Dell'Osso Liliana, Del Grande Claudia, Gesi Camilla, Carmassi Claudia, Musetti Laura
Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
Neuropsychiatr Dis Treat. 2016 Jul 11;12:1687-703. doi: 10.2147/NDT.S106479. eCollection 2016.
Increasing evidence highlights bipolar disorder as being associated with impaired neurogenesis, cellular plasticity, and resiliency, as well as with cell atrophy or loss in specific brain regions. This has led most recent research to focus on the possible neuroprotective effects of medications, and particularly interesting findings have emerged for lithium. A growing body of evidence from preclinical in vitro and in vivo studies has in fact documented its neuroprotective effects from different insults acting on cellular signaling pathways, both preventing apoptosis and increasing neurotrophins and cell-survival molecules. Furthermore, positive effects of lithium on neurogenesis, brain remodeling, angiogenesis, mesenchymal stem cells functioning, and inflammation have been revealed, with a key role played through the inhibition of the glycogen synthase kinase-3, a serine/threonine kinase implicated in the pathogenesis of many neuropsychiatric disorders. These recent evidences suggest the potential utility of lithium in the treatment of neurodegenerative diseases, neurodevelopmental disorders, and hypoxic-ischemic/traumatic brain injury, with positive results at even lower lithium doses than those traditionally considered to be antimanic. The aim of this review is to briefly summarize the potential benefits of lithium salts on neuroprotection and neuroregeneration, emphasizing preclinical and clinical evidence suggesting new therapeutic potentials of this drug beyond its mood stabilizing properties.
越来越多的证据表明,双相情感障碍与神经发生受损、细胞可塑性和恢复力受损以及特定脑区的细胞萎缩或丧失有关。这使得最近的研究集中在药物可能的神经保护作用上,锂盐尤其有一些有趣的发现。事实上,越来越多来自临床前体外和体内研究的证据记录了其对作用于细胞信号通路的不同损伤的神经保护作用,既能预防细胞凋亡,又能增加神经营养因子和细胞存活分子。此外,还揭示了锂盐对神经发生、脑重塑、血管生成、间充质干细胞功能和炎症的积极作用,其关键作用是通过抑制糖原合酶激酶-3发挥的,该酶是一种丝氨酸/苏氨酸激酶,与许多神经精神疾病的发病机制有关。这些最新证据表明锂盐在治疗神经退行性疾病、神经发育障碍和缺氧缺血/创伤性脑损伤方面具有潜在效用,甚至在低于传统认为的抗躁狂剂量时也能取得积极效果。本综述的目的是简要总结锂盐在神经保护和神经再生方面的潜在益处,强调临床前和临床证据表明该药物除了具有情绪稳定特性外还有新的治疗潜力。