Psychiatric benefits of lithium in water supplies may be due to protection from the neurotoxicity of lead exposure

Environmental Toxins and Alzheimer's Disease: a Comprehensive Analysis of Pathogenic Mechanisms and Therapeutic Modulation

Alzheimer's disease is a leading cause of mortality worldwide. Inorganic and organic hazards, susceptibility to harmful metals, pesticides, agrochemicals, and air pollution are major environmental concerns. As merely 5% of AD cases are directly inherited indicating that these environmental factors play a major role in disease development. Long-term exposure to environmental toxins is believed to progress neuropathology, which leads to the development of AD. Numerous in-vitro and in-vivo studies have suggested the harmful impact of environmental toxins at cellular and molecular level. Common mechanisms involved in the toxicity of these environmental pollutants include oxidative stress, neuroinflammation, mitochondrial dysfunction, abnormal tau, and APP processing. Increased expression of GSK-3β, BACE-1, TNF-α, and pro-apoptotic molecules like caspases is observed upon exposure to these environmental toxins. In addition, the expression of neurotrophins like BDNF and GAP-43 have been found to be reduced as a result of toxicity. Further, modulation of signaling pathways involving PARP-1, PGC-1α, and MAPK/ERK induced by toxins have been reported to contribute in AD pathogenesis. These pathways are a promising target for developing novel AD therapeutics. Drugs like epigallocatechin-gallate, neflamapimod, salsalate, dexmedetomidine, and atabecestat are in different phases of clinical trials targeting the pathways for possible treatment of AD. This review aims to culminate the correlation between environmental toxicants and AD development. We emphasized upon the signaling pathways involved in the progression of the disease and the therapeutics under clinical trial targeting the altered pathways for possible treatment of AD.

Prevention of suicidal behavior with lithium treatment in patients with recurrent mood disorders

Suicidal behavior is more prevalent in bipolar disorders than in other psychiatric illnesses. In the last thirty years evidence has emerged to indicate that long-term treatment of bipolar disorder patients with lithium may reduce risk of suicide and attempts, with possibly similar benefits in recurrent major depressive disorder. We review and update selected research literature on effects of lithium treatment in reducing suicidal behavior and consider proposals that higher levels of lithium in drinking water may be associated with lower suicide rates. We summarize results of a growing number of randomized, controlled studies of lithium treatment for suicide prevention including comparisons with placebos or alternative treatments, and comment on the severe challenges of such trials. The basis of a proposed protective effect of lithium against suicidal behaviors remains uncertain but may include protective effects against recurrences of depressive phases of mood disorders, especially with mixed features or agitation, and possibly through beneficial effects on impulsivity, agitation and dysphoric mood.

Firearm-Related Lead Exposure and Child Lead Levels in the United States, 2012-2018

OBJECTIVE

To determine if firearm ownership is positively related to elevated child lead levels at a state-level, even when accounting for other sources of lead.

STUDY DESIGN

For this cross-sectional ecological study, we investigated whether household firearm ownership rates (a proxy for firearm-related lead exposure) was associated with the prevalence of elevated child blood lead levels in 44 US States between 2012 and 2018. To account for potential confounding, we adjusted for other known lead exposures, poverty rate, population density, race, and calendar year. To address missing data, we used multiple imputation by chained equations.

RESULTS

Prevalence of elevated child blood lead positively correlated with household firearm ownership and established predictors of lead exposure. In fully adjusted negative binomial regression models, child blood lead was positively associated with household firearm ownership and older housing; each IQR (14%) increase in household firearm ownership rate was associated with a 41% higher prevalence of childhood elevated blood lead (prevalence ratio: 1.41, 95% CI: 1.11-1.79).

CONCLUSION

These data provide state-level evidence that firearms may be an important source of child lead exposure. More research is needed to substantiate this relationship and identify modifiable pathways of exposure at the individual level.

Estimating Lithium Concentrations in Groundwater Used as Drinking Water for the Conterminous United States

Lithium (Li) concentrations in drinking-water supplies are not regulated in the United States; however, Li is included in the 2022 U.S. Environmental Protection Agency list of unregulated contaminants for monitoring by public water systems. Li is used pharmaceutically to treat bipolar disorder, and studies have linked its occurrence in drinking water to human-health outcomes. An extreme gradient boosting model was developed to estimate geogenic Li in drinking-water supply wells throughout the conterminous United States. The model was trained using Li measurements from ∼13,500 wells and predictor variables related to its natural occurrence in groundwater. The model predicts the probability of Li in four concentration classifications, ≤4 μg/L, >4 to ≤10 μg/L, >10 to ≤30 μg/L, and >30 μg/L. Model predictions were evaluated using wells held out from model training and with new data and have an accuracy of 47-65%. Important predictor variables include average annual precipitation, well depth, and soil geochemistry. Model predictions were mapped at a spatial resolution of 1 km2 and represent well depths associated with public- and private-supply wells. This model was developed by hydrologists and public-health researchers to estimate Li exposure from drinking water and compare to national-scale human-health data for a better understanding of dose-response to low (<30 μg/L) concentrations of Li.

Association Between Estimated Geocoded Residential Maternal Exposure to Lithium in Drinking Water and Risk for Autism Spectrum Disorder in Offspring in Denmark

Importance

Lithium is a naturally occurring and trace element that has mood-stabilizing effects. Maternal therapeutic use of lithium has been associated with adverse birth outcomes. In animal models, lithium modulates Wnt/β-catenin signaling that is important for neurodevelopment. It is unknown whether exposure to lithium in drinking water affects brain health in early life.

Objective

To evaluate whether autism spectrum disorder (ASD) in offspring is associated with maternal exposure to lithium in drinking water during pregnancy.

Design, Setting, and Participants

This nationwide population-based case-control study in Denmark identified 8842 children diagnosed with ASD born from 2000 through 2013 and 43 864 control participants matched by birth year and sex from the Danish Medical Birth Registry. These data were analyzed from March 2021 through November 2022.

Exposures

Geocoded maternal residential addresses during pregnancy were linked to lithium level (range, 0.6 to 30.7 μg/L) in drinking water estimated using kriging interpolation based on 151 waterworks measurements of lithium across all regions in Denmark.

Main Outcomes and Measures

ASD diagnoses were ascertained using International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes recorded in the Danish Psychiatric Central Register. The study team estimated odds ratios (ORs) and 95% CIs for ASD according to estimated geocoded maternal exposure to natural source of lithium in drinking water as a continuous (per IQR) or a categorical (quartile) variable, adjusting for sociodemographic factors and ambient air pollutants levels. The study team also conducted stratified analyses by birth years, child's sex, and urbanicity.

Results

A total of 8842 participants with ASD (male, 7009 [79.3%]) and 43 864 control participants (male, 34 749 [79.2%]) were studied. Every IQR increase in estimated geocoded maternal exposure to natural source of lithium in drinking water was associated with higher odds for ASD in offspring (OR, 1.23; 95% CI, 1.17-1.29). Elevated odds among offspring for ASD were estimated starting from the second quartile (7.36 to 12.67 μg/L) of estimated maternal exposure to drinking water with lithium and the OR for the highest quartile (more than 16.78 μg/L) compared with the reference group (less than 7.39 μg/L) was 1.46 (95% CI, 1.35-1.59). The associations were unchanged when adjusting for air pollution exposures and no differences were apparent in stratified analyses.

Conclusions and Relevance

Estimated maternal prenatal exposure to lithium from naturally occurring drinking water sources in Denmark was associated with an increased ASD risk in the offspring. This study suggests that naturally occurring lithium in drinking water may be a novel environmental risk factor for ASD development that requires further scrutiny.

Firearm licensure, lead levels and suicides in Massachusetts

Nationally, between 2011 and 2019, suicide was the second leading cause of injury death, and about half of all suicides were firearm related. An overlooked factor connecting firearms and suicide is lead exposure. Lead bullets and primers are used throughout the US and pose danger to adults and children. Most (not all) studies link lead to mental illness, while others link lead with suicide. Research has linked lead and firearm violence, but rarely examined the relationship among firearms, lead exposure, and suicide. We collected data for cities/towns in Massachusetts between 2011 and 2019 regarding the number of firearm licenses, suicides, prevalence of blood lead levels, and covariates. We hypothesized that; 1) towns with higher levels of licensure will have higher levels of firearm suicides but licensure will have little relationship with non-firearm suicide; 2) towns with higher levels of licensures would have higher rates of lead exposure; 3) higher lead levels would be associated with higher rates of suicide by all methods. Individuals living in towns with higher rates of licensure were significantly more likely to die in firearm suicides and all suicide types. They were not more or less likely to die from non-firearm suicides. Lead was a predictor of all suicide types. Our study appears to be the first to show the established firearm suicide relationships holds within municipalities in a single state. We provide evidence concerning the link between lead exposure and suicide, particularly from firearms, and provide a glimpse into the relationship between firearm prevalence and elevated blood lead levels.

Silicate Mineral Eutectics with Special Reference to Lithium

In this paper, the system of natural mineral alkali fluxes used in typical mineral industry technologies was analyzed. The main objective was to reduce the melting temperature of the flux systems. Particular attention was paid to the properties of lithium aluminium silicates in terms of simplifying and accelerating the heat treatment process. In this area, an alkaline flux system involving lithium was analyzed. A basic flux system based on sodium potassium lithium aluminosilicates was analyzed; using naturally occurring raw materials such as spodumene, albite and orthoclase, an attempt was made to obtain the eutectic with the lowest melting point. Studies have shown that there are two eutectics in these systems, with about 30% spodumene content. The active influence of sodium feldspar was found.

Lithium in groundwater used for drinking-water supply in the United States

Lithium concentrations in untreated groundwater from 1464 public-supply wells and 1676 domestic-supply wells distributed across 33 principal aquifers in the United States were evaluated for spatial variations and possible explanatory factors. Concentrations nationwide ranged from <1 to 396 μg/L (median of 8.1) for public supply wells and <1 to 1700 μg/L (median of 6 μg/L) for domestic supply wells. For context, lithium concentrations were compared to a Health Based Screening Level (HBSL, 10 μg/L) and a drinking-water only threshold (60 μg/L). These thresholds were exceeded in 45% and 9% of samples from public-supply wells and in 37% and 6% from domestic-supply wells, respectively. However, exceedances and median concentrations ranged broadly across geographic regions and principal aquifers. Concentrations were highest in arid regions and older groundwater, particularly in unconsolidated clastic aquifers and sandstones, and lowest in carbonate-rock aquifers, consistent with differences in lithium abundance among major lithologies and rock weathering extent. The median concentration for public-supply wells in the unconsolidated clastic High Plains aquifer (central United States) was 24.6 μg/L; 24% of the wells exceeded the drinking-water only threshold and 86% exceeded the HBSL. Other unconsolidated clastic aquifers in the arid West had exceedance rates comparable to the High Plains aquifer, whereas no public supply wells in the Biscayne aquifer (southern Florida) exceeded either threshold, and the highest concentration in that aquifer was 2.6 μg/L. Multiple lines of evidence indicate natural sources for the lithium concentrations; however, anthropogenic sources may be important in the future because of the rapid increase of lithium battery use and subsequent disposal. Geochemical models demonstrate that extensive evaporation, mineral dissolution, cation exchange, and mixing with geothermal waters or brines may account for the observed lithium and associated constituent concentrations, with the latter two processes as major contributing factors.

Relationship between Lithium Levels in Drinking Water and Suicide Rates: A Nationwide Study in Lithuania

To investigate an association of lithium levels in the drinking water with suicide mortality rates in Lithuania. Methods: Samples from public drinking water systems were taken in all districts of Lithuania. Lithium levels were determined using the ion chromatography method. For the statistical calculations, lithium levels were averaged per district municipality and plotted against suicide standardized mortality rates (SMR) per 100,000 populations, within the 5-year period from 2012 to 2016. Results: We found that lithium concentrations in drinking water were significantly negatively associated with total suicide rates in a nonlinear way. Conclusion: Lithium intake with drinking water may affect suicide rates in some geographical areas.

A Scoping Review of Non-Occupational Exposures to Environmental Pollutants and Adult Depression, Anxiety, and Suicide

PURPOSE OF REVIEW

Despite a call for better understanding of the role of environmental pollutant influences on mental health and the tremendous public health burden of mental health, this issue receives far less attention than many other effects of pollutants. Here we summarize the body of literature on non-occupational environmental pollutant exposures and adult depression, anxiety, and suicide-in PubMed, Embase, Web of Science, and PsychINFO through the end of year 2018.

RECENT FINDINGS

One hundred twelve articles met our criteria for further review. Of these, we found 88 articles on depression, 33 on anxiety, and 22 on suicide (31 articles covered multiple outcomes). The earliest article was published in 1976, and the most frequent exposure of interest was air pollution (n = 33), followed by secondhand smoke (n = 20), metals (n = 18), noise (n = 17), and pesticides (n = 10). Other exposures studied less frequently included radiation, magnetic fields, persistent organic pollutants (POPs), volatile organic compounds, solvents, and reactive sulfur compounds. The current literature, although limited, clearly suggests many kinds of environmental exposures may be risk factors for depression, anxiety, and suicide. For several pollutants, important limitations exist with many of the studies. Gaps in the body of research include a need for more longitudinal, life-course studies, studies that can measure cumulative exposures as well as shorter-term exposures, studies that reduce the possibility of reverse causation, and mechanistic studies focused on neurotoxic exposures.

Lithium in drinking water sources in rural and urban communities in Southeastern Nigeria

There is a dearth of data on lithium content of domestic water sources in Nigeria. This study reported the lithium concentration in ground and surface water sources used for drinking in Southeastern Nigeria. Thirteen (13) natural springs, 24 streams, 7 hand-dug wells and 80 boreholes, making a total of 124 water samples were collected from strategic locations and analysed by ICP-OES. The distribution of lithium according to water sources and lithostratigraphic units as well as dietary contribution of lithium through drinking water was investigated. Average lithium concentrations in water samples from all sources were between 0.09 and 1.54 μg/L (overall mean ± SEM: 1.0 ± 0.2 μg/L). Results according to the geological formations of the areas studied indicated that only water sources located within the Benin Formation and Bende-Ameki Formation contained lithium in the range of <0.21-7.24 and < 0.21-1.97 μg/L respectively, whereas lithium was not detected in samples located within the Nsukka and Mamu lithostratigraphic units. Total intakes of lithium from water consumption (0.64 L for children and 2 L for adults) for all water sources were 79 and 247 μg/day for children and adults respectively, while the average daily intake of lithium from the water sources ranged from 0.004 to 0.066 and 0.002-0.044 μg/kg body weight for children (15 kg) and adults (70 kg) respectively. Drinking water in the study areas contributes only about 0.02-0.47% of the U.S. EPA estimated daily intake (9.3-44.3 μg/kg) of Lithium.

Relationship between suicide mortality and lithium in drinking water: A systematic review and meta-analysis

BACKGROUND

Lithium at therapeutic doses has protective effects against suicide in clinical practice. This meta-analysis aimed to investigate the relationship between lithium concentration in drinking water and suicide mortality in the general population.

METHODS

A systematic search was conducted in Web of Knowledge, PubMed, ScienceDirect, and Scopus to find papers reporting the crude relationship between drinking water lithium and suicide incidence in the general population until June 2019. The pooled effect measure was expressed as odds ratio (OR) and 95% confidence interval (CI) using the random-effects model.

RESULTS

We retrieved 308 English original articles, of which 13 ecologic studies with a total sample size of 939 regions and one cohort study with a sample size of 3,740,113 people were eligible for the meta-analysis. A significant relationship was found between the lithium concentration in drinking water and reduced suicide mortality (OR= 0.42; 95% CI: 0.27-0.67; p-value <0.01). Ten studies reported gender-specific responses to lithium, with the pooled estimates as follows: OR= 0.54; 95% CI: 0.35-0.84; p-value <0.01 for men, OR= 0.70; 95% CI: 0.48-1.01; p-value =0.057 for women, and OR= 0.63; 95% CI: 0.47-0.83; p-value <0.01 for total.

LIMITATIONS

The study was limited to the assessment of the crude relationship between lithium exposure and suicide rate without considering the role of confounders.

CONCLUSIONS

Lithium in drinking water is dose-dependently associated with reduced suicide mortality at least in ecological studies. However, we need well-designed clinical trials to confirm the protective effect of drinking water lithium intake against suicide.

Utilization of lithium incorporated mesoporous silica for preventing necrosis and increase apoptosis in different cancer cells

There are many molecules used as a drug carrier. TUD-1 is a newly synthesized mesoporous silica (SM) molecule possess two important features; consists of mesoporous so it is very suitable to be drug carrier in addition to that it has the ability to induce apoptosis in cancer cells. However, the effect of TUD-1 appears to act as cell death inducer, regardless of whether it is necrosis or apoptosis. Unfortunately, recent studies indicate that a proportion of cells undergo necrosis rather than apoptosis, which limits the use of TUD-1 as a secure treatment. On the other hand, lithium considered as necrosis inhibitor element. Hence, the current study based on the idea of producing a new Li-TUD-1 by incorporated mesoporous silica (TUD-1 type) with lithium in order to produce a new compound that has the ability to activate apoptosis by mesoporous silica (TUD-1 type) and at the same time can inhibit the activity of necrosis by lithium. Herein, lithium incorporated in TUD-1 mesoporous silica by using sol-gel technique in one-step synthesis procedure. Moreover, lithium incorporated in TUD-1 with different loading in order to form different active sites such as isolated lithium ions, nanoparticles of Li₂O, and bulky crystals of Li₂O. The ability of the new compounds to induce apoptosis and prevent necrosis was evaluated on three different types of cancer cell lines, which are; liver HepG-2, breast MCF-7, and colon HCT116. The obtained results show that Li-TUD-1 has the ability to control necrosis and thus reduce the side effects of treatments containing silica in the case of lithium added to them, especially in chronic cases. This opinion has demonstrated by the significant increase in the IC₅₀ value and cell viability compared to control groups. Consequently, the idea is new, so it needs more develop and test with materials that have a more apoptotic impact than silica to induce apoptosis without induction of necrosis.