Adenosine 5'-Monophosphate: Physiological Role and Applications in Asthma Management

Adenosine 5'-monophosphate (AMP) is a purine ribonucleoside 5'-monophosphate having adenine as the nucleobase. It has a role as an EC 3.1.3.11 (fructose-bisphosphatase) inhibitor, an EC 3.1.3.1 (alkaline phosphatase) inhibitor, an adenosine A1 receptor agonist, a nutraceutical, a micronutrient, a fundamental metabolite and a cofactor. It is an adenosine 5'-phosphate and a purine ribonucleoside 5'-monophosphate, which can bronchoprovocation reproduces the lung function abnormalities that occur spontaneously during acute asthma and detects peripheral airway inflammation better than direct bronchoconstrictive agents. 

Applications in Asthma

Adenosine-5'-monophosphate is an indirect challenge agent thought to reflect allergic airway inflammation. The forced oscillation technique (FOT) is ideal for use in young children and is suitable for inhaled challenge studies in patients who are in this age group.  Adenosine and its related nucleotide, adenosine 5′-monophosphate (AMP) induce bronchoconstriction in asthmatics, probably caused by histamine release from airway mast cells. 

Physiological Role  in Asthma

Adenosine 5′-monophosphate is a potent pharmacological agent increasingly used in indirect bronchial challenge tests in patients with asthma. Once inhaled, AMP is rapidly converted to adenosine by the enzyme 5′-nucleotidase. Adenosine is a natural signalling nucleoside and mediator of airway inflammation that induces bronchoconstriction, most likely via the release of inflammatory mediators from mast cells.  Moreover, it is suggested that AMP induces bronchoconstriction through the activation of inflammatory mechanisms at the level of the bronchial surface and also through local or central neuronal reflexes. 

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