Abstract

Adenosine receptors are a subfamily of highly-conserved G-protein coupled receptors. They are found in the membranes of various human cells and play many physiological functions. Blood platelets express two (A2A and A2B) of the four known adenosine receptor subtypes (A1, A2A, A2B, and A3). Agonization of these receptors results in an enhanced intracellular cAMP and the inhibition of platelet activation and aggregation. Therefore, adenosine receptors A2A and A2B could be targets for anti-platelet therapy, especially under circumstances when classic therapy based on antagonizing the purinergic receptor P2Y12 is insufficient or problematic. Apart from adenosine, there is a group of synthetic, selective, longer-lasting agonists of A2A and A2B receptors reported in the literature. This group includes agonists with good selectivity for A2A or A2B receptors, as well as non-selective compounds that activate more than one type of adenosine receptor. Chemically, most A2A and A2B adenosine receptor agonists are adenosine analogues, with either adenine or ribose substituted by single or multiple foreign substituents. However, a group of non-adenosine derivative agonists has also been described. This review aims to systematically describe known agonists of A2A and A2B receptors and review the available literature data on their effects on platelet function.

Highlights

  • Activation of blood platelets plays a critical role in the pathogenesis of arterial thrombotic diseases, such as coronary heart disease, myocardial infarction, and stroke, which are the primary cause of mortality in developed countries

  • Ticagrelor is an allosteric antagonist of P2Y12, acting directly via reversible binding to the P2Y12 receptor, which leads to the non-competitive inhibition of ADP-induced P2Y12 activation and is used for the prevention of thromboembolic events in patients with acute coronary syndromes [2,3,4,5]

  • Adenosine receptor agonists have been shown to have anti-platelet effect; not all of them are of the same magnitude, with some even presenting no discernible impact on aggregation

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Summary

Introduction

Activation of blood platelets plays a critical role in the pathogenesis of arterial thrombotic diseases, such as coronary heart disease, myocardial infarction, and stroke, which are the primary cause of mortality in developed countries. AMP597 was first described by Smits et al in 1998 as a novel cardioprotective A1/A2 agonist [85] It has high affinity for the A1 (Ki = 2 nM) and A2A (Ki = 56 nM) receptor subtypes [86] and was later determined to be an A2B agonist as well, based on the observation of its ability to induce phosphorylation of extracellular signal-regulated kinase and its protection against infarction in rabbit heart reperfusion studies [87]. It could be regarded, as a potent but non-selective AR agonist.

Adenosine Derivatives with Substituents at C1 to C5 Positions
Compounds with Substituents at C1 to C8 and C1 to C5 Positions
BAY 60-6583
LUF5834 and LUF5835
Dual Therapy
Findings
Conclusions
Full Text
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