An ultramicro method for analysis of lithium and other biologically important cations

Matrix modifiers in graphite furnace atomic absorption analysis of trace lithium in biological fluids

The use of KH2PO4/NH4NO3 as matrix modifier eliminates severe interference effects on the atomic absorption analysis of lithium in biological fluids. This enables determination of trace lithium in microliter size samples with absolute sensitivity (0.0044 absorbance) of 2 pg. There is no requirement for standard additions experiments to correct for interferences in specific matrices such as serum and saliva. The biological half-life of trace lithium was 16.9 +/- 2.8 h. Saliva lithium is a good estimate of serum level; the two are highly correlated (r = 0.97) and saliva level is about three times serum.

Lithium transport across squid axon membrane

This paper describes the pathways for lithium transport across the axonal membrane of squid. We were able to show that the membrane of this classical neuronal preparation possesses the lithium transport mechanisms previously identified in red blood cells. It is now possible to predict that the lithium treatment-induced changes in choline and lithium transport that have been observed in red blood cells of manic depressive patients also occur in nerve membrane.

Lithium concentration in the muscle compartment of manic-depressive patients during lithium therapy

Pharmacokinetic (PK) techniques were used to study the effect of lithium (Li+) on Li+ fluxes and concentrations in body compartments of manic-depressives. Patients not yet on Li+ therapy were similar to normal controls in all parameters. Comparison of patients before and during chronic Li+ therapy showed no effect of Li+ therapy on intestinal absorption and renal excretion of Li+. The calculated erythrocyte (RBC)-to-plasma Li+ concentration ratio increased with Li+ therapy, as already known from direct measurements. The calculated muscle-to-plasma Li+ concentration ratio was 6-8 times higher than the RBC ratio, and increased from 1.8 to 4.2 with Li+ therapy. The higher Li+ concentration in human muscle compared to RBC is attributed to muscle's higher inside-negative resting potential, and may underlie side effects that arise in muscle from Li+ therapy. The discrepancy between the observed muscle-to-plasma ratio and that predicted for a passively distributed ion is attributed to extrusion by a countertransport process, and the increase in the observed ratio with Li+ therapy is attributed to inhibition of countertransport, as already established for RBC. Since muscle resembles nerve as an excitable cell, muscle Li+ warrants evaluation as a predictor of therapeutic response and side effects during Li+ therapy.

Lithium's inhibition of erythrocyte cation countertransport involves a slow process in the erythrocyte

Chronic administration of lithium (Li+) to human subjects results in reduction of Li+/Na+ countertransport in their erythrocytes (RBC). The time course of development of inhibition is much slower than one would expect for an immediate effect of Li+ on the RBC membrane. Possible explanations include pharmacokinetic delays, a mediating humoral agent, and a slow process in the RBC. To discriminate among these possibilities, we incubated human RBC in sterile culture by the method of Freedman (Freedman, J.C. 1983. J. Membrane Biol. 75:225--231), which permits much longer incubations than other methods. As gauged by eight measures, the incubated RBC remain viable for two weeks. Small changes in intracellular concentrations with time during incubation are in the same direction as the changes associated with natural aging of RBC in vivo, except for a rise in ATP and related cation shifts during the first few days of incubation. Treatment of incubated RBC with 2 mM Li+ inhibits countertransport by 48% without affecting Li+ leak efflux. The inhibition develops slowly: it is half-maximal after 1--2 days and maximal by 4--7 days. Differences between in vivo results and our incubated cells in the time course of inhibition are as expected from the pharmacokinetic delays operating in vivo. The inhibition is reversible on removing Li+. Li+ inhibits countertransport similarly slowly and to a similar degree from inside the RBC and from outside. Hence the slow time course of inhibition in vivo is not due to a humoral factor or to the time required for intracellular Li+ accumulation and is only partly due to pharmacokinetic delays. The delay must involve an unidentified slow process at the level of the RBC.

The site of action of lithium ions in morphogenesis of Lymnaea stagnalis analyzed by secondary ion mass spectroscopy

Exogastrulation as a disturbance of development in eggs of Lymnaea stagnalis is caused by the action of LiCl at the second cleavage stage and not at the first or third. The percentage of exogastrulae formed is strongly concentration dependent. To determine the site of action of lithium ions, the cellular contents of Li, C, Na, Mg, P, K, and Ca were analyzed by secondary ion mass spectroscopy (SIMS). The mean elemental concentrations of Na, Mg, K, and Ca are close to those found earlier by electron probe microanalysis and atomic absorption spectroscopy. Lymnaea eggs at the first, second, and third cleavage stage were treated with LiCl in a series of concentrations ranging from 50 to 0.1 mM. In all cases the cells contained a few mM lithium after treatment. After treatment at the insensitive first cleavage stage the lithium content is carried over by the cells through the sensitive second cleavage to the insensitive third cleavage stage. These data allow the conclusion that it is the external lithium concentration which is responsible for the specific effect. This presents direct analytical evidence that the primary action of lithium ions is located at the cell membrane.

Na+, Li+, and Cl- transport by brush border membranes from rabbit jejunum

Na+, Li+, K+, Rb+, Br-, Cl- and SO4(2-) transport were studied in brush border membrane vesicles isolated from rabbit jejunum. Li+ uptakes were measured by flameless atomic absorption spectroscopy, and all others were measured using isotopic flux and liquid scintillation counting. All uptakes were performed with a rapid filtration procedure. A method is presented for separating various components of ion uptake: 1) passive diffusion, 2) mediated transport and 3) binding. It was concluded that a Na+/H+ exchange mechanism exists in the jejunal brush border. The exchanger was inhibited with 300 microM amiloride or harmaline. The kinetic parameters for sodium transport by this mechanism depend on the pH of the intravesicular solution. The application of a pH gradient (pHin = 5.5, pHout = 7.5) causes an increase in Jmax (50 to 125 pmol/mg protein . sec) with no change in Kt (congruent to 4.5 nM). Competition experiments show that other monovalent cations, e.g. Li+ and NH4+, share the Na+/H+ exchanger. This was confirmed with direct measurements of Li+ uptakes. Saturable uptake mechanisms were also observed for K+, Rb+ and SO4(2-), but not for Br-. The Jmax for K+ and Rb+ are similar to the Jmax for Na+, suggesting that they may share a transporter. The SO4(2-) system appears to be a Na+/SO4(2-) cotransport system. There does not appear to be either a Cl-/OH- transport mechanism of the type observed in ileum or a specific Na+/Cl- symporter.

Lithium absorption in tight and leaky segments of intestine

There is significant absorption of Li+ by human jejunum and ileum, but negligible absorption by human colon. Thus, a proximal-to-distal gradient of decreasing Li+ absorption and increasing junctional tightness exists in intestine as well as in renal tubule. For six leaky epithelia the relative permeabilities of K+, Na+, and Li+ by the junctional route are in the sequence PK greater than PNa greater than PLi and all fall within a factor of 2.5. In contrast, for tight epithelia PLi approximately PNa much greater than PK in the amiloride-sensitive channel of the apical membrane, but PK much greater than PLi approximately PNa in the basolateral membrane. The ability of several tight epithelia to sustain nonzero transepithelial Li+ absorption despite this basolateral barrier may be due to Na+/Li+ countertransport at the basolateral membrane, resulting in secondary active transport of Li+ across the epithelium.

Transport pathways for lithium ions in neuroblastoma x glioma hybrid cells at 'therapeutic' concentrations of Li+

The pathways of Li+ transport in neuroblastoma X glioma hybrid cells were studied at 2 mM external Li+. Five components of Li+ transport were identified. (1) A Na+-dependent Li+ countertransport system mediating Li+ transport in both directions across the plasma membrane. This transport pathway is insensitive to ouabain or external K+. It shows trans-stimulation (i.e. acceleration of Li+ extrusion by external Na+ and stimulation of Li+ uptake by internal Na+) and cis-inhibition (i.e. reduction of Li+ uptake by external Na+). (2) The Na+-K+ pump mediates Li+ uptake but not Li+ release in cells with physiological Na+ and K+ content. Li+ uptake by the pump in choline media is inhibited by both external Na+ and K+. In Na+ media, external K+ exhibits a biphasic effect: in concentrations up to about 1 mM, K+ accelerates, and at higher concentrations, K+ inhibits Li+ uptake by the pump. (3) Li+ can enter the voltage-dependent Na+ channel. Li+ uptake through this pathway is stimulated by veratridine and scorpion toxin, the stimulation being blocked by tetrodotoxin. Residual pathways comprise (4) a saturable component, which is comparable to basal Na+ uptake, and (5) a ouabain-resistant component promoting Li+ extrusion against an electrochemical gradient in choline media. The mechanisms for Li+ extrusion described here possibly explain how neuronal cells maintain the steady-state ratio of internal to external Li+ below 1 during chronic exposure to 1-2 mM external Li+.

Choline and PAH transport across blood-CSF barriers: the effect of lithium

The components of the blood-CSF barrier responsible for the transport of p-aminohippuric acid (PAH) and choline from CSF to blood were identified using in vitro preparations of frog choroid plexus and arachnoid membranes. Choline was transported out of CSF across the arachnoid, while PAH was transported out across the choroid plexus. Probenecid and ouabain blocked both processes. The effect of Li on these transport processes was tested by the addition of 5 mM LiCl to the incubation media. Li increased, by a factor of two, choline transport across the arachnoid, but there was no effect of Li on PAH transport across the plexus. Lithium was passively transported across the choroid plexus, and we suggest that the major transport pathway is through the tight junctions. The steady-state distribution of Li between the choroidal epithelium and the incubation medium was only half that expected for passive distribution. This suggests the existence of sodium/lithium countertransport in these epithelial cell membranes.

Recovery of erythrocyte Li+/Na+ countertransport and choline transport from lithium therapy

Li+/Na+ countertransport, choline transport, and intracellular Li+ and choline were measured in the RBC of a manic-depressive subject as a function of time after termination of Li+ therapy. Countertransport recovered from its inhibition by Li+ in 10 days. This recovery involved a decrease in the Michaelis-Menten parameter Km, without change in Vmax. RBC choline decreased, and choline influx rose, much more slowly back towards pre-Li+ values over the course of two months. Thus, choline transport was still inhibited long after Li+ levels in RBC and plasma had become undetectable. Measurements on age-separated RBC fractions showed that recovery of choline transport was mainly in the young-cell fraction. Hence inhibition of choline transport by Li+ may be irreversible at the level of the individual RBC.

Lithium pharmacokinetics: single-dose experiments and analysis using a physiological model

The kinetics of lithium (Li+) distribution after a single dose was studied in healthy human subjects. Experiments were performed by simultaneously following changes of Li+ concentration in plasma, erythrocytes (RBC), and urine. The data were fitted by a simple but physiologically realistic model, so that extracted rate constants could be assigned to real body compartments and compared with independent measurements of cellular transport characteristics. The extracted rate constants were used to calculate steady-state cell-to-plasma Li+ ratios for RBC and for inaccessible cells (mainly muscle). In both cell types, the intracellular Li+ concentration is far below electrochemical equilibrium. This finding suggests that the Li+ countertransport efflux mechanism of RBC may be shared with muscle. We also present evidence for a circadian rhythm in Li+ excretion that parallels the daily cycle of Na+ and K+ excretion.