title: Adenosine hypothesis of schizophrenia--opportunities for pharmacotherapy.
abstract: Pharmacotherapy of schizophrenia based on the dopamine hypothesis remains unsatisfactory for the negative and cognitive symptoms of the disease. Enhancing N-methyl-D-aspartate receptors (NMDAR) function is expected to alleviate such persistent symptoms, but successful development of novel clinically effective compounds remains challenging. Adenosine is a homeostatic bioenergetic network modulator that is able to affect complex networks synergistically at different levels (receptor-dependent pathways, biochemistry, bioenergetics, and epigenetics). By affecting brain dopamine and glutamate activities, it represents a promising candidate for reversing the functional imbalance in these neurotransmitter systems believed to underlie the genesis of schizophrenia symptoms, as well as restoring homeostasis of bioenergetics. Suggestion of an adenosine hypothesis of schizophrenia further posits that adenosinergic dysfunction might contribute to the emergence of multiple neurotransmitter dysfunctions characteristic of schizophrenia via diverse mechanisms. Given the importance of adenosine in early brain development and regulation of brain immune response, it also bears direct relevance to the aetiology of schizophrenia. Here, we provide an overview of the rationale and evidence in support of the therapeutic potential of multiple adenosinergic targets, including the high-affinity adenosine receptors (A(1)R and A(2A)R), and the regulatory enzyme adenosine kinase (ADK). Key preliminary clinical data and preclinical findings are reviewed.
authors.affiliation: Robert Stone Dow Neurobiology Laboratories, Legacy Research Institute, 1225 NE 2nd Avenue, Portland, OR 97232, USA. dboison@downeurobiology.org
authors.forename: Detlev
authors.initials: D
authors.lastname: Boison
authors.forename: Philipp
authors.initials: P
authors.lastname: Singer
authors.forename: Hai-Ying
authors.initials: HY
authors.lastname: Shen
authors.forename: Joram
authors.initials: J
authors.lastname: Feldon
authors.forename: Benjamin K
authors.initials: BK
authors.lastname: Yee
mesh_terms: D000241:Adenosine / Q000378:metabolism*; D000248:Adenosine Kinase / Q000378:metabolism; D000818:Animals; D014150:Antipsychotic Agents / Q000378:metabolism* / Q000627:therapeutic use*; D006801:Humans; D018047:Receptors, Purinergic P1 / Q000378:metabolism; D012559:Schizophrenia / Q000188:drug therapy* / Q000378:metabolism*
chemical_list: D014150:Antipsychotic Agents; D018047:Receptors, Purinergic P1; D000248:Adenosine Kinase; D000241:Adenosine