Comparison A1 adenosine receptor The adenosine A1 receptor has been found to be ubiquitous throughout the entire body.
Mechanism This receptor has an inhibitory function on most of the tissues in which it is expressed. In the brain, it slows metabolic activity by a combination of actions. Presynaptically, it reduces
synaptic vesicle release while post synaptically it has been found to stabilize the
magnesium on the
NMDA receptorsource?.
Antagonism and agonism Specific A1
antagonists include
8-cyclopentyl-1,3-dipropyl xanthine (DPCPX), and
cyclopentyltheophylline (CPT) or 8-cyclopentyl-1,3-
dipropylxanthine (CPX), while specific agonists include 2-chloro-N(6)-cyclopentyladenosine (CCPA).
Tecadenoson is an effective A1 adenosine agonist, as is
selodenoson.
In the heart The A1, together with A2A receptors of endogenous adenosine play a role in regulating
myocardial oxygen consumption and coronary blood flow. Stimulation of the A1 receptor has a myocardial depressant effect by decreasing the conduction of electrical impulses and suppressing
pacemaker cell function, resulting in a decrease in
heart rate. This makes adenosine a useful medication for treating and diagnosing
tachyarrhythmias, or excessively fast heart rates. This effect on the A1 receptor also explains why there is a brief moment of cardiac standstill when adenosine is administered as a rapid
IV push during
cardiac resuscitation. The rapid infusion causes a momentary myocardial stunning effect. In normal physiological states, this serves as a protective mechanism. However, in altered cardiac function, such as
hypoperfusion caused by
hypotension,
heart attack or
cardiac arrest caused by
nonperfusing bradycardias (e.g.,
ventricular fibrillation or
pulseless ventricular tachycardia), adenosine has a negative effect on physiological functioning by preventing necessary compensatory increases in heart rate and blood pressure that attempt to maintain cerebral perfusion.
In neonatal medicine Adenosine antagonists are widely used in
neonatal medicine; A reduction in A1 expression appears to prevent hypoxia-induced
ventriculomegaly and loss of white matter, which raises the possibility that pharmacological blockade of A1 may have clinical utility. Theophylline and caffeine are nonselective adenosine antagonists that are used to stimulate respiration in premature infants.
Bone homeostasis Adenosine receptors play a key role in the homeostasis of bone. The A1 receptor has been shown to stimulate
osteoclast differentiation and function. Studies have found that blockade of the A1 Receptor suppresses the osteoclast function, leading to increased bone density.
A2A adenosine receptor As with the A1, the A2A receptors are believed to play a role in regulating myocardial oxygen consumption and coronary blood flow.
Mechanism The activity of A2A adenosine receptor, a G-protein coupled receptor family member, is mediated by G proteins that activate
adenylyl cyclase. It is abundant in basal ganglia, vasculature and platelets and it is a major target of caffeine.
Function The A2A receptor is responsible for regulating myocardial blood flow by
vasodilating the
coronary arteries, which increases blood flow to the
myocardium, but may lead to hypotension. Just as in A1 receptors, this normally serves as a protective mechanism, but may be destructive in altered cardiac function.
Agonists and antagonists Specific antagonists include
istradefylline (KW-6002) and
SCH-58261, while specific agonists include
CGS-21680 and ATL-146e.
Bone homeostasis The role of A2A receptor opposes that of A1 in that it inhibits osteoclast differentiation and activates
osteoblasts. Studies have shown it to be effective in decreasing inflammatory osteolysis in inflamed bone. This role could potentiate new therapeutic treatment in aid of bone regeneration and increasing bone volume.
A2B adenosine receptor This integral membrane protein stimulates adenylate cyclase activity in the presence of adenosine. This protein also interacts with
netrin-1, which is involved in axon elongation.
In the brain In the brain, A2B receptor activation by adenosine released in response to increased neuronal activity engages the cAMP–PKA signalling pathway in astrocytes, stimulating glucose metabolism in these glial cells to support neuronal energy needs.
Bone homeostasis Similarly to A2A receptor, the A2B receptor promotes osteoblast differentiation. The osteoblast cell is derived from the Mesenchymal Stem Cell (MSC) which can also differentiate into a chondrocyte. The cell signalling involved in the stimulation of the A2B receptor directs the route of differentiation to osteoblast, rather than chondrocyte via the Runx2 gene expression. Its function in regards to osteoblasts remains ambiguous. ==Ligand affinities==