Purinergic system in the pathogenesis and treatment of mood disorders

Objectives.
The study aims to present the role of the purinergic system in the pathogenesis and treatment of mood disorders.

Literature review.
The purinergic system includes, among others, uric acid, P1 receptors whose agonist is adenosine, and P2 receptors activated by nucleotides (including adenosine triphosphate, ATP). Accumulated evidence indicates that these factors play a role in the pathogenesis of mood disorders. The studies show a higher prevalence of gout and higher uric acid levels in patients with bipolar disorder (BD), especially during a manic episode, and lower concentration of this acid in depression. It was found that adenosine and its receptors, as well as the P2X₂ nucleotide receptor may have pathogenic importance in BD and depression. The P2X₂ receptor moderates an inflammatory response. In the clinical conditions, it was found that allopurinol, which lowers uric acid concentration, has shown therapeutic effects on mania when used as an addition to mood stabilisers. In animal models, antidepressant effects of A_2A and P2X₇ receptor antagonists have been observed.

Conclusions.
The article discusses purinergic mechanisms and identifies key targets in the pathogenesis and pharmacotherapy of mood disorders that merit further research. It highlights the importance of uric acid concentration and the modulation of adenosine receptor A_2A and receptor P2X₇. Future research is needed to elucidate the usefulness, safety, and efficacy of drugs targeting purinergic activity, such as allopurinol and A_2A and P2X₇ receptor antagonists.