The purinergic system in allotransplantation

A. Vergani, S. Tezza, C. Fotino, G. Visner, A. Pileggi, A. Chandraker, P. Fiorina

Research output: Contribution to journalArticlepeer-review


The purine nucleotide adenosine triphosphate (ATP) is a universal source of energy for any intracellular reaction. Under specific physiological or pathological conditions, ATP can be released into extracellular spaces, where it binds and activates the purinergic receptors system (i.e. P2X, P2Y and P1 receptors). Extracellular ATP (eATP) binds to P2X or P2Y receptors in immune cells, where it mediates proliferation, chemotaxis, cytokine release, antigen presentation and cytotoxicity. eATP is then hydrolyzed by ectonucleotidases into adenosine diphosphate (ADP), which activates P2Y receptors. Ectonucleotidases also hydrolyze ADP to adenosine monophosphate and adenosine, which binds P1 receptors. In contrast to P2X and P2Y receptors, P1 receptors exert mainly an inhibitory effect on the immune response. In transplantation, a prominent role has been demonstrated for the eATP/P2X7R axis; the targeting of this pathway in fact is associated with long-term graft function and reduced graft versus host disease severity in murine models. Novel P2X receptor inhibitors are available for clinical use and are under assessment as immunomodulatory agents. In this review, we will focus on the relevance of the purinergic system and on the potential benefits of targeting this system in allograft rejection and tolerance.

Original languageEnglish
Pages (from-to)507-514
Number of pages8
JournalAmerican Journal of Transplantation
Issue number3
Publication statusPublished - Mar 2014


  • ATP
  • P2X7R
  • purinergic system
  • rejection

ASJC Scopus subject areas

  • Transplantation
  • Immunology and Allergy
  • Pharmacology (medical)


Dive into the research topics of 'The purinergic system in allotransplantation'. Together they form a unique fingerprint.

Cite this