Adenosine A 2A receptor agonists for the local treatment of inflammatory bowel disease (IBS) were designed and synthesized. Polar groups were introduced to prevent peroral absorption and subsequent systemic, e.g., hypotensive, side effects. 4-(2-{6-Amino-9-[(2R,3R,4S,5R)-3,4-dihydroxy-5-(hydroxymethyl)tetrahydrofuran-2-yl]-9H-purin-2-ylthio}ethyl)-benzenesulfonic acid (7, PSB-0777) was selected for further evaluation in rat ileum/jejunum preparations in ex vivo experiments. Compound 7 significantly improved impaired acetylcholine-induced contractions induced by 2,4,6-trinitrobenzenesulfonic acid and showed synergism with an A 2B -selective antagonist. Thus, nonabsorbable, locally active A 2A agonists, as a monotherapy or in combination with an A 2B antagonist, may be an efficient novel treatment for IBS, preventing the severe systemic side effects of known A 2A agonists. Activation of the A 2A AR on a variety of inflammatory cell types leads to anti-inflammatory effects that can attenuate injury as a result of mucosal inflammation, ischemia, or sepsis. Adenosine, being part of the innate immune system, is one of the strongest endogenous immunosuppressive agents. Therefore, A 2A AR agonists have been suggested as novel antiinflammatory drugs. 2,6,7 Inflammatory bowel disease (IBD) is an inflammatory condition in the gastrointestinal tract. A 2A AR agonists have had beneficial effects on the development of intestinal inflammation in a variety of animal models of IBD, including Crohn's disease, colitis, and irritable bowel disease, as well as other inflammatory conditions. 8−11 However, the systemic use of A 2A adenosine receptor agonists as anti-inflammatory drugs is limited by their potent hypotensive activity caused by the activation of A 2A AR expressed in heart and blood vessels. 1,7 Received: August 8, 2011 Accepted: October 10, 2011 Published: October 10, 2011