Positive allosteric modulation of the adenosine A2a receptor attenuates inflammation.

Background: Adenosine is produced at high levels at inflamed sites as a by-product of cellular activation and breakdown. Adenosine mediates its anti-inflammatory activity primarily through the adenosine A2a receptor (A2aR), a member of the G-protein coupled receptors. A2aR agonists have demonstrated anti-inflammatory efficacy, however, their therapeutic utility is hindered by a lack of adenosine receptor subtype selectivity upon systemic exposure. We sought to harness the anti-inflammatory effects of adenosine by enhancing the responsiveness of A2aR to endogenously produced adenosine through allosteric modulation. We have identified a family of positive allosteric modulators (PAMs) of the A2aR. Using one member of this PAM family, AEA061, we demonstrate that A2aRs are amenable to allosteric enhancement and such enhancement produces increased A2aR signaling and diminished inflammation in vivo.

Methods: A2aR activity was evaluated using a cell-based cAMP assay. Binding affinity of A2aR was determined using [(3)H]CGS 21680. A2aR-mediated G-protein activation was quantified using [(35)S]GTP-γS. The effect of AEA061 on cytokine production was evaluated using primary monocytes and splenocytes. The anti-inflammatory effect of AEA061 was evaluated in the LPS-induced mouse model of inflammation.

Results: AEA061 had no detectable intrinsic agonist activity towards either rat or human A2aRs. AEA061 enhanced the efficacy of adenosine to rat and human A2aRs by 11.5 and 2.8 fold respectively. AEA061 also enhanced the maximal response by 4.2 and 2.1 fold for the rat and the human A2aR respectively. AEA061 potentiated agonist-mediated Gα activation by 3.7 fold. Additionally, AEA061 enhanced both the affinity as well as the Bmax at the human A2aR by 1.8 and 3 fold respectively. Consistent with the anti-inflammatory role of the A2aR, allosteric enhancement with AEA061 inhibited the production of TNF-α, MIP-1α, MIP-1β, MIP-2, IL-1α, KC and RANTES by LPS-stimulated macrophages and/or splenocytes. Moreover, AEA061 reduced circulating plasma TNF-α and MCP-1 levels and increased plasma IL-10 in endotoxemic A2aR intact, but not in A2aR deficient, mice.

Conclusions: AEA061 increases affinity and Bmax of A2aR to adenosine, thereby increasing adenosine potency and efficacy, which translates to enhanced A2aR responsiveness. Since the A2aR negatively regulates inflammation, PAMs of the receptor offer a novel means of modulating inflammatory processes.