P2X7 Receptors: An Untapped Target for the Management of Cardiovascular Disease

Arterioscler Thromb Vasc Biol. 2021 Jan;41(1):186-199. doi: 10.1161/ATVBAHA.120.315116. Epub 2020 Oct 1.

Abstract

Chronic low-grade inflammation contributes to the development of several diseases, including cardiovascular disease. Adequate strategies to target inflammation in cardiovascular disease are in their infancy and remain an avenue of great interest. The purinergic receptor P2X7 is a ubiquitously expressed receptor that predominately mediates inflammation and cellular death. P2X7 is a ligand-gated cation channel that is activated in response to high concentrations of extracellular ATP, triggering the assembly and activation of the NLRP3 (nuclear oligomerization domain like receptor family pyrin domain containing 3) inflammasome and subsequent release of proinflammatory cytokines IL (interleukin)-1β and IL-18. Increased P2X7 activation and IL-1β and IL-18 concentrations have been implicated in the development of many cardiovascular conditions including hypertension, atherosclerosis, ischemia/reperfusion injury, and heart failure. P2X7 receptor KO (knockout) mice exhibit a significant attenuation of the inflammatory response, which corresponds with reduced disease severity. P2X7 antagonism blunts blood pressure elevation in hypertension and progression of atherosclerosis in animal models. IL-1β and IL-18 inhibition has shown efficacy in clinical trials reducing major adverse cardiac events, including myocardial infarction, and heart failure. With several P2X7 antagonists available with proven safety margins, P2X7 antagonism could represent an untapped potential for therapeutic intervention in cardiovascular disorders.

Keywords: cardiovascular diseases; heart failure; infant; inflammation; interleukins.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Anti-Inflammatory Agents / adverse effects
  • Anti-Inflammatory Agents / therapeutic use*
  • Cardiovascular Agents / adverse effects
  • Cardiovascular Agents / therapeutic use*
  • Cardiovascular Diseases / drug therapy*
  • Cardiovascular Diseases / metabolism
  • Cardiovascular Diseases / physiopathology
  • Cardiovascular System / drug effects*
  • Cardiovascular System / metabolism
  • Cardiovascular System / pathology
  • Humans
  • Interleukin-18 / metabolism
  • Interleukin-1beta / metabolism
  • NLR Family, Pyrin Domain-Containing 3 Protein / metabolism
  • Purinergic P2X Receptor Antagonists / adverse effects
  • Purinergic P2X Receptor Antagonists / therapeutic use*
  • Receptors, Purinergic P2X7 / drug effects*
  • Receptors, Purinergic P2X7 / metabolism
  • Signal Transduction

Substances

  • Anti-Inflammatory Agents
  • Cardiovascular Agents
  • IL18 protein, human
  • IL1B protein, human
  • Interleukin-18
  • Interleukin-1beta
  • NLR Family, Pyrin Domain-Containing 3 Protein
  • NLRP3 protein, human
  • P2RX7 protein, human
  • Purinergic P2X Receptor Antagonists
  • Receptors, Purinergic P2X7