Academic Journal
Exploratory CT-Based Assessment of Emphysema Burden in Smokers with Bipolar Disorder Receiving Lithium Treatment.
| Τίτλος: | Exploratory CT-Based Assessment of Emphysema Burden in Smokers with Bipolar Disorder Receiving Lithium Treatment. |
|---|---|
| Συγγραφείς: | Şimşek ŞM; Department of Chest Diseases, Giresun University Faculty of Medicine, Giresun, Turkey., Şimşek MH; Department of Psychiatry, Giresun University Faculty of Medicine, Giresun, Turkey., Cörüt R; Department of Chest Diseases, Giresun University Faculty of Medicine, Giresun, Turkey., Helvacı Çelik FG; Department of Psychiatry, Giresun University Faculty of Medicine, Giresun, Turkey., Tonkaz G; Department of Radiology, Giresun University Faculty of Medicine, Giresun, Turkey., Kaya A; Department of Radiology, Giresun University Faculty of Medicine, Giresun, Turkey., Takır S; Department of Medical Pharmacology, Giresun University Faculty of Medicine, Giresun, Turkey. |
| Πηγή: | International journal of chronic obstructive pulmonary disease [Int J Chron Obstruct Pulmon Dis] 2026 Aug 28; Vol. 21, pp. 626791. Date of Electronic Publication: 2026 Aug 28 (Print Publication: 2026). |
| Τύπος έκδοσης: | Journal Article; Observational Study |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: DOVE Medical Press Country of Publication: New Zealand NLM ID: 101273481 Publication Model: eCollection Cited Medium: Internet ISSN: 1178-2005 (Electronic) Linking ISSN: 11769106 NLM ISO Abbreviation: Int J Chron Obstruct Pulmon Dis Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Auckland, N.Z. : DOVE Medical Press |
| Ιατρικοί όροι (MeSH): | Bipolar Disorder*/drug therapy , Lithium Compounds*/therapeutic use , Lung*/diagnostic imaging , Lung*/drug effects , Lung*/physiopathology , Pulmonary Emphysema*/diagnostic imaging , Pulmonary Emphysema*/etiology , Pulmonary Emphysema*/physiopathology , Pulmonary Emphysema*/prevention & control , Smoking*/adverse effects , Smokers* , Tomography, X-Ray Computed*, Adult ; Female ; Humans ; Male ; Middle Aged ; Linear Models ; Multivariate Analysis ; Predictive Value of Tests ; Retrospective Studies ; Risk Factors ; Time Factors |
| Περίληψη: | Purpose: Experimental studies suggest that lithium may modulate emphysema-related tissue injury through activation of the WNT/β-catenin signaling pathway. However, clinical data examining the relationship between lithium exposure and emphysema burden remain limited. This study aimed to investigate the association between long-term lithium use and CT-derived emphysema burden in smokers with bipolar disorder. Patients and Methods: This retrospective observational study included 67 smokers with bipolar disorder who had received lithium treatment for at least 5 years and 71 matched controls with similar demographic and smoking characteristics. Quantitative emphysema measurements were obtained from thoracic computed tomography using low attenuation area percentage (LAA%). Multivariable linear regression analyses were performed adjusting for age, sex, BMI, and smoking exposure. Results: Right, left, and total lung LAA% values were lower in the lithium-treated group than in controls (7.53% vs 10.11%, p=0.009; 7.73% vs 10.02%, p=0.019; and 7.64% vs 10.07%, p=0.011, respectively). In multivariable analysis, lithium treatment remained independently associated with lower total LAA% after adjustment for age, sex, body mass index, and smoking exposure (B = -2.636, standardized β = -0.236, 95% CI -4.537 to -0.736; p = 0.007). Weak inverse correlations between serum lithium concentrations and emphysema measurements were observed in unadjusted analyses but were no longer significant after multivariable adjustment. Conclusion: Long-term lithium exposure was associated with lower CT-derived emphysema burden in smokers with bipolar disorder. Given the observational design and potential influence of inspiratory effort during CT acquisition, these findings should be considered hypothesis-generating rather than evidence of a protective effect. Prospective longitudinal and mechanistic studies are warranted to clarify the relationship between lithium exposure and smoking-related parenchymal lung injury. (© 2026 Şimşek et al.) |
| Competing Interests: | The authors declare no conflicts of interest in this work. |
| References: | Curr Med Sci. 2018 Jun;38(3):473-481. (PMID: 30074215) Exp Dermatol. 2024 Apr;33(4):e15078. (PMID: 38610097) ACS Chem Neurosci. 2014 Jun 18;5(6):451-8. (PMID: 24803181) Int J Angiol. 2021 Sep 21;33(1):57-61. (PMID: 38352640) Cell Rep. 2016 Apr 19;15(3):638-650. (PMID: 27068460) Radiology. 2006 Mar;238(3):1036-43. (PMID: 16424242) BMJ. 2007 Oct 20;335(7624):806-8. (PMID: 17947786) Stem Cells. 2020 Nov;38(11):1467-1478. (PMID: 32526076) Front Cell Dev Biol. 2023 Sep 19;11:1165581. (PMID: 37795260) J Trace Elem Med Biol. 2016 Jul;36:7-15. (PMID: 27259346) BMC Pulm Med. 2024 May 14;24(1):236. (PMID: 38745304) COPD. 2010 Feb;7(1):32-43. (PMID: 20214461) Int Immunopharmacol. 2013 May;16(1):35-40. (PMID: 23542012) J Appl Toxicol. 1988 Oct;8(5):373-5. (PMID: 3230249) Front Pharmacol. 2020 Apr 07;11:430. (PMID: 32317977) Aging (Albany NY). 2020 Jun 13;12(11):10035-10040. (PMID: 32534451) Eur Psychiatry. 2021 Feb 26;64(1):e22. (PMID: 33632347) Br J Pharmacol. 2021 Oct;178(19):4026-4041. (PMID: 34089180) J Toxicol Environ Health. 1986;18(4):627-37. (PMID: 3735461) Respir Res. 2021 Nov 6;22(1):286. (PMID: 34742298) Mol Psychiatry. 2025 Feb;30(2):777-785. (PMID: 39543369) Am J Respir Crit Care Med. 2011 Mar 15;183(6):723-33. (PMID: 20889911) Pathology. 2006 Feb;38(1):58-62. (PMID: 16484010) J Cell Mol Med. 2018 Jul;22(7):3514-3525. (PMID: 29659176) Lab Invest. 2016 Feb;96(2):218-29. (PMID: 26322419) Front Psychiatry. 2020 May 07;11:377. (PMID: 32457664) Chin Med J (Engl). 2021 Jul 1;134(18):2214-2222. (PMID: 34224402) Int J Bipolar Disord. 2021 Feb 1;9(1):4. (PMID: 33521836) J Biol Chem. 2000 Jun 9;275(23):17894-9. (PMID: 10749878) Front Psychiatry. 2023 Jan 09;13:1114432. (PMID: 36699491) Matrix Biol. 2018 Aug;68-69:67-80. (PMID: 29572156) COPD. 2018 Dec;15(6):612-620. (PMID: 30714418) Environ Int. 2025 May;199:109466. (PMID: 40286557) Lancet. 2020 Dec 5;396(10265):1841-1856. (PMID: 33278937) Arch Toxicol. 2018 May;92(5):1673-1684. (PMID: 29550861) |
| Contributed Indexing: | Keywords: COPD; WNT/β-catenin; bipolar disorder; chronic obstructive pulmonary disease; emphysema; lithium |
| Substance Nomenclature: | 0 (Lithium Compounds) |
| Entry Date(s): | Date Created: 20260902 Date Completed: 20260902 Latest Revision: 20260910 |
| Update Code: | 20260910 |
| PubMed Central ID: | PMC13532643 |
| DOI: | 10.2147/COPD.S626791 |
| PMID: | 42683441 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1178-2005 |
|---|---|
| DOI: | 10.2147/COPD.S626791 |