Erythrocyte membrane Na-K ATPase activity in affective disorder

Substrate kinetics of erythrocyte membrane Na,K-ATPase and lipid peroxides in schizophrenia

Previous studies have shown decreased erythrocyte membrane (EM) Na,K-ATPase activity in chronic patients suffering from schizophrenia (SCH). There are no data about changes at the onset of psychosis and enzyme kinetics. Increased lipid peroxidation could be responsible for alterations in Na,K-ATPase activity. Substrate kinetics pattern of EM Na,K-ATPase and levels of lipid peroxides in plasma and erythrocytes were measured in (1) patients with first episode of psychosis (n=20) before medication and after the first 3 weeks of treatment, (2) chronic medicated schizophrenic patients (n=52) in the exacerbation phase, and (3) age- and sex-matched control subjects (n=30). All patients were assigned to groups with predominantly positive or predominantly negative symptoms on the basis of their scores on Positive and Negative Syndrome Scale (PANSS). In first-episode patients with predominantly negative symptoms before treatment, uncompetitive inhibition of Na,K-ATPase was noticed. The first-episode patients with predominantly positive symptoms had increased enzyme catalytic activity. After 3 weeks of treatment, activities were normalized in both groups. Among chronic patients, uncompetitive inhibition was found only in patients with predominantly negative symptoms. Plasma lipid peroxides (thiobarbituric acid-reactive substances [TBARS]) were elevated in both groups of patients with first episode of psychosis. Despite the presence of peroxidative injury indicative for the loss of membrane phospholipid essential fatty acids, the activities of Na,K-ATPase differ between SCH (+) and SCH (-) patients.

Inhibitory effects of lithium ion on intracellular Ca2+ mobilization in the rat hippocampal slices

Lithium is well established as a treatment of manic-depressive illness. As for the mechanism of action of lithium, it is proposed that lithium has effects on intracellular calcium ion (Ca2+) movement. But there are few reports in which the effects of lithium on intracellular Ca2+ movement are observed in the mammalian brain. We therefore examined the effects of lithium on intracellular Ca2+ changes in the rat hippocampal slices with a Ca2+ sensitive dye fura-2, and analyzed by means of a fluorescence microscope, a video-camera and photometrical devices. From the results of treatment with various noradrenergic agonists or antagonists, noradrenaline (NA)-induced intracellular Ca2+ change appears to be mainly mediated by alpha 1-adrenoceptors (AR) rather than alpha 2- or beta-AR. Furthermore, they are considered to be mediated by both alpha 1A-AR and alpha 1B-AR, and to be partly dependent on extracellular Ca2+. Lithium decreased NA-induced intracellular Ca2+ mobilization by attenuation of T1/2 rather than a change in the peak value, and antagonized ouabain-induced intracellular Ca2+ increase. Lithium may therefore suppress intracellular Ca2+ movement by enhancing the extrusion of intracellular Ca2+.

The Na,K-ATPase hypothesis for bipolar illness

A cellular model for bipolar illness is presented. It is propounded that alterations in the activity of the membrane sodium- and potassium-activated adenosine triphosphatase pump (Na,K-ATPase) may be responsible for alterations in neuronal excitability and activity. Specifically, a reduction in Na,K-ATPase activity can lead to both mania and depression by increasing membrane excitability and decreasing neurotransmitter release, respectively. Supporting evidence is reviewed, and clinical and research implications are discussed.

Cation transport mediated by Na+,K(+)-adenosine triphosphatase in lymphoblastoma cells from patients with bipolar I disorder, their relatives, and unrelated control subjects

In an investigation of cation transport in bipolar affective disorder, we have measured parameters related to Na+,K(+)-adenosine triphosphatase, the enzyme that carries out active transport of sodium and potassium, in lymphoblastoid cells cultured from patients with bipolar affective disorder, age-matched nonaffected family relatives, and unrelated control subjects. Patients had lower ion transport per cell and per transport enzyme site than did related or unrelated control subjects. The rate of transport per cell appeared higher in nonaffected relatives of patients than in unrelated control subjects, though this difference did not reach significance. These data suggest that abnormally regulated ion transport may be associated with bipolar affective disorder independently of clinical state.

Erythrocyte membrane sodium-potassium adenosine triphosphatase activity in affective disorders

Erythrocyte membrane Na+,K(+)-ATPase activity was studied in drug naive patients with bipolar (BP) mania (n = 62) and unipolar (UP) depression (n = 60) and normal controls (n = 66). Compared to controls there was a significantly decreased Na+,K(+)-ATPase activity in UP depressives but no change in BP manics. However, lithium treatment caused a significant increase in Na+,K(+)-ATPase activity although there was no correlation between plasma lithium levels and enzyme activity. Plasma cortisol correlated inversely with Na+,K(+)-ATPase in UP depressives. Interestingly, the lithium responders [less than 50% Beck Rafaelson's Mania Rating Scale (BRMS) score] showed a significant increase in Na+,K(+)-ATPase activity compared to lithium nonresponders (greater than 50% BRMS score). These observations indicate that monitoring of Na+,K(+)-ATPase activity during lithium therapy is useful to predict a therapeutic response.

CSF amine metabolites in depression

The amine metabolites, namely homovanillic acid (HVA) and 5-hydroxy indoleacetic acid (5-HIAA) were measured in cerebrospinal fluid (CSF) of depressives (n = 30) and controls (n = 30). Depressed patients had significantly lower HVA levels than controls. No significant differences were noted between the two groups in 5-HIAA levels. However, the differences between the groups for the CSF HVA/5-HIAA ratio were larger than those for the CSF HVA alone (p less than 0.01 versus p less than 0.025, respectively). HVA levels correlated positively with monoamine oxidase activity and adenosine deaminase activity.