Purinergic contribution to amyotrophic lateral sclerosis.

By signalling through purinergic receptors classified as ionotropic P2X (for ATP) and metabotropic P1 (for adenosine) and P2Y (mainly for ADP, UDP, UTP, ATP), the extracellular nucleotides and their metabolic derivatives originated by extracellular activity of several different ectonucleotidases, are involved in the functioning of the nervous system. Here they exert a central role during physiological processes, but also in the precarious balance between beneficial and noxious events. Indeed, in recent years, the dysregulation of extracellular purinergic homeostasis has been correlated to well-characterized acute and chronic neurodegenerative and neuroinflammatory diseases. Among these, we focus our attention on purinergic signalling occurring in amyotrophic lateral sclerosis (ALS), the most common late onset motoneuron disease, characterized by specific loss of motoneurons in brain stem and ventral horns of spinal cord. ALS is a progressive non-cell-autonomous and multifactorial neuroinflammatory disease, whose aetiology and pathological mechanisms are unidentified for most patients and initiate long before any sign or symptom becomes apparent. By combining purinergic with ALS knowledge, in this work we thus present and sustain a novel line of investigation on the purinergic contribution to ALS. In particular, here we recapitulate very early results about P2X4, P2X7 and P2Y6 receptor expression in tissues from ALS animal and cell models and patients, and more recent achievements about purinergic signalling mainly performed in vitro in microglia and lately in astrocytes and motoneurons. We finally highlight how purinergic signalling has progressively evolved up to preclinical trials, to the point of deserving now full consideration with reference to ALS.