Relevance of red blood cell Lithium concentration in the management of Lithium-treated bipolar and unipolar disorders: a systematic narrative review.

IF 2.8 2区医学 Q2 PSYCHIATRY International Journal of Bipolar Disorders Pub Date : 2024-10-16 DOI:10.1186/s40345-024-00356-5

Manon Coyac, Lynn Jalabert, Xavier Declèves, Bruno Etain, Frank Bellivier

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Abstract

Background: Despite a variability in response and a narrow therapeutic index, Lithium (Li) remains the gold standard treatment for bipolar disorders (BD), and a treatment of choice for unipolar disorders (UD). Red blood cell Li concentration (RBCLiC) and red blood cell/plasma Li ratio (LiR) have been studied in many areas of mood disorders (such as acute or chronic Li efficacy, adherence, side effects (SE), intoxication management) as well as in several research domains. This systematic review aims to synthesize the existing literature.

Methods: We conducted a systematic review, based on preferred reporting items for systematic reviews and Metanalysis (PRISMA) guidelines, of articles published between 1972 and February 2023, indexed in the following databases: EMBASE, MEDLINE, Cochrane Library. The search terms were combinations of the following headings: "Lithium AND Plasma AND Erythrocyte AND Mood disorders". The systematic review protocol was published to PROSPERO (CRD42023406154).

Results and conclusion: Out of the 252 identified studies, 57 met the selection criteria. The articles investigated the interest of RBCLiC and other blood parameters (PLiC and LiR) in various areas: (i) disease management (31 articles) (compliance/adherence (5 articles), SE/toxicity (13 articles), prediction of Li response/therapeutic efficacy for acute episode or for relapse prevention (17 articles)), (ii) Li blood parameters as trait markers of mood disorders subtypes (UD, BDI, BDII) (16 articles), (iii) Li blood parameters as state markers of mood episodes (11 articles), (iv) factors influencing Li blood parameters (age, gender, ethnicity, dosage and duration of Li treatment, co-medications with other treatments, seasonality) associated with RBCLiC or LiR (24 articles), and (v) potential pathophysiological mechanisms (30 articles).

Conclusion: Overall, this review suggests that RBCLiC or LiR could be of interest for tolerance monitoring. However, the heterogeneity of methods and results, coupled with the limited amount of data, does not allow clear conclusions to be drawn in the other areas explored in this literature review. Given the potential interest in exploring brain Li pharmacokinetics (PK)s, this review calls for further research.

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红细胞锂浓度与锂治疗双相情感障碍和单相情感障碍管理的相关性：系统性叙事回顾。

背景：尽管锂（Li）的反应多变且治疗指数较窄，但它仍然是治疗双相情感障碍（BD）的金标准疗法，也是治疗单相情感障碍（UD）的首选疗法。红细胞锂浓度（RBCLiC）和红细胞/血浆锂比率（LiR）已在情绪障碍的多个领域（如急性或慢性锂疗效、依从性、副作用（SE）、中毒管理）以及多个研究领域进行了研究。本系统综述旨在综合现有文献：根据系统综述和元分析首选报告项目（PRISMA）指南，我们对 1972 年至 2023 年 2 月间发表的文章进行了系统综述，这些文章已被以下数据库收录：EMBASE、MEDLINE、Cochrane Library。检索词为以下标题的组合："锂、血浆、红细胞、情绪障碍"。系统综述方案已在 PROSPERO（CRD42023406154）上公布：在已确定的 252 项研究中，有 57 项符合筛选标准。这些文章调查了 RBCLiC 和其他血液参数（PLiC 和 LiR）在不同领域的意义：(i) 疾病管理（31 篇文章）（依从性/依从性（5 篇文章）、SE/毒性（13 篇文章）、对急性发作或预防复发的 Li 反应/疗效预测（17 篇文章）），(ii) 作为情绪障碍亚型（UD、BDI、BDII）特质标记的 Li 血液参数（16 篇文章）、(iv) 与 RBCLiC 或 LiR 相关的影响 Li 血液参数的因素（年龄、性别、种族、Li 治疗的剂量和持续时间、与其他治疗的联合用药、季节性）（24 篇文章），以及 (v) 潜在的病理生理机制（30 篇文章）。结论：总体而言，本综述表明 RBCLiC 或 LiR 可用于耐受性监测。然而，由于方法和结果的不一致性，再加上数据量有限，因此无法就本文献综述所探讨的其他领域得出明确的结论。鉴于探索脑锂离子药代动力学 (PK) 的潜在兴趣，本综述呼吁开展进一步的研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Bipolar Disorders Medicine-Psychiatry and Mental Health

CiteScore

6.70

自引率

5.00%

发文量

审稿时长

13 weeks

期刊介绍： The International Journal of Bipolar Disorders is a peer-reviewed, open access online journal published under the SpringerOpen brand. It publishes contributions from the broad range of clinical, psychological and biological research in bipolar disorders. It is the official journal of the ECNP-ENBREC (European Network of Bipolar Research Expert Centres ) Bipolar Disorders Network, the International Group for the study of Lithium Treated Patients (IGSLi) and the Deutsche Gesellschaft für Bipolare Störungen (DGBS) and invites clinicians and researchers from around the globe to submit original research papers, short research communications, reviews, guidelines, case reports and letters to the editor that help to enhance understanding of bipolar disorders.