5 replies to this topic

[ta5]

World J Biol Psychiatry. 2017 Feb;18(1):54-62.

The effect of long-term lithium treatment of bipolar disorder on stem cells circulating in peripheral blood.

Ferensztajn-Rochowiak E1, Kucharska-Mazur J2, Samochowiec J2, et al.

OBJECTIVES:

To investigate the effect of long-term lithium treatment on very small embryonic-like stem cells (VSELs), haematopoietic stem cells (HSCs), mesenchymal stem cells (MSCs) and endothelial progenitor cells (EPCs) circulating in peripheral blood (PB), in bipolar disorder (BD).

METHODS:

The study included 15 BD patients (aged 55 ± 6 years) treated with lithium for 8-40 years (mean 16 years), 15 BD patients (aged 53 ± 7 years) with duration of illness >10 years, who had never received lithium, and 15 healthy controls (aged 50 ± 5 years). The VSELs, HSCs, MSCs and EPCs were measured by flow cytometric analysis.

RESULTS:

In BD subjects not taking lithium the number of CD34+ VSELs was significantly higher, and MSCs and EPCs numerically higher, than in control subjects and the number of CD34+ VSELs correlated with the duration of illness. In lithium-treated patients these values were similar to controls and the number of CD34+ VSELs correlated negatively with the duration of lithium treatment and serum lithium concentration.

CONCLUSIONS:

Long-term treatment with lithium may suppress the activation of regenerative processes by reducing the number of VSELs circulating in PB. These cells, in BD patients not treated with lithium, may provide a new potential biological marker of the illness and its clinical progress.

KEYWORDS:

Bipolar disorder; lithium; staging; stem cells; very small embryonic-like stem cells

PMID: 27071327

[stephen_b]

The mean dose is not reported here for individuals with BD (bipolar disorder). It can be rather high (link).

 

 

Usual Adult Dose for Mania Acute Control: 1800 mg/day
-Regular release formulations: 600 mg orally 2 to 3 times a day
-Extended release formulations: 900 mg orally 2 times a day

Long-term Control: 900 to 1200 mg/day
-Regular release formulations: 300 to 600 mg orally 2 to 3 times a day
-Extended release formulations: 600 mg orally 2 times a day

 

[Turnbuckle]

The depletion may be the result of long-term overstimulation of asymmetric division, as it is known from previous work that lithium stimulates SCs.

[QuestforLife]

The depletion may be the result of long-term overstimulation of asymmetric division, as it is known from previous work that lithium stimulates SCs.

 

According to my reading of the abstract, BD patients without lithium treatment actually had more VSELs than non-BD controls and this increased with disease duration. Lithium reduced numbers back to normal. So perhaps there is something about the damage done by BD that is stimulating VSEL release. Lithium may just be restoring homeostasis.   

[Turnbuckle]

The paper actually admits to both possibilities--

 

The second finding of the study is that the number of CD34+ VSELs, CD34+ HSCs,

MSCs and EPCs was at similar levels in the lithium-treated patients to those in the control

subjects. In the lithium-treated patients, the number of VSELs inversely correlated with the

duration of lithium treatment and serum lithium concentration. In the light of the increasing

number of these cells circulating in the PB of BD patients not receiving lithium, this

observation may suggest that long-term treatment with lithium may result in a normalization

of the number of these cells in PB to the levels observed in healthy control subjects. It might

also be a result of time- and/ or age-related depletion of these cells as a result of the lithium

treatment. 

 

 

 

[QuestforLife]

How do you detect a VSEL, anyway? CD34+ and CD133+ surface markers, both mentioned in the study, are not unique to VSELs.

 

I assume you select the right markers and then filter by size? I couldn't find an explanation in the study.