Adenosine: an old drug newly discovered.
Over decades, anesthesiologists have used intravenous adenosine as mainstay therapy for diagnosing or treating supraventricular tachycardia in the perioperative setting. More recently, specific adenosine receptor therapeutics or gene-targeted mice deficient in extracellular adenosine production or individual adenosine receptors became available. These models enabled physicians and scientists to learn more about the biologic functions of extracellular nucleotide metabolism and adenosine signaling. Such functions include specific signaling effects through adenosine receptors expressed by many mammalian tissues; for example, vascular endothelia, myocytes, hepatocytes, intestinal epithelia, or immune cells. At present, pharmacological approaches to modulate extracellular adenosine signaling are evaluated for their potential use in perioperative medicine, including attenuation of acute lung injury; renal, intestinal, hepatic and myocardial ischemia; or vascular leakage. If these laboratory studies can be translated into clinical practice, adenosine receptor-based therapeutics may become an integral pharmacological component of daily anesthesiology practice.
Eltzschig
Holger K
HK
Department of Anesthesiology, University of Colorado-Denver, 12700 E. 19th Avenue, Aurora, CO 80045, USA. holger.eltzschig@ucdenver.edu
D000241:Adenosine / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use*; D000758:Anesthesia; D000818:Animals; D002317:Cardiovascular Agents / Q000494:pharmacology / Q000627:therapeutic use*; D005110:Extracellular Space / Q000378:metabolism; D006801:Humans; D000860:Hypoxia / Q000378:metabolism; D007431:Intraoperative Complications / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D019990:Perioperative Care; D015398:Signal Transduction / Q000502:physiology; D013617:Tachycardia, Supraventricular / Q000188:drug therapy / Q000503:physiopathology
D002317:Cardiovascular Agents; D000241:Adenosine