Targeting the visceral purinergic system for pain control.

Autonomic Neuroscience Centre, University College Medical School, London NW3 2PF, United Kingdom. g.burnstock@ucl.ac.uk

Current opinion in pharmacology 2012 Feb

Experimental evidence is presented to support the hypothesis that purinergic mechanosensory transduction can initiate visceral pain in urinary bladder, ureter, gut and uterus. In general, physiological reflexes are mediated via P2X3 and P2X2/3 receptors on low threshold sensory fibres, while these receptors on high threshold sensory fibres mediate pain. Potential therapeutic strategies are considered for the treatment of visceral pain in such conditions as renal colic, interstitial cystitis and inflammatory bowel disease by purinergic agents, including P2X3 and P2X2/3 receptor antagonists that are orally bioavailable and stable in vivo and agents that modulate ATP release and breakdown. Copyright Â© 2011 Elsevier Ltd. All rights reserved.