Post-ischemic cardioprotection by A2A adenosine receptors:: Dependent of phosphatidylinositol 3-kinase pathway

Activation of myocardial A(2A) adenosine receptors during reperfusion has been shown to be cardioprotective. The intracellular mechanisms underlying this protection remain unknown. To understand the beneficial effects of activated A(2A) adenosine receptors in such a state, we investigated whether the enzymes phosphatidylinositol 3-kinase (PI3K) and caspase-3 can account for this post-ischemic cardioprotective effect in an anesthetized rabbit model of myocardial infarction (30 minutes ischemia; 5 hours reperfusion). Administration of the A(2A) agonist CGS21680 (0.2 mug/kg/min) 5 minutes before reperfusion began (Early) reduced infarct size expressed as a percentage of the area at risk (25.7 +/- 5.3% versus 46.5 +/- 5.3% for the control group; *P < 0.05). Treatment with the A(2A) agonist 5 minutes after the onset of reperfusion (Late) had no effect on infarct size (38.2 +/- 6.2%). In the presence of a selective inhibitor of PI3K (LY294002), the beneficial effects of CGS21680 on infarct size was no longer observed (43.9 +/- 7.9%). After 5 hours of reperfusion, higher PI3K activity in the ischemic region was observed in the Early group compared with the other experimental groups. Caspase-3 activity was not observed in these different groups. In another set of experiments, PI3K activity was significantly higher during the first 15 minutes of reperfusion in the Early group as compared with the Control group. Caspase-3 activity increased rapidly during the first 15 minutes of reperfusion in the Control group and remained stable in the Early group. These results indicated that post-ischemic cardioprotection afforded by A(2A) adenosine receptor activation is PI3K-dependent and modulate rapidly other signaling pathways such as caspase-3.