Tissue vanadium levels in manic-depressive psychosis

The mineral depletion of foods available to us as a nation (1940-2002)--a review of the 6th Edition of McCance and Widdowson

Over the past 60 years there have been fundamental changes in the quality and quantity of food available to us as a nation. The character, growing method, preparation, source and ultimate presentation of basic staples have changed significantly to the extent that trace elements and micronutrient contents have been severely depleted. This trend, established in a review of the 5th Edition of McCance & Widdowson's The Composition of Foods, is still apparent in this review of the 6th edition of the same work. Concurrently there has been a precipitous change towards convenience and pre-prepared foods containing saturated fats, highly processed meats and refined carbohydrates, often devoid of vital micronutrients yet packed with a cocktail of chemical additives including colourings, flavourings and preservatives. It is proposed that these changes are significant contributors to rising levels of diet-induced ill health. Ongoing research clearly demonstrates a significant relationship between deficiencies in micronutrients and physical and mental ill health.

Vanadium

Vanadium is a steel-grey, corrosion-resistant metal, which exists in oxidation states ranging from -1 to +5. Metallic vanadium does not occur in nature, and the most common valence states are +3, +4, and +5. The pentavalent form (VO3-) predominates in extracellular body fluids whereas the quadrivalent form (VO+2) is the most common intracellular form. Because of its hardness and its ability to form alloys, vanadium (i.e., ferrovanadium) is a common component of hard steel alloys used in machines and tools. Although most foods contain low concentrations of vanadium (< 1 ng/g), food is the major source of exposure to vanadium for the general population. High air concentrations of vanadium occur in the occupation setting during boiler-cleaning operations as a result of the presence of vanadium oxides in the dust. The lungs absorb soluble vanadium compounds (V2O5) well, but the absorption of vanadium salts from the gastrointestinal tract is poor. The excretion of vanadium by the kidneys is rapid with a biological half-life of 20-40 hours in the urine. Vanadium is probably an essential trace element, but a vanadium-deficiency disease has not been identified in humans. The estimated daily intake of the US population ranges from 10-60 micrograms V. Vanadyl sulfate is a common supplement used to enhance weight training in athletes at doses up to 60 mg/d. In vitro and animal studies indicate that vanadate and other vanadium compounds increase glucose transport activity and improve glucose metabolism. In general, the toxicity of vanadium compounds is low. Pentavalent compounds are the most toxic and the toxicity of vanadium compounds usually increases as the valence increases. Most of the toxic effects of vanadium compounds result from local irritation of the eyes and upper respiratory tract rather than systemic toxicity. The only clearly documented effect of exposure to vanadium dust is upper respiratory tract irritation characterized by rhinitis, wheezing, nasal hemorrhage, conjunctivitis, cough, sore throat, and chest pain. Case studies have described the onset of asthma after heavy exposure to vanadium compounds, but clinical studies to date have not detected an increased prevalence of asthma in workers exposed to vanadium.

Effects of vanadium on activity and learning in rats

The effects of vanadate administration on activity and learning were assessed in rats. Four groups of adult male rats were given by gavage 0, 4.1, 8.2, and 16.4 mg/kg/day of sodium metavanadate for eight consecutive weeks. Three weeks after the cessation of the treatment, general motor activity of all animals was measured in an open-field. Rats were also tested for two-way shock avoidance learning in an automatic reflex conditioner. At the end of the testing period, rats were killed and vanadium concentration was determined in a number of tissues. Vanadium exposure caused an observable but not significant effect on body weight gain, while a persistent presence of vanadium was observed in all tissues measured. The results of the behavioral testing show that oral vanadate administration resulted in significant reductions in both general activity and learning.

Leukocyte transmembrane potential in bipolar illness

Abnormalities in ion regulation and distribution are commonly reported in bipolar disorder. In an effort to determine if these alter cellular physiological function, we determined the transmembrane potential (TMP) in mononuclear leukocytes from normal individuals and patients with bipolar illness either during normal phase or manic and hypomanic episodes. TMP was analyzed by flow cytometry using dihexyloxacarbocyanine iodide (DIOC6(3)), a cationic potential sensitive fluorescent dye. A normal range was established from measurements on leukocytes from 5 control individuals. TMP of manic and hypomanic patients was significantly hyperpolarized (P = 0.0036). The TMP of euthymic bipolar individuals was not different from normal controls. Pathologic moods in bipolar illness may be associated with altered cellular membrane physiology.

Lithium in scalp hair of adults, students, and violent criminals. Effects of supplementation and evidence for interactions of lithium with vitamin B12 and with other trace elements

The lithium content of human hair shows an approximately linear response to extradietary lithium supplementation at dosage levels of up to 2000 micrograms/d. From the mean hair lithium concentration of 0.063 micrograms/g in 2648 predominantly American adults, and the reference hair lithium concentrations determined in the present study, the mean lithium intakes were calculated to be 730 micrograms/d. Hair lithium concentrations were extremely low in nearly 20% of the American samples, and in samples collected in Munich, Germany and Vienna, Austria. Hair lithium levels are low in certain pathological conditions, e.g., heart disease, in learning-disabled subjects, and in incarcerated violent criminals. The highest levels were observed in samples of a lithium-treated psychiatric patient. A statistically highly significant direct association was observed between the hair lithium and cobalt concentrations, which suggests a role of lithium in the transport and distribution of vitamin B12. Interactions of lithium with other trace elements are also discussed.

Haematological effects of vanadium on living organisms

Although vanadium has been of great interest for many researchers over a number of years, its biochemical and physiological role is not yet fully clear. There are many papers describing the haematological consequences of its excess in living organisms and most of their data are quoted in this mini-review. The authors of these papers used various laboratory animals, different vanadium compounds, frequently different routes of administration and duration of intoxication. Hence a checklist and comparison of the results are rather difficult. Vanadium reduces the deformability of erythrocytes, and such cells are rather frequently retained in the reticuloendothelial system of the spleen and eliminated faster from the blood stream (Kogawa et al., 1976). Vanadium produces peroxidative changes in the erythrocyte membrane, this leading to haemolysis. Therefore, the depressed erythrocyte count in animals intoxicated with vanadium may be the consequence of both the haemolytic action of vanadium and the shortened time of survival of erythrocytes. Changes of the haem precursor level in blood serum and urine observed in humans exposed occupationally to vanadium suggest an influence of this element on haem synthesis. This problem requires, however, further studies and observations. Changes occurring under the influence of vanadium on the leukocyte system of animals suggest the influence of this element on the resistance of the organism, but the mechanism of the action of vanadium still requires elucidation.(ABSTRACT TRUNCATED AT 250 WORDS)

Vanadate amplifies receptor-mediated accumulation of inositol trisphosphates and inhibits inositol tris- and tetrakis-phosphatase activities

Lithium ion, which inhibits hydrolytic degradation of inositol monophosphates, is the most common therapeutic agent used in the control of bipolar disorder. There exists evidence that elevated elemental vanadium levels may play an etiological role in at least some forms of manic-depression. Here we demonstrate that vanadate treatment of intact cells from several different clonal lines synergistically induces substantial augmentation in neurotransmitter receptor-mediated or growth factor receptor-triggered inositol trisphosphate accumulation in situ. Furthermore, studies done using cellular extracts indicate that effects of vanadate treatment in situ may be due to its ability to inhibit hydrolysis of inositol 1,4,5-trisphosphate inositol 1,3,4-trisphosphate, and inositol 1,3,4,5-tetrakisphosphate in vitro. These results suggest that vanadate treatment may facilitate characterization of inositol phosphate metabolism and intracellular signaling.

Vanadium determination at the ultra-trace level in biological reference materials and serum by radiochemical neutron activation analysis

In order to help resolve present inconsistencies of two orders of magnitude or more in reported levels of vanadium in human serum and blood, a totally postirradiation radiochemical neutron activation analysis (NAA) method was further developed and applied to some pertinent nanogram and subnanogram reference materials. In particular, the second generation human serum reference material of Versieck was found to contain a value of 0.67 +/- 0.05 ng/g dry wt., corresponding to 0.061 +/- 0.005 /4/ ng/mL original fresh serum. Results are also reported for some other appropriate CRMs. Additionally, a small-scale study in 10 normal subjects (5 m, 5 f) revealed levels similar to those in the serum reference material and in agreement with the lowest data reported in the literature. Discussion of pitfalls of vanadium determination and the use of reference materials is included.

Factors affecting the levels reported for vanadium in human serum

Chemometric techniques may be applied to extract significant analytical information from a series of publications that present methods and results for determining trace elements in biological material. This approach was applied to the total of 28 papers published in 1971-1988 that reported determination of vanadium in normal human serum or plasma; the levels spanned four orders of magnitude. The most important factors affecting the analytical results were found to be the choice of analytical method and the experience of the laboratory in trace-element research. Results from the most experienced laboratories with the best analytical methods were found to be correlated with the precision of the data, indicating that the correct concentration of vanadium would be less than 1 mg/m3. This is in agreement with results subsequently obtained by radiochemical neutron activation analysis of eight samples of serum from Danish colleagues.

The effect of lithium on cation transport measured in vivo in patients suffering from bipolar affective illness

We have investigated cation transport in vivo in patients being treated with lithium for bipolar affective illness by studying the disposition of rubidium after an oral load of rubidium chloride. The rate of erythrocyte cation transport was increased in the patients when compared with matched healthy volunteers. However, the rate of in-vivo erythrocyte rubidium accumulation in the euthymic treated patients was significantly lower than in a matched group of unmedicated manic patients. The regulation of specific pathways for cation transport may be altered in individuals predisposed to affective illness.

The measurement of transmembrane cation transport in vivo in acute manic illness

We have used a novel technique to assess the transport of cations across the erythrocyte membrane in vivo in unmedicated patients suffering an acute manic illness. The results show that erythrocyte cation transport via the sodium-pump enzyme Na+,K+-ATPase is increased in manic patients compared with healthy controls.

Vanadium and other trace elements in patients taking lithium

The serum concentrations of 24 trace elements were measured by neutron activation analysis in 32 patients on long-term lithium treatment and 32 age- and sex-matched healthy controls. Whole blood and hair samples were also taken from a number of these subjects. Compared to controls, patients on lithium were found to have a lower serum vanadium, a lower serum cobalt, and an elevated serum aluminium level. These findings are discussed.

Further studies of vanadium in depressive psychosis

Three studies are reported. In study 1, vanadium concentration was estimated by neutron activation analysis in hair, whole blood, serum and urine from 13 patients suffering from depressive psychosis and then when on recovery. Vanadium concentration of hair, whole blood and serum decreased significantly with recovery, but there was no significant change in 24-h urinary excretion or in renal clearance of vanadium. In study 2, vanadium concentration was estimated by neutron activation analysis in serum and urine of 31 patients with depressive psychosis and of 27 normal controls. Mean renal clearance of vanadium was significantly lower and mean serum vanadium concentration significantly higher in depressed patients than in controls. Mean 24-h excretion of vanadium did not differ between the two groups. Vanadium excretion did not correlate with urine volume, with serum concentration or with age. In study 3, erythrocyte Na-K ATPase activity and serum vanadium concentrations were estimated in 58 patients. There was a strong negative correlation between the two, supporting the suggestion that changes in tissue vanadium concentration may explain the changes in sodium transport which occur in depressive psychosis.

A two-year double-blind crossover trial of the prophylactic effect of methylene blue in manic-depressive psychosis

A 2-year prophylactic trial was carried out in 31 bipolar manic-depressive subjects, comparing 300 mg/day methylene blue on a double-blind crossover basis with 15 mg/day. All patients were also maintained on lithium. Seventeen patients completed the 2-year trial. During the year the patients were treated with methylene blue at 300 mg/day, they were significantly less depressed than during the year on 15 mg/day. No significant difference in the severity of manic symptoms was shown. The trial had obvious limitations, e.g., a small number of subjects, a relatively large number of dropouts, relatively simple rating scales, doubts about blindness, and uncertainty as to whether or not 15 mg methylene blue per day could be considered a placebo. However, the results suggest that methylene blue may be a useful addition to lithium in the long-term treatment of manic-depressive psychosis and warrants further investigation.

Blood levels of vanadium, caesium, and other elements in depressive patients

Levels of vanadium and 29 other elements were measured in whole blood of 25 depressive patients, 13 recovered depressive, and 24 control subjects. Vanadium levels were normal in depressive patients, and did not change on recovery. Changes of doubtful significance were found in blood levels of copper, strontium and chromium on recovery from depressive illness. The depressive patients had reduced blood levels of caesium which increased towards normal on recovery. This finding is discussed in relation to pertinent neurochemical and behavioural effects of caesium.

Trace elements in manic depressive psychosis

The concentrations of 16 elements (Al, Ba, Br, Ca, Cl, Cu, I, Pb, Mg, Mn, Mo, Rb, Se, Na, S and Ti) were estimated by neutron activation analysis in samples of hair, whole blood, serum and urine from normal controls, from patients suffering from mania and depression and from patients who had recovered from mania and from depression. Significant differences between groups were shown but apart from molybdenum, no element showed a significant change in more than one tissue. The differences in molybdenum concentrations appear to be of potential interest but the results must be interpreted with caution.

The therapeutic effect of ascorbic acid and EDTA in manic-depressive psychosis: double-blind comparisons with standard treatments

The effect of ascorbic acid and ethylene diamine tetra acetic acid (EDTA) in the treatment of manic-depressive psychosis was compared, using double-blind procedures, with recognized treatment regimes. There was no significant difference between the response of depressed patients to amitriptyline or ascorbic acid and EDTA. Manic patients responded significantly better to lithium than to ascorbic acid and EDTA. These results are in keeping with the suggestion that vanadium may be of aetiological importance in depressive psychosis, but do not support such a suggestion for mania.