Munteanu Constantin, Rotariu Mariana, Turnea Marius, Tătăranu Ligia Gabriela, Dogaru Gabriela, Popescu Cristina, Spînu Aura, Andone Ioana, Ionescu Elena Valentina, Țucmeanu Roxana Elena, Oprea Carmen, Țucmeanu Alin, Cseppento Carmen Nistor, Silișteanu Sînziana Calina, Onose Gelu
Faculty of Medical Bioengineering, University of Medicine and Pharmacy "Grigore T. Popa" Iași, 700454 Iași, Romania.
Teaching Emergency Hospital "Bagdasar-Arseni", 041915 Bucharest, Romania.
Life (Basel). 2022 Oct 22;12(11):1680. doi: 10.3390/life12111680.
Lithium is a source of great scientific interest because although it has such a simple structure, relatively easy-to-analyze chemistry, and well-established physical properties, the plethora of effects on biological systems-which influence numerous cellular and molecular processes through not entirely explained mechanisms of action-generate a mystery that modern science is still trying to decipher. Lithium has multiple effects on neurotransmitter-mediated receptor signaling, ion transport, signaling cascades, hormonal regulation, circadian rhythm, and gene expression. The biochemical mechanisms of lithium action appear to be multifactorial and interrelated with the functioning of several enzymes, hormones, vitamins, and growth and transformation factors. The widespread and chaotic marketing of lithium salts in potions and mineral waters, always at inadequate concentrations for various diseases, has contributed to the general disillusionment with empirical medical hypotheses about the therapeutic role of lithium. Lithium salts were first used therapeutically in 1850 to relieve the symptoms of gout, rheumatism, and kidney stones. In 1949, Cade was credited with discovering the sedative effect of lithium salts in the state of manic agitation, but frequent cases of intoxication accompanied the therapy. In the 1960s, lithium was shown to prevent manic and also depressive recurrences. This prophylactic effect was first demonstrated in an open-label study using the "mirror" method and was later (after 1970) confirmed by several placebo-controlled double-blind studies. Lithium prophylaxis was similarly effective in bipolar and also unipolar patients. In 1967, the therapeutic value of lithemia was determined, included in the range of 0.5-1.5 mEq/L. Recently, new therapeutic perspectives on lithium are connected with improved neurological outcomes after ischemic stroke. The effects of lithium on the development and maintenance of neuroprotection can be divided into two categories: short-term effects and long-term effects. Unfortunately, the existing studies do not fully explain the lithium biological action mechanisms after ischemic stroke.
锂是一个极具科学研究价值的对象，因为尽管它具有如此简单的结构、相对易于分析的化学性质以及已明确的物理特性，但它对生物系统产生的大量影响——通过尚未完全阐明的作用机制影响众多细胞和分子过程——却引发了一个现代科学仍在试图破解的谜团。锂对神经递质介导的受体信号传导、离子转运、信号级联反应、激素调节、昼夜节律和基因表达都有多种影响。锂的作用生化机制似乎是多因素的，并且与几种酶、激素、维生素以及生长和转化因子的功能相互关联。锂盐在药水和矿泉水中广泛而混乱的销售，其浓度对于各种疾病而言总是不足，这导致了人们对关于锂治疗作用的经验性医学假说普遍感到失望。锂盐于1850年首次用于治疗痛风、风湿和肾结石的症状。1949年，凯德因发现锂盐在躁狂激动状态下的镇静作用而受到赞誉，但该疗法常伴有中毒病例。在20世纪60年代，锂被证明可以预防躁狂发作以及抑郁复发。这种预防作用首先在一项使用“镜像”方法的开放标签研究中得到证实，后来（1970年之后）又被多项安慰剂对照双盲研究所证实。锂预防在双相情感障碍患者和单相情感障碍患者中同样有效。1967年，确定了锂血症的治疗价值范围为0.5 - 1.5毫当量/升。最近，锂的新治疗前景与缺血性中风后改善神经学预后相关。锂对神经保护的发展和维持作用可分为两类：短期作用和长期作用。不幸的是，现有研究并未完全解释缺血性中风后锂的生物学作用机制。
