Multiple roles of ATP and adenosine in somatosensory processing: Therapeutic implications

A number of lines of evidence support roles for adenosine and adenosine 5'-triphosphate (ATP) in the transmission and modulation of somatosensory information in the dorsal horn of the spinal cord. Adenosine and ATP have also been demonstrated to have nociceptive (pain-related) and antinociceptive actions in the periphery. Thus, adenosine and ATP have multiple functions in somatosensory processing, which are dependent upon the site and on the relative activation of P1 and P2 purinoceptor subtypes on neurons and non-neuronal cells. The multiple roles provide a rich number of potential therapeutic targets for producing analgesia in a number of clinical pain states. However, because of the multiple and potentially contrasting pro- and anti-nociceptive roles of adenosine and ATP, pharmacological targeting of specific sites and purinoceptor subtypes will be necessary to achieve maximum effectiveness while minimizing side effects. (C) 1997 Wiley-Liss, Inc.