TY - JOUR
T1 - Lithium's antiviral effects
T2 - a potential drug for CoViD-19 disease?
AU - Murru, Andrea
AU - Manchia, Mirko
AU - Hajek, Tomas
AU - Nielsen, René E
AU - Rybakowski, Janusz K
AU - Sani, Gabriele
AU - Schulze, Thomas G
AU - Tondo, Leonardo
AU - Bauer, Michael
AU - International Group for The Study of Lithium Treated Patients (IGSLi)
PY - 2020/5/20
Y1 - 2020/5/20
N2 - BACKGROUND: Since its introduction in modern medicine, naturalistic observations emerged about possible uses of lithium treatment for conditions different from recurring affective disorders, for which it is still a first-line treatment option. Some evidence about the antiviral properties of lithium began in the early 1970s, when some reports found a reduction of labial-herpetic recurrences. The present review aims to present most of the pre-clinical and clinical evidence about lithium's ability to inhibit DNA and RNA viruses, including Coronaviridae, as well as the possible pathways and mechanisms involved in such antiviral activity.MAIN BODY: Despite a broad number of in vitro studies, the rationale for the antiviral activity of lithium failed to translate into methodologically sound clinical studies demonstrating its antiviral efficacy. In addition, the tolerability of lithium as an antiviral agent should be addressed. In fact, treatment with lithium requires continuous monitoring of its serum levels in order to prevent acute toxicity and long-term side effects, most notably affecting the kidney and thyroid. Yet lithium reaches heterogeneous but bioequivalent concentrations in different tissues, and the anatomical compartment of the viral infection might underpin a different, lower need for tolerability concerns which need to be addressed.CONCLUSIONS: Lithium presents a clear antiviral activity demonstrated at preclinical level, but that remains to be confirmed in clinical settings. In addition, the pleiotropic mechanisms of action of lithium may provide an insight for its possible use as antiviral agent targeting specific pathways.
AB - BACKGROUND: Since its introduction in modern medicine, naturalistic observations emerged about possible uses of lithium treatment for conditions different from recurring affective disorders, for which it is still a first-line treatment option. Some evidence about the antiviral properties of lithium began in the early 1970s, when some reports found a reduction of labial-herpetic recurrences. The present review aims to present most of the pre-clinical and clinical evidence about lithium's ability to inhibit DNA and RNA viruses, including Coronaviridae, as well as the possible pathways and mechanisms involved in such antiviral activity.MAIN BODY: Despite a broad number of in vitro studies, the rationale for the antiviral activity of lithium failed to translate into methodologically sound clinical studies demonstrating its antiviral efficacy. In addition, the tolerability of lithium as an antiviral agent should be addressed. In fact, treatment with lithium requires continuous monitoring of its serum levels in order to prevent acute toxicity and long-term side effects, most notably affecting the kidney and thyroid. Yet lithium reaches heterogeneous but bioequivalent concentrations in different tissues, and the anatomical compartment of the viral infection might underpin a different, lower need for tolerability concerns which need to be addressed.CONCLUSIONS: Lithium presents a clear antiviral activity demonstrated at preclinical level, but that remains to be confirmed in clinical settings. In addition, the pleiotropic mechanisms of action of lithium may provide an insight for its possible use as antiviral agent targeting specific pathways.
KW - CoViD-19
KW - Virus
KW - GSK-3β
KW - Inositol
KW - Coronavirus
KW - Bipolar disorder
UR - http://www.scopus.com/inward/record.url?scp=85085057223&partnerID=8YFLogxK
U2 - 10.1186/s40345-020-00191-4
DO - 10.1186/s40345-020-00191-4
M3 - Review article
C2 - 32435920
SN - 2194-7511
VL - 8
JO - International Journal of Bipolar Disorders
JF - International Journal of Bipolar Disorders
IS - 1
M1 - 21
ER -