T helper-1 (Th1) cells are necessary for EAMG development and interferon-γ (IFN-γ) and interleukin-12 (IL-12; the major Th1 cytokines) play a critical role in EAMG development [[5-7]]. Th2 cells secrete a different cytokine profile that confers different effects on EAMG pathogenesis. On one hand, research describing the role of cytokines in the progression of MG and EAMG has revealed that the Th2 cell-related cytokine IL-4 (an efficient growth promoter for B-cell proliferation and differentiation) is important to the development of anti-AChR antibody production [[8]]. On the other hand, IL-4 appears to be involved in
the prevention of the development of EAMG [[9]]. Treg RG-7388 cells that secrete transforming growth factor-β (TGF-β) and down-regulate various T-cell-mediated responses are functionally defective in MG patients [[10, 11]]. Furthermore, the IL-17-producing Th17 Th-cell phenotype has been shown to play
a dominant role in promoting inflammation autoimmunity [[12, 13]] and EAMG [[14]]. Extracellular adenosine is considered to be an essential physiologically negative regulator click here of immune reactions [[15-17]] that initiates transmembrane signaling via 4 G protein-coupled adenosine receptor subtypes designated A1 receptor (R), A2AR, A2BR, and A3R [[18]] and the A2AR is predominantly expressed on T cells [[19, 20]]. The importance of A2AR in mediating adenosine-mediated negative regulation
has been clearly demonstrated in A2AR null mice [[15]] and increased awareness of the role played by both adenosine and A2AR in controlling immune function and inflammation has generated significant Clomifene interest regarding the potential use of adenosine-receptor-based therapies in the treatment of autoimmune-based diseases [[18]]. In addition, recent reports have also indicated the development of A2AR-based treatments for autoimmune diseases such as systemic lupus erythematosus [[21]], Parkinson disease [[22]], and experimental autoimmune encephalomyelitis [[23, 24]]. Methotrexate, an antirheumatic drug, has been shown to modulate anti-inflammatory responses via interactions with the A2AR in vivo [[25]]. Besides, A2AR agonists have been reported to possess inhibitory effects in the context of alloantigen-induced immune responses associated with the attenuation of tissue rejection following skin transplantation [[26]] or hepatic ischemia/reperfusion injury [[27]]. However, the regulatory role of A2AR in mediating EAMG disease severity and progression has not been described. In this study, we investigated whether A2AR expression was functionally altered in rats presenting with EAMG and whether the administration of an A2AR agonist prevented EAMG induction or facilitated improvement of clinical symptoms associated with established disease.