Human melanomas express functional P2X7 receptors

Pathophysiology and therapeutic potential of purinergic signaling

The concept of a purinergic signaling system, using purine nucleotides and nucleosides as extracellular messengers, was first proposed over 30 years ago. After a brief introduction and update of purinoceptor subtypes, this article focuses on the diverse pathophysiological roles of purines and pyrimidines as signaling molecules. These molecules mediate short-term (acute) signaling functions in neurotransmission, mechanosensory transduction, secretion and vasodilatation, and long-term (chronic) signaling functions in cell proliferation, differentiation, and death involved in development and regeneration. Plasticity of purinoceptor expression in pathological conditions is frequently observed, including an increase in the purinergic component of autonomic cotransmission. Recent advances in therapies using purinergic-related drugs in a wide range of pathological conditions will be addressed with speculation on future developments in the field.

P2 receptors and cancer

Purinergic signalling has been implicated in many biological processes, and ATP and other extracellular nucleotides might have therapeutic potential in the treatment of cancer by signalling through P2 receptors. Different P2 receptor subtypes have been identified in a variety of different cancer types, in both primary samples of human cancer tissue and cell lines. Recent evidence suggests that different receptor subtypes mediate different pathophysiological functions such as proliferation, differentiation and apoptosis. In vivo studies of the use of ATP suggest that it can decrease the rate of cancer growth, and the first clinical trials have been undertaken. Thus, agents acting at P2 receptors might provide novel therapeutic tools in the treatment of cancer. In this article, background information about purinergic signalling and purinoceptor subtypes will be provided and then the proposed role of ATP in different cancers will be discussed in detail, including a discussion of in vivo studies and animal models, clinical trials and the specific P2 receptor subtypes involved.