cfC3H mice.

Synthetic immunomodulators for prevention of fatal infections in a burned guinea pig model

Individuals who have suffered severe trauma, such as burns, have a high incidence of infection associated with impaired host resistance. Nonspecific stimulators of host defense mechanisms, i.e., immunomodulators, may be of benefit in such situations. A small animal model (guinea pigs) was developed to study the efficacy of immunomodulators in burns. Anesthetized animals received a 20% total body surface area, full-thickness, scald burn. There was no mortality associated with this injury, but these animals were highly susceptible to challenge with Pseudomonas aeruginosa strain 1244 by direct injection into the burn wound within 24 hours of injury. This susceptibility persisted about 7 days. The standard model adopted was to injure animals, then challenge with 1 median lethal dose (LD50) of P. aeruginosa 96 hours after injury. Using this model, six synthetic immunomodulators were tested: CP-20,961, CP-46,665, muramyl dipeptide, thymopoietin pentapeptide (TP-5), levamisole, and lithium. Drug administration began 24 hours after injury and ended prior to challenge with P. aeruginosa at 96 hours. CP-20,961, muramyl dipeptide, levamisole, and lithium all had no beneficial effect on survival. A single dosage (0.3 mg/kg, I.V.) of CP-46,665, administered 24 hours postinjury, increased the survival rate from 50% to 85% and mean survival time (MST) from 8.2 days to 12.4 days. TP-5, given in four doses (0.1 mg/kg, I.V. each) every 24 hours, increased the survival rate from 40% to 80% and MST from 6.9 days to 11.6 days. These data show that immunomodulators could be of benefit in burns, but also that not all agents are effective in this particular situation.

A review and controlled study of cutaneous conditions associated with lithium carbonate

This study compares the incidence of a variety of cutaneous conditions among 91 patients treated with lithium carbonate with the incidence of such conditions among 44 patients treated with other non-neuroleptic, maintenance medications. Data on cutaneous conditions and allergies were obtained using structured interviews, demographic data, medication histories and personal and family histories. A significantly greater proportion of the lithium-treated patients than the comparison patients reported a cutaneous condition which may have been secondary to treatment in that it developed for the first time after the medication or appeared to have been exacerbated by the medication. Among the lithium-treated patients, females were found to be significantly more likely to report a secondary cutaneous condition. This effect was found across the whole range of cutaneous conditions. Male lithium-treated patients on the other hand reported approximately the same rate of secondary cutaneous conditions as both male and female comparison patients. Possible reasons for this sexual effect on incidence are discussed. The literature on cutaneous conditions which have been associated with lithium therapy is also reviewed.

Effects of short-term lithium treatment on peripheral blood lymphocytes and granulocytes in healthy volunteers

The effects of a short-term treatment with lithium carbonate on lymphocytes and granulocytes were studied in six normal subjects. The lithium effects are related to a direct, immediate and quickly reversible action of the drug on the bone marrow, as demonstrated by the granulocyte number and variations in Arneth's index. Although lymphocyte and granulocyte functions do not seem to be affected by lithium when investigated by the usual methods, the ability of the drug to counteract the theophylline-induced inhibition of cellular functions would suggest that lithium acts mainly through the modulation of intracellular levels of cyclic nucleotides. This is confirmed by evaluation of cellular cyclic 3',5'-adenosine monophosphate (cAMP). The above hypothesis could explain the quick onset and loss of lithium action on granulopoiesis.