Abstract

Lithium is the prototype mood stabilizer but its mechanism is still unresolved. Two hypotheses dominate—the consequences of lithium's inhibition of inositol monophosphatase at therapeutically relevant concentrations (the ‘inositol depletion' hypothesis), and of glycogen-synthase kinase-3. To further elaborate the inositol depletion hypothesis that did not decisively determine whether inositol depletion per se, or phosphoinositols accumulation induces the beneficial effects, we utilized knockout mice of either of two inositol metabolism-related genes—IMPA1 or SMIT1, both mimic several lithium's behavioral and biochemical effects. We assessed in vivo, under non-agonist-stimulated conditions, 3H-inositol incorporation into brain phosphoinositols and phosphoinositides in wild-type, lithium-treated, IMPA1 and SMIT1 knockout mice. Lithium treatment increased frontal cortex and hippocampal phosphoinositols labeling by several fold, but decreased phosphoinositides labeling in the frontal cortex of the wild-type mice of the IMPA1 colony strain by ~50%. Inositol metabolites were differently affected by IMPA1 and SMIT1 knockout. Inositoltrisphosphate administered intracerebroventricularly affected bipolar-related behaviors and autophagy markers in a lithium-like manner. Namely, IP3 but not IP1 reduced the immobility time of wild-type mice in the forced swim test model of antidepressant action by 30%, an effect that was reversed by an antagonist of all three IP3 receptors; amphetamine-induced hyperlocomotion of wild-type mice (distance traveled) was 35% reduced by IP3 administration; IP3 administration increased hippocampal messenger RNA levels of Beclin-1 (required for autophagy execution) and hippocampal and frontal cortex protein levels ratio of Beclin-1/p62 by about threefold (p62 is degraded by autophagy). To conclude, lithium affects the phosphatidylinositol signaling system in two ways: depleting inositol, consequently decreasing phosphoinositides; elevating inositol monophosphate levels followed by phosphoinositols accumulation. Each or both may mediate lithium-induced behavior.

Highlights

  • Bipolar disorder (BPD) is a mental illness characterized by severe high and low moods

  • The inositol depletion hypothesis, dealt with in the present study, suggests that the uncompetitive inhibition of IMPase-1 causes modulation of brain levels of inositol and its metabolites resulting in reduced signaling capacity, but it has not decisively determined whether inositol depletion per se or phosphoinositol accumulation induces the drug’s beneficial effects

  • Up until now observations related to the inositol depletion hypothesis are inconsistent and do not prove or refute the hypothesis

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Summary

Introduction

Bipolar disorder (BPD) is a mental illness characterized by severe high and low moods. For ~ 70 years, lithium salts (lithium, Li) have been the mainstay mood-stabilizing drug. The drug’s therapeutic mechanism at the molecular level has not yet been resolved.[1]. The discovery of the inhibitory effect of therapeutically relevant Li concentration on inositol monophosphatase-1 (IMPase1)[2] led to the inositol depletion hypothesis of Li’s beneficial effect in BPD.[3]. The inositol depletion hypothesis, dealt with in the present study, suggests that the uncompetitive inhibition of IMPase-1 causes modulation of brain levels of inositol and its metabolites resulting in reduced signaling capacity, but it has not decisively determined whether inositol depletion per se or phosphoinositol accumulation induces the drug’s beneficial effects. Some studies[5,6] suggested that rather than inositol depletion increased brain phosphoinositols levels following IMPase-1 inhibition mediate Li’s therapeutic action. Up until now observations related to the inositol depletion hypothesis are inconsistent and do not prove or refute the hypothesis

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