Purines and pain mechanisms: recent developments.

Purines, such as adenosine and ATP, are endogenous ligands involved in modulating pain transmission and pain hypersensitivity by acting on P1 and P2 purinoceptors, respectively, at sites both in peripheral tissues and in the central nervous system. For P1 (adenosine) receptors, clinical studies in humans, as well as experimental animal studies, have demonstrated that activation of the A1 subtype reduces both inflammatory and neuropathic types of chronic pain. For P2 receptors, there is a growing body of evidence indicating that multiple receptor subtypes are differentially involved in pain processing. The most well-known of the P2 receptors is the P2X3 subtype, which is found in primary sensory neurons. Inhibition of P2X3 receptors is effective in reducing pain behaviors in animal models of chronic inflammatory and neuropathic pain. Recently, the P2X, subtype has been implicated in nerve-injury-induced pain hypersensitivity. There is also emerging evidence for roles for P2Y, and P2Y2 receptors, subtypes of G protein-coupled P2 receptors, in pain hypersensitivity. Thus, multiple subtypes of purinoceptors are potential molecular targets for development of new pharmacological agents for the treatment of pain.