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A3 adenosine receptor-mediated protection of the ischemic heart
1Heart Foundation Research Centre, Griffith University Gold Coast Campus, Southport, QLD 4217, Australia. j.headrick@g.edu.au
Insights
The A3 adenosine receptor (A3AR) shows promise for treating heart attack by protecting heart tissue from damage. Activating A3AR with drugs offers therapeutic benefits with fewer side effects than other related treatments.
Area of Science:
- Cardiology
- Pharmacology
- Molecular Biology
Background:
- The A3 adenosine receptor (A3AR) plays a role in heart attack recovery.
- Endogenous adenosine minimally activates A3AR during ischemia, suggesting exogenous agonists could be beneficial.
Purpose of the Study:
- To review the protective actions and signaling of A3ARs in ischemic-reperfused heart.
- To discuss the potential of A3AR agonists as anti-ischemic therapeutics.
Main Methods:
- Literature review of studies on A3AR in myocardial ischemia-reperfusion.
- Analysis of evidence regarding A3AR activation and its effects on cardiac function and outcome.
Main Results:
- A3AR activation modulates cell death and enhances contractile function in ischemic myocardium.
- Pre- and post-ischemic treatment with A3AR agonists provides protection and triggers preconditioned states.
- A3AR agonists show fewer side effects compared to other adenosine receptor subtypes.
Conclusions:
- A3AR is a promising therapeutic target for anti-ischemic therapy.
- Further research is needed to fully define the molecular basis of A3AR's protective actions across species and responses.
Abstract:
The A3 adenosine receptor (A3AR) is attributed with multiple beneficial actions in ischemic-reperfused myocardium, including modulation of oncotic and apoptotic cell death and enhancement of contractile function. Additionally, the A3AR may attenuate vascular dysfunction and improve long-term outcome from myocardial insult (modulating hypertrophy and angiogenesis). Available evidence indicates that this receptor sub-type is minimally activated by endogenous adenosine during ischemia (A3AR antagonists exerting no effects on ischemic outcome), and is thus amenable to activation with exogenous agonists. Protected phenotypes arise with both pre- and post-ischemic treatment with A3AR agonists, and transient A3AR agonism also triggers early and delayed preconditioned states. The molecular basis for the varied protective actions of the A3AR remains poorly defined, and may well vary between species (e.g. rodent vs. human) and protective responses (e.g. acute vs. delayed protection). Nonetheless, A3ARs may be more promising as therapeutic "anti-ischemic" targets compared with other adenosine receptor subtypes, since A3AR agonists elicit fewer and less significant side-effects. This review addresses current knowledge and controversy regarding the protective actions (and associated signaling) of A3ARs in ischemic-reperfused heart.
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