Beneficial effect of digoxin-specific Fab fragments in bipolar disorder- a preliminary study

Zilberstein, Ariel; Krivoy, Norberto; Horesh, Noa; Klein, Ehud; Lichtstein, David

doi:10.1016/j.jadr.2023.100600

Cited by 1 publication

(1 citation statement)

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“…We speculate that this decrease in ECS might potentially be responsible for the improvement in the patients after the treatment, although we do not have direct experimental evidence supporting this possibility. Importantly, however, we have recently demonstrated, in a preliminary study, that the treatment of patients with BD with anti-digoxin antibodies (Digibind), which decreases ECS in the circulation, elicits significant clinical improvements in patients with BD [46].…”

Section: Discussionmentioning

confidence: 99%

Involvement of the Na+, K+-ATPase α1 Isoform and Endogenous Cardiac Steroids in Depression- and Manic-like Behaviors

Horesh,

Pelov,

Pogodin

et al. 2024

IJMS

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Bipolar disorder (BD) is a severe and common chronic mental illness characterized by recurrent mood swings between depression and mania. The biological basis of the disease is poorly understood, and its treatment is unsatisfactory. Na+, K+-ATPase is a major plasma membrane transporter and signal transducer. The catalytic α subunit of this enzyme is the binding site for cardiac steroids. Three α isoforms of the Na+, K+-ATPase are present in the brain. Previous studies have supported the involvement of the Na+, K+-ATPase and endogenous cardiac steroids (ECS) in the etiology of BD. Decreased brain ECS has been found to elicit anti-manic and anti-depressive-like behaviors in mice and rats. However, the identity of the specific α isoform involved in these behavioral effects is unknown. Here, we demonstrated that decreasing ECS through intracerebroventricular (i.c.v.) administration of anti-ouabain antibodies (anti-Ou-Ab) decreased the activity of α1+/− mice in forced swimming tests but did not change the activity in wild type (wt) mice. This treatment also affected exploratory and anxiety behaviors in α1+/− but not wt mice, as measured in open field tests. The i.c.v. administration of anti-Ou-Ab decreased brain ECS and increased brain Na+, K+-ATPase activity in wt and α1+/− mice. The serum ECS was lower in α1+/− than wt mice. In addition, a study in human participants demonstrated that serum ECS significantly decreased after treatment. These results suggest that the Na+, K+-ATPase α1 isoform is involved in depressive- and manic-like behaviors and support that the Na+, K+-ATPase/ECS system participates in the etiology of BD.

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Section: Discussionmentioning

confidence: 99%