Lithium interacts with cardiac remodeling: the fundamental value in the pharmacotherapy of bipolar disorder

Research output: Contribution to journalReview article

Abstract

Patients with bipolar disorder (BD) have an increased risk of cardiovascular morbidity and mortality during the course of their illness. For over half a century, lithium has been the gold-standard medication used to treat the mood burdens of BD. In addition, lithium possesses several biological effects that may modulate cardiovascular risk in patients with BD. In this review, we update the current knowledge of cellular and molecular mechanisms underlying the possible cardiac actions of lithium. The mechanistic insights suggest that lithium at therapeutic levels potentially exerts cardioprotective effects on ischemic hearts by modulating structural and electrical remodeling. The possible cardioprotective actions of lithium may involve an extensive range of signaling pathways, including the Wnt/glycogen synthase kinase-3β phosphatidylinositol-3-kinase/protein kinase B, phosphoinositide/protein kinase C, and mitogen-activated protein kinase/extracellular signal-regulated kinase cascades. Accordingly, understanding the cardioprotective effects of lithium may lead to the development of a potential strategy for reducing cardiovascular morbidity in patients with BD.

LanguageEnglish
Pages208-214
Number of pages7
JournalProgress in Neuro-Psychopharmacology and Biological Psychiatry
Volume88
DOIs
Publication statusPublished - Jan 10 2019

Fingerprint

Bipolar Disorder
Lithium
Drug Therapy
Phosphatidylinositol 3-Kinase
Atrial Remodeling
Morbidity
Glycogen Synthase Kinases
Proto-Oncogene Proteins c-akt
Wnt Signaling Pathway
1-Phosphatidylinositol 4-Kinase
Extracellular Signal-Regulated MAP Kinases
Mitogen-Activated Protein Kinases
Gold
Protein Kinase C
Mortality

Keywords

  • Bipolar disorder
  • Cardioprotection
  • Electrical remodeling
  • Lithium
  • Structural remodeling

ASJC Scopus subject areas

  • Pharmacology
  • Biological Psychiatry

Cite this

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abstract = "Patients with bipolar disorder (BD) have an increased risk of cardiovascular morbidity and mortality during the course of their illness. For over half a century, lithium has been the gold-standard medication used to treat the mood burdens of BD. In addition, lithium possesses several biological effects that may modulate cardiovascular risk in patients with BD. In this review, we update the current knowledge of cellular and molecular mechanisms underlying the possible cardiac actions of lithium. The mechanistic insights suggest that lithium at therapeutic levels potentially exerts cardioprotective effects on ischemic hearts by modulating structural and electrical remodeling. The possible cardioprotective actions of lithium may involve an extensive range of signaling pathways, including the Wnt/glycogen synthase kinase-3β phosphatidylinositol-3-kinase/protein kinase B, phosphoinositide/protein kinase C, and mitogen-activated protein kinase/extracellular signal-regulated kinase cascades. Accordingly, understanding the cardioprotective effects of lithium may lead to the development of a potential strategy for reducing cardiovascular morbidity in patients with BD.",
keywords = "Bipolar disorder, Cardioprotection, Electrical remodeling, Lithium, Structural remodeling",
author = "Chen, {Pao Huan} and Chao, {Tze Fan} and Kao, {Yu Hsun} and Chen, {Yi Jen}",
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AU - Chen, Pao Huan

AU - Chao, Tze Fan

AU - Kao, Yu Hsun

AU - Chen, Yi Jen

PY - 2019/1/10

Y1 - 2019/1/10

N2 - Patients with bipolar disorder (BD) have an increased risk of cardiovascular morbidity and mortality during the course of their illness. For over half a century, lithium has been the gold-standard medication used to treat the mood burdens of BD. In addition, lithium possesses several biological effects that may modulate cardiovascular risk in patients with BD. In this review, we update the current knowledge of cellular and molecular mechanisms underlying the possible cardiac actions of lithium. The mechanistic insights suggest that lithium at therapeutic levels potentially exerts cardioprotective effects on ischemic hearts by modulating structural and electrical remodeling. The possible cardioprotective actions of lithium may involve an extensive range of signaling pathways, including the Wnt/glycogen synthase kinase-3β phosphatidylinositol-3-kinase/protein kinase B, phosphoinositide/protein kinase C, and mitogen-activated protein kinase/extracellular signal-regulated kinase cascades. Accordingly, understanding the cardioprotective effects of lithium may lead to the development of a potential strategy for reducing cardiovascular morbidity in patients with BD.

AB - Patients with bipolar disorder (BD) have an increased risk of cardiovascular morbidity and mortality during the course of their illness. For over half a century, lithium has been the gold-standard medication used to treat the mood burdens of BD. In addition, lithium possesses several biological effects that may modulate cardiovascular risk in patients with BD. In this review, we update the current knowledge of cellular and molecular mechanisms underlying the possible cardiac actions of lithium. The mechanistic insights suggest that lithium at therapeutic levels potentially exerts cardioprotective effects on ischemic hearts by modulating structural and electrical remodeling. The possible cardioprotective actions of lithium may involve an extensive range of signaling pathways, including the Wnt/glycogen synthase kinase-3β phosphatidylinositol-3-kinase/protein kinase B, phosphoinositide/protein kinase C, and mitogen-activated protein kinase/extracellular signal-regulated kinase cascades. Accordingly, understanding the cardioprotective effects of lithium may lead to the development of a potential strategy for reducing cardiovascular morbidity in patients with BD.

KW - Bipolar disorder

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KW - Electrical remodeling

KW - Lithium

KW - Structural remodeling

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