Targeting purinergic signaling for perioperative organ protection

摘要

ADVANCEMENTS in the field of anesthe-sia have led to significant improvement in our moni-tonng capabilities, sarer anesthetic drugs, and improved pain control. Despite this remarkable progress, acute organ injury remains one of the leading causes for morbidity and mortality in surgical patients. Patients who require a major surgical intervention-such as cardiothoracic, vascular, general surgery, or solid organ transplantation-may have had a "perfect" operation but are threatened during their perioperative course by the development of acute organ injury. For example, acute kidney injury, myocardial infarction, intestinal ischemia, and reperfusion injury or stroke are some of the threats that are among the leading causes of perioperative morbidity and mortality. A recent review article published in the New England Journal of Medicine discussed "Purinergic Signaling during Inflammation," provides an update on how signaling events through extracellular receptors for the purines ade-nosine triphosphate (ATP) and adenosine can be targeted to alter inflammatory endpoints. As discussed in this review article, recent studies implicate purinergic signaling via ATP or adenosine receptors as important-therapeutic targets to prevent or treatracute organ injury in perioperative patients.