ATP and adenosine in the regulation of skeletal muscle blood flow during exercise

Adenosine was identified as a regulator of skeletal muscle blood flow almost 50 years ago. It was first proposed that increased use of ATP during muscle contractions led to net ATP breakdown, and its breakdown product, adenosine, diffused through the interstitial space to the blood stream to be washed away. En-route to its removal, adenosine was suggested to relax the vascular smooth muscle, thereby increasing the blood flow and oxygen supply to the contracting muscle. This mechanism has been researched quite intensively over the years, yet there are still many aspects that remain unclear. It has been confirmed that adenosine does, indeed, relax vascular smooth muscle and contribute to exercise hyperaemia, but the discovery that adenosine was formed extracellularly has shifted the research focus onto its precursor, ATP. ATP is released from many tissues, and produces many effects, including both vasodilation and vasoconstriction, as well as modulation of the neural mechanisms for skeletal muscle blood flow control. This review summarizes the current state of knowledge on the contributions of adenosine and ATP to the skeletal muscle vasodilation that accompanies contractile activity.