Adenosine receptors and reperfusion injury of the heart

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Title Adenosine receptors and reperfusion injury of the heart
Author Headrick, John Patrick; Lasley, Robert D.
Book Title Handbook of Experimental Pharmacology, Adenosine Receptors in Health and Disease
Editor CN Wilson, J Mustafa
Year Published 2009
Place of publication Berlin
Publisher Springer-Verlag
Abstract Adenosine, a catabolite of ATP, exerts numerous effects in the heart, including modulation of the cardiac response to stress, such as occurs during myocardial ischemia and reperfusion. Over the past 20 years substantial evidence has accumulated that adenosine, administered either prior to ischemia or during reperfusion, reduces both reversible and irreversible myocardial injury. The latter effect results in reduction of both necrosis or myocardial infarction (MI) and apoptosis. These effects appear to be mediated via the activation of one or more G-protein coupled receptors (GPCRs), referred to as A1, A2A, A2B and A3 adenosine receptor (AR) subtypes. Experimental studies in different species and models suggest that activation of the A1 or A3ARs prior to ischemia is cardioprotective. Further experimental studies reveal that the administration of A2AAR agonists during reperfusion can also reduce MI, and recent reports suggest that A2BARs may also play an important role in modulating myocardial reperfusion injury. Despite convincing experimental evidence for AR-mediated cardioprotection, there have been only a limited number of clinical trials examining the beneficial effects of adenosine or adenosine-based therapeutics in humans, and the results of these studies have been equivocal. This review summarizes our current knowledge of AR-mediated cardioprotection, and the roles of the four known ARs in experimental models of ischemia-reperfusion. The chapter concludes with an examination of the clinical trials to date assessing the safety and efficacy of adenosine as a cardioprotective agent during coronary thrombolysis in humans.
Peer Reviewed Yes
Published Yes
Publisher URI
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Chapter Number 7
Page from 189
Page to 214
ISBN 978-3-540-89614-2
Date Accessioned 2009-06-17
Language en_AU
Research Centre Menzies Health Institute Qld; Heart Foundation Research Centre
Faculty Griffith Health Faculty
Subject Clinical Pharmacology and Therapeutics
Publication Type Book Chapters
Publication Type Code b1

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