Adenosinebased

Adenosine-based refers to substances and interventions that are derived from, or act via, the purine nucleoside adenosine. This includes the native molecule itself, as well as receptor-targeting drugs and prodrugs designed to modulate adenosine signaling. Adenosine acts through four G protein–coupled receptors (A1, A2A, A2B, and A3) and can influence cardiovascular, neural, and inflammatory processes by altering cellular signaling and tissue adenosine levels.

Adenosine is an endogenous mediator with a very short plasma half-life, rapidly metabolized by enzymes such as adenosine deaminase. In physiological conditions, adenosine modulates heart rate, slows AV nodal conduction, dilates blood vessels, and exerts anti-inflammatory effects. Because of its rapid clearance, therapeutic use often requires intravenous administration, with careful monitoring for adverse reactions.

Clinically, adenosine itself is used to terminate certain types of supraventricular tachycardia by transiently interrupting AV nodal conduction. Other adenosine-based agents include regadenoson, a selective A2A receptor agonist used to induce coronary hyperemia during pharmacologic stress testing, and dipyridamole, a vasodilator that increases extracellular adenosine by inhibiting uptake and metabolism. Research and clinical development also employ adenosine analogs and prodrugs to study receptor signaling and tissue responses.

Pharmacology and safety considerations include receptor selectivity, potential cardiovascular and bronchial effects, and interactions with caffeine or other methylxanthines that block adenosine receptors. The use of adenosine-based therapies requires consideration of patient history, including asthma, hypotension, or electrolyte disturbances, to minimize risk.

Examples of adenosine-based agents include adenosine itself, regadenoson, dipyridamole, and various adenosine analogs used in research and imaging.