Adenosine agonists for the prevention of restenosis

: Balloon angioplasty involves the simultaneous activation of platelets and neutrophils. Activated platelets release mitogenic substances that cause smooth muscle cell proliferation and thereby contribute to restenosis. Activated neutrophils activate platelets and activated platelets activate neutrophils. Therefore the simultaneous activation of both cell types may be responsible for the exaggerated repair mechanisms resulting in restenosis of coronary blood vessels. Adenosine inhibits neutrophil activation, platelet activation and smooth muscle cell proliferation and stimulates endothelial cell proliferation predominantly through activation of A2A-receptors. Adenosine and A2A-selective agonists may be useful in the prevention of restenosis following balloon angioplasty.