title: Purinergic Mechanisms and Pain.
abstract: There is a brief introductory summary of purinergic signaling involving ATP storage, release, and ectoenzymatic breakdown, and the current classification of receptor subtypes for purines and pyrimidines. The review then describes purinergic mechanosensory transduction involved in visceral, cutaneous, and musculoskeletal nociception and on the roles played by receptor subtypes in neuropathic and inflammatory pain. Multiple purinoceptor subtypes are involved in pain pathways both as an initiator and modulator. Activation of homomeric P2X3 receptors contributes to acute nociception and activation of heteromeric P2X2/3 receptors appears to modulate longer-lasting nociceptive sensitivity associated with nerve injury or chronic inflammation. In neuropathic pain activation of P2X4, P2X7, and P2Y12 receptors on microglia may serve to maintain nociceptive sensitivity through complex neural-glial cell interactions and antagonists to these receptors reduce neuropathic pain. Potential therapeutic approaches involving purinergic mechanisms will be discussed.
authors.affiliation: Autonomic Neuroscience Centre, Royal Free and University College Medical School, London, United Kingdom; Department of Pharmacology and Therapeutics, The University of Melbourne, Melbourne, Australia. Electronic address: g.burnstock@ucl.ac.uk.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Burnstock
mesh_terms: D000700:Analgesics / Q000494:pharmacology / Q000627:therapeutic use; D000818:Animals; D006801:Humans; D040542:Mechanotransduction, Cellular; D008881:Migraine Disorders / Q000378:metabolism; D010146:Pain / Q000188:drug therapy / Q000378:metabolism*; D058914:Purinergic Antagonists / Q000494:pharmacology / Q000627:therapeutic use; D011983:Receptors, Purinergic / Q000378:metabolism*
chemical_list: D000700:Analgesics; D058914:Purinergic Antagonists; D011983:Receptors, Purinergic
keywords: ATP; Adenosine; Inflammation; Mechanosensory transduction; Neuropathic pain; Nociceptive sensory fibers; Purinoceptors