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Vol. 285, Issue 1, 307-316, April 1998
Departments of
Psychiatry (D.G.W., R.H.L.) and
Pharmacology
(J.M.W., R.H.L.), Neural Program in Signal Transduction,
Neuroplasticity, and Drug Discovery, University of Florida College of
Medicine, Gainesville, Florida
Sodium valproate (VPA) is a short-chain fatty acid with
well-established anticonvulsant properties and apparent clinical
efficacy in the treatment of bipolar disorder (manic-depressive
illness). Little is known regarding the mechanism of action of VPA in
the brain that could account for this clinical therapeutic profile. Lithium has been the standard treatment for bipolar disorder, and it is
known to be an uncompetitive inhibitor of inositol monophosphatase in
the phosphoinositide (PI) signaling cascade at clinically relevant concentrations. Recent studies have provided data in support of a role
for protein kinase C and the down-regulation of expression of the
myristoylated alanine-rich C kinase substrate (MARCKS) in the long-term
therapeutic action of lithium in the brain, which is dependent on both
the relative activity of receptor-coupled PI signaling and the
concentration of myo-inositol. Our current results
demonstrated that valproate induces a concentration- and time-dependent
reduction of MARCKS in immortalized hippocampal cells that appears to
be independent of both the level of muscarinic receptor-activated PI
signaling as well as the concentration of myo-inositol. In
CHO-K1 cells transfected with the human m1 muscarinic receptor, unlike
lithium, there is no evidence for receptor-mediated accumulation of
CMP-PA in the presence of VPA, providing more direct data for its lack
of interaction within the PI signaling cascade. The action of VPA on
MARCKS occurs within the therapeutic concentrations and time course
observed in clinical studies of patients with bipolar disorder.
Furthermore, the effect on MARCKS protein is additive in the presence
of therapeutic concentrations of both lithium and valproate, consistent
with clinical observations regarding the enhanced efficacy of the
combination treatment. Finally, in studies examining acute and chronic
effects of a variety of psychotropic compounds and VPA structural
analogs, it is evident that the property of regulation of MARCKS is
shared by the mood-stabilizers lithium and VPA, which may be specific
to a class of drugs effective in the treatment of bipolar disorder.
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