Adenosine regulation of alveolar fluid clearance

Abstract

Adenosine is a purine nucleoside that regulates cell function through G protein-coupled receptors that activate or inhibit adenylyl cyclase. Based on the understanding that cAMP regulates alveolar epithelial active Na ؉ transport, we hypothesized that adenosine and its receptors have the potential to regulate alveolar ion transport and airspace fluid content. Herein, we report that type 1 (A1R), 2a (A2aR), 2b (A2bR), and 3 (A3R) adenosine receptors are present in rat and mouse lungs and alveolar type 1 and 2 epithelial cells (AT1 and AT2). Rat AT2 cells generated and produced cAMP in response to adenosine, and micromolar concentrations of adenosine were measured in bronchoalveolar lavage fluid from mice. Ussing chamber studies of rat AT2 cells indicated that adenosine affects ion transport through engagement of A1R, A2aR, and/or A3R through a mechanism that increases CFTR and amiloride-sensitive channel function. Intratracheal instillation of low concentrations of adenosine (<10 ؊8 M) or either A2aR-or A3R-specific agonists increased alveolar fluid clearance (AFC), whereas physiologic concentrations of adenosine (>10 ؊6 M) reduced AFC in mice and rats via an A1R-dependent pathway. Instillation of a CFTR inhibitor (CFTRinh-172) attenuated adenosine-mediated down-regulation of AFC, suggesting that adenosine causes Cl ؊ efflux by means of CFTR. These studies report a role for adenosine in regulation of alveolar ion transport and fluid clearance. These findings suggest that physiologic concentrations of adenosine allow the alveolar epithelium to counterbalance active Na ؉ absorption with Cl ؊ efflux through engagement of the A1R and raise the possibility that adenosine receptor ligands can be used to treat pulmonary edema.active sodium transport ͉ adenosine receptors ͉ cystic fibrosis transmembrane conductance regulator P ulmonary edema is due to increased fluid flux into the airspace and impairment of the active Na ϩ transport that clears it (1-4). A variety of approaches to improve alveolar epithelial cell active Na ϩ transport for purposes of accelerating alveolar fluid clearance (AFC) have been explored in experimental systems. Of particular interest are receptor-ligand interactions that increase cAMP production in alveolar epithelial cells. Adenosine is a purine nucleoside that signals through four distinct G protein-coupled receptors, type 1 (A 1 R), type 2a (A 2a R), type 2b (A 2b R), and type 3 (A 3 R). In most cell systems, the A 1 R and A 3 R receptors inhibit adenylyl cyclase and/or lead to signaling through inositol-3-phosphate and phospholipase C. Engagement of type 2 receptors activates adenylyl cyclase by means of Gs␣ and increases cAMP levels. The ability of adenosine receptors (ARs) to couple to adenylyl cyclase led us to hypothesize that ARs might participate in regulation of alveolar epithelial active Na ϩ transport. We approached this hypothesis in rats and mice by testing whether adenosine and its receptors are present in the distal airspace and whether they affect AFC in vivo and vectorial Na ϩ...

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An oxygen-sensitive mechanism in regulation of epithelial sodium channel

“…Control of ENaC in the alveolar epithelium is particularly intriguing. Na ϩ flux through ENaC is crucial for clearance of alveolar edema (41), yet apparently paradoxically, channel activity is reduced under hypoxic conditions (8). However, inhibition of ENaC under hypoxic conditions, leading to an increase in airway surface liquid, may be beneficial for clearance of mucus (42,43).…”

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