[P2X4 or P2X7: which of these two receptors is the best target to promote salivation?]

P2 Receptors as Therapeutic Targets in the Salivary Gland: From Physiology to Dysfunction

Although often overlooked in our daily lives, saliva performs a host of necessary physiological functions, including lubricating and protecting the oral cavity, facilitating taste sensation and digestion and maintaining tooth enamel. Therefore, salivary gland dysfunction and hyposalivation, often resulting from pathogenesis of the autoimmune disease Sjögren's syndrome or from radiotherapy of the head and neck region during cancer treatment, severely reduce the quality of life of afflicted patients and can lead to dental caries, periodontitis, digestive disorders, loss of taste and difficulty speaking. Since their initial discovery in the 1970s, P2 purinergic receptors for extracellular nucleotides, including ATP-gated ion channel P2X and G protein-coupled P2Y receptors, have been shown to mediate physiological processes in numerous tissues, including the salivary glands where P2 receptors represent a link between canonical and non-canonical saliva secretion. Additionally, extracellular nucleotides released during periods of cellular stress and inflammation act as a tissue alarmin to coordinate immunological and tissue repair responses through P2 receptor activation. Accordingly, P2 receptors have gained widespread clinical interest with agonists and antagonists either currently undergoing clinical trials or already approved for human use. Here, we review the contributions of P2 receptors to salivary gland function and describe their role in salivary gland dysfunction. We further consider their potential as therapeutic targets to promote physiological saliva flow, prevent salivary gland inflammation and enhance tissue regeneration.

Purinergic signalling in the gastrointestinal tract and related organs in health and disease

Purinergic signalling plays major roles in the physiology and pathophysiology of digestive organs. Adenosine 5'-triphosphate (ATP), together with nitric oxide and vasoactive intestinal peptide, is a cotransmitter in non-adrenergic, non-cholinergic inhibitory neuromuscular transmission. P2X and P2Y receptors are widely expressed in myenteric and submucous enteric plexuses and participate in sympathetic transmission and neuromodulation involved in enteric reflex activities, as well as influencing gastric and intestinal epithelial secretion and vascular activities. Involvement of purinergic signalling has been identified in a variety of diseases, including inflammatory bowel disease, ischaemia, diabetes and cancer. Purinergic mechanosensory transduction forms the basis of enteric nociception, where ATP released from mucosal epithelial cells by distension activates nociceptive subepithelial primary afferent sensory fibres expressing P2X3 receptors to send messages to the pain centres in the central nervous system via interneurons in the spinal cord. Purinergic signalling is also involved in salivary gland and bile duct secretion.

[Microglial cells and development of the embryonic central nervous system]

Microglia cells are the macrophages of the central nervous system with a crucial function in the homeostasis of the adult brain. However, recent studies showed that microglial cells may also have important functions during early embryonic central nervous system development. In this review we summarize recent works on the extra embryonic origin of microglia, their progenitor niche, the pattern of their invasion of the embryonic central nervous system and on interactions between embryonic microglia and their local environment during invasion. We describe microglial functions during development of embryonic neuronal networks, including their roles in neurogenesis, in angiogenesis and developmental cell death. These recent discoveries open a new field of research on the functions of neural-microglial interactions during the development of the embryonic central nervous system.

[Microglia: immune cells sculpting and controlling neuronal synapses]

The development of new animal models and functional analysis methods has dramatically changed our understanding of the physiology of microglial cells. These cells which are the resident macrophages of central nervous system have the ability to adapt rapidly to subtle changes of their environment. Recent findings indicate in particular that they can establish contacts with neuronal synapses that they can eliminate and modulate by releasing specific mediators. Here we review the experimental observations that have revealed the occurrence of these interactions not only in pathological conditions but also in the healthy brain and in particular during normal brain development. The discovery of bi-directional communications between synapses and microglia sheds a new light on our understanding of brain functioning and should allow a better understanding of brain functioning and of interactions between immune and nervous systems.

[The inflammasomes: platforms of innate immunity]

Human beings are constantly exposed to pathogens. The innate immune system is the first line of defense against microbes. It has evolved to recognize conserved microbial motifs (PAMP or pathogen-associated molecular patterns) thanks to a limited array of receptors termed pattern recognition receptors (PRR). Upon activation, most PRR trigger a transcriptional response leading to neosynthesis of hundreds of genes. In contrast, engagement of various PRR in the recently identified inflammasome complexes lead to activation of a cysteine protease, caspase-1. This inflammatory caspase has a dual activity: it triggers the release of very potent proinflammatory cytokines IL-1β and IL-18 and, an hyperinflammatory cell death termed pyroptosis. In this review, we describe the inflammasome receptors and their ligands, the molecular mechanisms leading to the assembly of this innate immune platform and the role of the inflammasome during viral and bacterial infections.