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Adenosine as a marker and mediator of cardiovascular homeostasis: a translational perspective.

INTRODUCTION: Adenosine, a purine nucleoside, is produced broadly and implicated in the homeostasis of many cells and tissues. It signals predominantly via 4 purinergic adenosine receptors (ADORs) - ADORA1, ADORA2A, ADORA2B and ADORA3 in addition to non-ADOR mediated effects. Through these signaling mechanisms, adenosine exerts effects on numerous cell types crucial to maintaining vascular homeostasis, especially following vascular injury. Both in vitro and in vivo models have provided considerable insights into adenosine signaling and identified targets for therapeutic intervention. While numerous pharmacologic agents have been developed that modulate adenosine signaling, both through design as specific ADOR agonists and antagonists and as off-target effects of existing anti-platelet medications. However, adenosine has yet to be firmly established as either a therapeutic or a prognostic tool in clinical medicine to date. Conclusion Herein, we provide a bench-to-bedside review of adenosine biology, highlighting the key considerations for further translational development of this promising molecule.

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