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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Pharmacol.</journal-id>
<journal-title>Frontiers in Pharmacology</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Pharmacol.</abbrev-journal-title>
<issn pub-type="epub">1663-9812</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="publisher-id">1098976</article-id>
<article-id pub-id-type="doi">10.3389/fphar.2023.1098976</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Pharmacology</subject>
<subj-group>
<subject>Review</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Adenosine and P1 receptors: Key targets in the regulation of sleep, torpor, and hibernation</article-title>
<alt-title alt-title-type="left-running-head">Ma et al.</alt-title>
<alt-title alt-title-type="right-running-head">
<ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/fphar.2023.1098976">10.3389/fphar.2023.1098976</ext-link>
</alt-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Ma</surname>
<given-names>Wei-Xiang</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="fn" rid="fn1">
<sup>&#x2020;</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Yuan</surname>
<given-names>Ping-Chuan</given-names>
</name>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
</xref>
<xref ref-type="fn" rid="fn1">
<sup>&#x2020;</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/1338489/overview"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Zhang</surname>
<given-names>Hui</given-names>
</name>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
</xref>
<xref ref-type="fn" rid="fn1">
<sup>&#x2020;</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Kong</surname>
<given-names>Ling-Xi</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Lazarus</surname>
<given-names>Michael</given-names>
</name>
<xref ref-type="aff" rid="aff3">
<sup>3</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/86079/overview"/>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Qu</surname>
<given-names>Wei-Min</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="corresp" rid="c001">&#x2a;</xref>
<uri xlink:href="https://loop.frontiersin.org/people/648068/overview"/>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Wang</surname>
<given-names>Yi-Qun</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="corresp" rid="c001">&#x2a;</xref>
<uri xlink:href="https://loop.frontiersin.org/people/475041/overview"/>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Huang</surname>
<given-names>Zhi-Li</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="corresp" rid="c001">&#x2a;</xref>
<uri xlink:href="https://loop.frontiersin.org/people/118316/overview"/>
</contrib>
</contrib-group>
<aff id="aff1">
<sup>1</sup>
<institution>State Key Laboratory of Medical Neurobiology</institution>, <institution>MOE Frontiers Center for Brain Science</institution>, <institution>Department of Pharmacology</institution>, <institution>School of Basic Medical Sciences</institution>, <institution>Institutes of Brain Science</institution>, <institution>Fudan University</institution>, <addr-line>Shanghai</addr-line>, <country>China</country>
</aff>
<aff id="aff2">
<sup>2</sup>
<institution>Anhui Provincial Engineering Research Center for Polysaccharide Drugs</institution>, <institution>Provincial Engineering Laboratory for Screening and Re-evaluation of Active Compounds of Herbal Medicines in Southern Anhui</institution>, <institution>School of Pharmacy</institution>, <institution>Wannan Medical College</institution>, <addr-line>Wuhu</addr-line>, <country>China</country>
</aff>
<aff id="aff3">
<sup>3</sup>
<institution>International Institute for Integrative Sleep Medicine (WPI-IIIS) and Faculty of Medicine</institution>, <institution>University of Tsukuba</institution>, <addr-line>Tsukuba</addr-line>, <addr-line>Ibaraki</addr-line>, <country>Japan</country>
</aff>
<author-notes>
<fn fn-type="edited-by">
<p>
<bold>Edited by:</bold> <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/563292/overview">Yong Tang</ext-link>, Chengdu University of Traditional Chinese Medicine, China</p>
</fn>
<fn fn-type="edited-by">
<p>
<bold>Reviewed by:</bold> <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/287896/overview">Aleksandra Korac</ext-link>
</p>
<p>
<ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/477571/overview">Shangdong Liang</ext-link>, Nanchang University, China</p>
</fn>
<corresp id="c001">&#x2a;Correspondence: Wei-Min Qu, <email>quweimin@fudan.edu.cn</email>; Yi-Qun Wang, <email>yiqunwang@fudan.edu.cn</email>; Zhi-Li Huang, <email>huangzl@fudan.edu.cn</email>
</corresp>
<fn fn-type="equal" id="fn1">
<label>
<sup>&#x2020;</sup>
</label>
<p>These authors have contributed equally to this work</p>
</fn>
<fn fn-type="other">
<p>This article was submitted to Experimental Pharmacology and Drug Discovery, a section of the journal Frontiers in Pharmacology</p>
</fn>
</author-notes>
<pub-date pub-type="epub">
<day>10</day>
<month>03</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="collection">
<year>2023</year>
</pub-date>
<volume>14</volume>
<elocation-id>1098976</elocation-id>
<history>
<date date-type="received">
<day>15</day>
<month>11</month>
<year>2022</year>
</date>
<date date-type="accepted">
<day>27</day>
<month>02</month>
<year>2023</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#xa9; 2023 Ma, Yuan, Zhang, Kong, Lazarus, Qu, Wang and Huang.</copyright-statement>
<copyright-year>2023</copyright-year>
<copyright-holder>Ma, Yuan, Zhang, Kong, Lazarus, Qu, Wang and Huang</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p>
</license>
</permissions>
<abstract>
<p>Sleep, torpor, and hibernation are three distinct hypometabolic states. However, they have some similar physiological features, such as decreased core body temperature and slowing heart rate. In addition, the accumulation of adenosine seems to be a common feature before entry into these three states, suggesting that adenosine and its receptors, also known as P1 receptors, may mediate the initiation and maintenance of these states. This review, therefore, summarizes the current research on the roles and possible neurobiological mechanisms of adenosine and P1 receptors in sleep, torpor, and hibernation. Understanding these aspects will give us better prospects in sleep disorders, therapeutic hypothermia, and aerospace medicine.</p>
</abstract>
<abstract abstract-type="graphical">
<title>Graphical Abstract</title>
<p>
<fig>
<caption>
<p>Adenosine mediates sleep, torpor and hibernation through P1 receptors. Recent reasearch has shown that P1 receptors play a vital role in the regulation of sleep-wake, torpor and hibernation-like states. In this review, we focus on the roles and neurobiological mechanisms of the CNS adenosine and P1 receptors in these three states. Among them, A<sub>1</sub> and A<sub>2A</sub> receptors are key targets for sleep-wake regulation, A<sub>1</sub>Rs and A<sub>3</sub>Rs are very important for torpor induction, and activation of A<sub>1</sub>Rs is sufficient for hibernation-like state.</p>
</caption>
<graphic xlink:href="FPHAR_fphar-2023-1098976_wc_abs.tif" position="anchor"/>
</fig>
</p>
</abstract>
<kwd-group>
<kwd>adenosine</kwd>
<kwd>P1 receptors</kwd>
<kwd>hibernation</kwd>
<kwd>sleep</kwd>
<kwd>torpor</kwd>
</kwd-group>
</article-meta>
</front>
<body>
<sec id="s1">
<title>1 Introduction</title>
<p>Sleep, torpor, and hibernation are three distinct states which can reduce energy expenditure. Sleep, which takes up nearly one-third lifetime of most mammals and birds, is divided into rapid eye movement (REM) sleep and non-REM (NREM) sleep. REM sleep is characterized by phasic changes in various autonomic functions and an elevation in metabolic rate. However, NREM sleep is characterized by the organism&#x2019;s active contact with the environment and by a decrease in metabolism, body temperature (T<sub>b</sub>), and energy expenditure (<xref ref-type="bibr" rid="B105">Silvani and Dampney, 2013</xref>; <xref ref-type="bibr" rid="B101">Schmidt, 2014</xref>; <xref ref-type="bibr" rid="B104">Silvani et al., 2018</xref>). Torpor is an energy-saving strategy in most mammals and birds, sometimes lasting only for a few hours, that helps organisms cope with the stress of an adverse environment (<xref ref-type="bibr" rid="B95">Ruf and Geiser, 2015</xref>). Just like NREM sleep, torpor state occurs with a reduction in T<sub>b</sub> and metabolic rate (<xref ref-type="bibr" rid="B95">Ruf and Geiser, 2015</xref>). Hibernation, also called multi-day torpor, is a seasonal energy conservation strategy that reduces T<sub>b</sub>, energy expenditure, and water loss (<xref ref-type="bibr" rid="B38">Geiser, 2013</xref>; <xref ref-type="bibr" rid="B95">Ruf and Geiser, 2015</xref>). Most hibernators generally remain in hibernation for a winter, which helps them effectively withstand the cold environment.</p>
<p>Adenosine is a ubiquitous endogenous cell signal transducer and regulator, which mainly acts by activating 4&#xa0;G protein-coupled receptors (GPCRs), namely, adenosine A<sub>1</sub>, A<sub>2A</sub>, A<sub>2B,</sub> and A<sub>3</sub> receptors, as known as P1 receptors (<xref ref-type="bibr" rid="B58">Kazemzadeh-Narbat et al., 2015</xref>). Activation of A<sub>1</sub> and A<sub>3</sub> receptors exert inhibitory effects, however A<sub>2A</sub> and A<sub>2B</sub> exert excitatory. The four P1 receptors can reduce and increase the intracellular cyclic adenosine-3, 5 monophosphate (cAMP) concentration <italic>via</italic> inhibiting or activating adenylate cyclase (AC), which makes adenosine and P1 receptors essential for the regulation of energy balance (<xref ref-type="bibr" rid="B16">Chiu and Freund, 2014</xref>).</p>
<p>Sleep, torpor, and hibernation are integral to energy balance. At the same time, adenosine which is a homeostatic bioenergetic network regulator appears to accumulate before entry into the three states, suggesting that adenosine and P1 receptors, may mediate sleep, torpor and hibernation (<xref ref-type="bibr" rid="B24">Drew and Jinka, 2013</xref>; <xref ref-type="bibr" rid="B104">Silvani et al., 2018</xref>). Much evidence suggests that activation or inhibition of the central nervous system (CNS) adenosine receptors by genetic or pharmacological means can alter the states of sleep, torpor, and hibernation. In this review, we focus on the role of adenosine in the CNS and summarize the current research on the roles and possible biological mechanisms of adenosine and P1 receptors in sleep, torpor, and hibernation. This may help us solve many problems in the future, such as treating sleep disorders and using artificial hibernation for medical applications and space exploration.</p>
</sec>
<sec id="s2">
<title>2 Physiological characteristics during sleep, torpor, and hibernation</title>
<p>Sleep, torpor, and hibernation appear shallow to deep states of diminished body temperature and metabolic rate. Sleep is a relatively rapid and reversible state. However, the animals in a torpor state are more difficult to awaken than sleepers. They may not respond immediately to stimuli, while hibernators typically take an hour or more from hibernation to awakening (<xref ref-type="bibr" rid="B103">Siegel, 2009</xref>). Animals control the duration of torpor based on the circadian system, typically remaining dormant for only part of the day and returning to a physiological state when T<sub>b</sub> rises to a consistently high level.</p>
<p>In contrast to torpor, hibernation lasts for days or weeks, and hibernators generally do not forage, relying mainly on early food storage or fat storage (<xref ref-type="bibr" rid="B95">Ruf and Geiser, 2015</xref>). Hibernation is not as common as daily sleep and torpor; only one-third of mammalian species are hibernators (<xref ref-type="bibr" rid="B8">Berger, 1984</xref>). Sleep, torpor, and hibernation are both energy-saving strategies for animals that share similar physiological characteristics and have their own characteristics (<xref ref-type="table" rid="T1">Table 1</xref>). An interesting commonality between sleep, torpor, and hibernation is the involvement of adenosine receptors. Adenosine is a purine nucleoside involved in many signaling pathways of energy homeostasis. One of the functions of sleep is to restore brain energy homeostasis, while the primary function of hibernation and torpor is to restore or protect body energy homeostasis (<xref ref-type="bibr" rid="B24">Drew and Jinka, 2013</xref>). According to many previous studies, adenosine A<sub>1</sub> receptors and A<sub>2A</sub> receptors (A<sub>1</sub>Rs and A<sub>2A</sub>Rs) play an essential role in inducing NREM, the activation of A<sub>1</sub>R and A<sub>3</sub> receptors (A<sub>3</sub>Rs) may induce torpor (<xref ref-type="bibr" rid="B104">Silvani et al., 2018</xref>), and the onset of hibernation may be due to the activation of A<sub>1</sub>Rs (<xref ref-type="bibr" rid="B56">Jinka et al., 2011</xref>; <xref ref-type="bibr" rid="B31">Frare and Drew, 2021</xref>). In the following, we will briefly introduce the physiological characteristics of the three states and expand our review based on this.</p>
<table-wrap id="T1" position="float">
<label>TABLE 1</label>
<caption>
<p>Physiological characteristics of sleep, daily torpor, and hibernation.</p>
</caption>
<table>
<thead valign="top">
<tr>
<th align="left"/>
<th align="left">Sleep</th>
<th align="left">Torpor</th>
<th align="left">Hibernation</th>
<th align="left">References</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td align="left">Energy saving</td>
<td align="left">5%&#x2013;15%</td>
<td align="left">60%&#x2013;70%</td>
<td align="left">&#x3e;90%</td>
<td align="left">
<xref ref-type="bibr" rid="B115">Swoap et al. (2017)</xref>, <xref ref-type="bibr" rid="B77">Mohr et al. (2020)</xref>
</td>
</tr>
<tr>
<td align="left">Metabolic rate</td>
<td align="left">70%&#x2013;90% of BMR</td>
<td align="left">&#x223c;35% of BMR</td>
<td align="left">6% of BMR</td>
<td align="left">
<xref ref-type="bibr" rid="B95">Ruf and Geiser (2015)</xref>
</td>
</tr>
<tr>
<td align="left">BP (relative decrease to normal value)</td>
<td align="left">&#x223c;10%</td>
<td align="left">25%&#x2013;30%</td>
<td align="left">40%&#x2013;80%</td>
<td align="left">
<xref ref-type="bibr" rid="B105">Silvani and Dampney (2013)</xref>, <xref ref-type="bibr" rid="B3">Ambler et al. (2021)</xref>
</td>
</tr>
<tr>
<td align="left">Body temperature (the decrease compared to 36&#xb0;C&#x2013;40&#xb0;C)</td>
<td align="left">&#x3c;3&#xb0;C</td>
<td align="left">5&#xb0;C&#x2013;20&#xb0;C</td>
<td align="left">15&#xb0;C&#x2013;35&#xb0;C</td>
<td align="left">
<xref ref-type="bibr" rid="B8">Berger (1984)</xref>
</td>
</tr>
<tr>
<td align="left">Respiration rate (% of active state)</td>
<td align="left">100%&#x2013;80%</td>
<td align="left">5%&#x2013;20%</td>
<td align="left">2%&#x2013;3%</td>
<td align="left">
<xref ref-type="bibr" rid="B77">Mohr et al. (2020)</xref>
</td>
</tr>
<tr>
<td align="left">HR (% of active state)</td>
<td align="left">70%&#x2013;90%</td>
<td align="left">10%&#x2013;30% minimum HR (70 to 150 bpm)</td>
<td align="left">1%&#x2013;4% minimum HR (5 to 10 bpm)</td>
<td align="left">
<xref ref-type="bibr" rid="B115">Swoap et al. (2017)</xref>, <xref ref-type="bibr" rid="B77">Mohr et al. (2020)</xref>
</td>
</tr>
<tr>
<td align="left">EEG (NREM)</td>
<td align="left">&#x2193;</td>
<td align="left">&#x2193;&#x2193;</td>
<td align="left">&#x2193;&#x2193;&#x2193;</td>
<td align="left">
<xref ref-type="bibr" rid="B48">Huang et al. (2021)</xref>
</td>
</tr>
<tr>
<td align="left">EMG (NREM)</td>
<td align="left">&#x2193;</td>
<td align="left">&#x2193;&#x2193;</td>
<td align="left">&#x2193;&#x2193;&#x2193;</td>
<td align="left">
<xref ref-type="bibr" rid="B48">Huang et al. (2021)</xref>
</td>
</tr>
<tr>
<td align="left">HP</td>
<td align="left">&#x2191;</td>
<td align="left">&#x2191;</td>
<td align="left">&#x2191;</td>
<td align="left">
<xref ref-type="bibr" rid="B105">Silvani and Dampney (2013)</xref>
</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn>
<p>Note: &#x2193;: decrease, &#x2191;: increase.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<sec id="s2-1">
<title>2.1 Sleep</title>
<p>Most mammals and birds spend about one-third of their lives asleep, a quiet state in which humans or animals are less sensitive to their environment. Sleep is regulated by biological rhythms and neural loops and plays a vital role in the human body&#x2019;s functional recovery, learning and memory, and growth and development. It is characterized by loss of consciousness, decreased T<sub>b</sub>, metabolism, and a decrease in heart rate (HR) and blood pressure (BP). According to the characteristic electroencephalographic (EEG) patterns, sleep can be divided into NREM and REM sleep.</p>
<p>NREM and REM sleep occur alternately throughout sleep time, with NREM accounting for the majority of the sleep time (<xref ref-type="bibr" rid="B105">Silvani and Dampney, 2013</xref>; <xref ref-type="bibr" rid="B101">Schmidt, 2014</xref>; <xref ref-type="bibr" rid="B104">Silvani et al., 2018</xref>). NREM sleep shows decreased systemic function, regular breathing, HR, reduced energy consumption, an EEG that consisted mainly of slow waves, reduced muscle tension, but still a definite posture, with no noticeable eye changes. NREM sleep is divided into four stages. Stages &#x2160; and &#x2161; are light sleep, and stages &#x2162; and &#x2163; are deep sleep. During deep sleep, cellular metabolism can be promoted throughout the body, immunity can be strengthened, and energy depleted during the wake period can be restored (<xref ref-type="bibr" rid="B104">Silvani et al., 2018</xref>). REM sleep is characterized by rapid eye movement, loss of thermoregulation, EEG activity similar to waking, marked decrease or disappearance of muscle tension, muscle relaxation, but active neurons in most brain regions, increased cerebral blood flow, irregular breathing, and increased HR. During REM sleep, humans or animals maintain a relatively high level of vigilance, which is essential for animals to survive in nature (<xref ref-type="bibr" rid="B94">Roth, 2004</xref>; <xref ref-type="bibr" rid="B101">Schmidt, 2014</xref>).</p>
</sec>
<sec id="s2-2">
<title>2.2 Torpor</title>
<p>Torpor, a behavior that saves energy by reducing metabolic rate (MR), is often identical to sleep, which occurs daily or lasts for days, transitions into sleep (also called daily torpor), and is regulated by circadian rhythms (<xref ref-type="bibr" rid="B8">Berger, 1984</xref>). A drastic reduction of MR associated with a decrease in T<sub>b</sub> results in the occurrence of torpor (<xref ref-type="bibr" rid="B40">Giroud et al., 2020</xref>). In addition, the autonomic nervous system is intimately involved in all stages of torpor. During an episode of torpor, the respiratory rate decreased, the HR related to ventilation increased periodically, and the decrease in ventilation was more significant than the MR, resulting in mild respiratory acidosis (<xref ref-type="bibr" rid="B104">Silvani et al., 2018</xref>).</p>
<p>A decrease in brain temperature usually accompanies the onset of torpor. If the brain temperature is above 25&#xb0;C, EEG morphology and frequency during torpor are closest to the characteristics of NREM sleep. Then, both EEG amplitude and power decrease with decreasing T<sub>b</sub>. When the brain temperature falls below 25&#xb0;C, REM sleep gradually disappears, and when the temperature is between 10&#xb0;C and 20&#xb0;C, the animals alternate between long NREM sleep and short wakefulness. EEG becomes equipotential when the brain temperature is below 10&#xb0;C, and it is impossible to determine alertness by electrophysiological methods (<xref ref-type="bibr" rid="B95">Ruf and Geiser, 2015</xref>; <xref ref-type="bibr" rid="B3">Ambler et al., 2021</xref>; <xref ref-type="bibr" rid="B48">Huang et al., 2021</xref>). When electromyography (EMG) was examined, EMG activity was found to decrease significantly with the inhibition of shivering thermogenesis, and a decrease of T<sub>b</sub> when entering the state of torpor was observed (<xref ref-type="bibr" rid="B48">Huang et al., 2021</xref>). Daily torpor appears independent of ambient temperature (Ta), season, and nutritional status, as it can last only a few hours and is frequently interrupted by activity and foraging. Torpor can occur throughout the year, although it is more frequent in winter. However, in some species that live in warm climates, summer torpor is more common than winter torpor. Compared with waking, the metabolic rate drops to an average of about 30% of the basal metabolic rate (BMR) during torpor. The energy consumption is usually reduced by 10% to 80%, depending on the time and depth of torpor (<xref ref-type="bibr" rid="B38">Geiser, 2013</xref>).</p>
</sec>
<sec id="s2-3">
<title>2.3 Hibernation</title>
<p>Hibernation is a physiological adaptation that allows endothermic animals to cope with periodic limitations in their energy supply by lowering T<sub>b</sub> and metabolism and improve their freezing tolerance, which may enable them to survive seasonal changes in the food supply and temperature reduction (<xref ref-type="bibr" rid="B38">Geiser, 2013</xref>; <xref ref-type="bibr" rid="B110">Storey and Storey, 2013</xref>; <xref ref-type="bibr" rid="B111">Storey and Storey, 2017</xref>). When the metabolic rate decreases during hibernation, ventilation decreases, and prolonged apnea occurs (<xref ref-type="bibr" rid="B75">Milsom and Jackson, 2011</xref>). During deep hibernation, the T<sub>b</sub> of most mammals is near Ta. However, as T<sub>b</sub> approaches the freezing, MR rises sharply, preventing tissue damage from increased heat production (<xref ref-type="bibr" rid="B75">Milsom and Jackson, 2011</xref>; <xref ref-type="bibr" rid="B38">Geiser, 2013</xref>). Hibernating species include facultative hibernators (hamsters, bats) and obligatory hibernators (ground squirrels, bears, and lemurs). Facultative hibernators are animals that go into hibernation only when they sense cold, lack of food, or photoperiodic changes. Obligatory hibernators are animals that go into hibernation spontaneously and punctually at a specific time of year, regardless of food availability or temperature (<xref ref-type="bibr" rid="B129">Xu et al., 2013</xref>; <xref ref-type="bibr" rid="B77">Mohr et al., 2020</xref>).</p>
<p>Hibernation is not an uninterrupted process over several months. With the rise of Ta and the accumulation of metabolites, spontaneous periodic awakening may occur and interrupt dormancy. After a brief awakening, the animal returns to dormancy and repeats the cycle of dormancy-awakening until the end of hibernation. This periodic awakening consumes most of the energy during hibernation. The onset of hibernation is highly dependent on temperature. When Ta is between 20&#xb0;C and 30&#xb0;C, some species still hibernate, but the duration is usually only a few hours, similar to daily torpor (<xref ref-type="bibr" rid="B38">Geiser, 2013</xref>; <xref ref-type="bibr" rid="B95">Ruf and Geiser, 2015</xref>; <xref ref-type="bibr" rid="B77">Mohr et al., 2020</xref>; <xref ref-type="bibr" rid="B3">Ambler et al., 2021</xref>). Gene transcription and translation are significantly inhibited during hibernation, and many other physiological parameters are significantly reduced and recover after awakening, such as HR, respiration, metabolic rate, and so on (<xref ref-type="bibr" rid="B129">Xu et al., 2013</xref>).</p>
</sec>
</sec>
<sec id="s3">
<title>3 Sources and metabolic pathways of adenosine in the central nervous system</title>
<sec id="s3-1">
<title>3.1 Source of adenosine</title>
<p>Intracellular adenosine is mainly produced through five pathways (<xref ref-type="fig" rid="F1">Figure 1</xref>): 1) Adenosine triphosphate (ATP) loses two phosphate groups under the action of ATPase to become adenosine monophosphate (AMP), and AMP continues to lose the phosphate group under the action of an internal 5&#x2032;-nucleotidase (5&#x2032;-NT) to produce adenosine (<xref ref-type="bibr" rid="B70">Lopes et al., 2011</xref>). 2) Adenine reacts with 1-phosphate ribose to form adenosine (<xref ref-type="bibr" rid="B44">Hall and Frenguelli, 2018</xref>). 3) S-adenosylmethionine (SAM) and L-homocysteine produce S-adenosylhomocysteine (SAH) and further produce adenosine under the action of S-adenosylhomocysteine hydrolase (SAHH), but this pathway is not common in the CNS (<xref ref-type="bibr" rid="B19">Deussen et al., 1989</xref>; <xref ref-type="bibr" rid="B61">Latini and Pedata, 2001</xref>). 4) Extracellular adenosine is transported into the cell by the balanced nucleoside transporter in the cell membrane (<xref ref-type="bibr" rid="B66">Liu Y. J. et al., 2019</xref>). 5) cAMP is generated from ATP under the action of AC, which is regulated by GPCRs, and then converted through phosphodiesterases (PDEs) to AMP, which is eventually used to generate adenosine (<xref ref-type="bibr" rid="B22">Dos Santos-Rodrigues et al., 2015</xref>).</p>
<fig id="F1" position="float">
<label>FIGURE 1</label>
<caption>
<p>Adenosine metabolism and P1 receptors in the central nervous system. Adenosine metabolism occurs mainly in neuronal synapses and astrocytes. In cells, adenosine is formed from ATP, cAMP, or SAH. Extracellular adenosine is produced by ATP and cAMP metabolism but mainly by the balance of nucleoside transporters to regulate the concentration level inside and outside the membrane. SAM, S-adenosylmethionine; SAH, S-adenosyl homocysteine; LH, L-homocysteine; SAHH, S-adenosyl homocysteine hydrolase; ATP, adenosine triphosphate; ADP, adenosine diphosphate; AMP, adenosine monophosphate; cAMP, cyclic adenosine monophosphate; ADO, adenosine; ADD, adenosine deaminase; ADK, adenosine kinase; 5&#x2032;-NT, 5&#x2032;-nucleotidase; etco-5&#x2032;-NT, etco-5&#x2032;-nucleotidase; AC, adenylate cyclase; GPCR, G protein-coupled receptors; ENT, equilibrating nucleoside transporter; A<sub>1</sub>Rs, adenosine A<sub>1</sub> receptors; A<sub>2A</sub>Rs, adenosine A<sub>2A</sub> receptors; A<sub>2B</sub>Rs, adenosine A<sub>2B</sub> receptors; A<sub>3</sub>Rs, adenosine A<sub>3</sub> receptors; Pre-, presynaptic membrane; Post-, postsynaptic membrane.</p>
</caption>
<graphic xlink:href="fphar-14-1098976-g001.tif"/>
</fig>
<p>Production of extracellular adenosine occurs mainly by two pathways (<xref ref-type="fig" rid="F1">Figure 1</xref>): 1) intracellular adenosine is transported to the extracellular space by the balanced nucleoside transporter located in the cell membrane (<xref ref-type="bibr" rid="B96">Sala-Newby et al., 1999</xref>). 2) Extracellular ATP and adenosine diphosphate (ADP) are converted to AMP by the enzyme ecto-nucleoside triphosphate diphosphohydrolase (E-NTPDase), also known as CD39. Subsequently, adenosine is generated by ecto-5&#x2032;-nucleotidase (ecto-5&#x2032;-NT), also known as CD73, which is mainly expressed on astrocytes, oligodendrocytes and microglia (<xref ref-type="bibr" rid="B62">Lazarus et al., 2019a</xref>).</p>
<p>In the equilibrium state, the intracellular adenosine level is 100&#xa0;nM, and the extracellular adenosine level is 140&#x2013;200&#xa0;nM (<xref ref-type="bibr" rid="B25">Dunwiddie and Diao, 1994</xref>), but in the pathological state, such as ischemia and hypoxia, extracellular adenosine level increases three- to 10-fold (<xref ref-type="bibr" rid="B5">Andin&#xe9; et al., 1990</xref>; <xref ref-type="bibr" rid="B26">Dux et al., 1990</xref>). It is worth noting that although adenosine can be produced from the synaptic terminals of neurons and enter the synaptic space, it is not secreted through vesicles but transported through nucleoside transporters, which has nothing to do with neural activities. Thus, adenosine is not a neurotransmitter but a regulatory factor (<xref ref-type="bibr" rid="B50">Huang et al., 2011</xref>; <xref ref-type="bibr" rid="B70">Lopes et al., 2011</xref>; <xref ref-type="bibr" rid="B51">Huang et al., 2014</xref>).</p>
</sec>
<sec id="s3-2">
<title>3.2 Adenosine metabolism</title>
<p>Adenosine has three main metabolic pathways (<xref ref-type="fig" rid="F1">Figure 1</xref>): 1) It becomes inosine under the action of adenosine deaminase [8], and then generates hypoxanthine and hypoxanthine nucleotides by nucleoside phosphorylase, and finally becomes uric acid (<xref ref-type="bibr" rid="B35">Fredholm et al., 2005</xref>). 2) Adenosine is transported intracellular and extracellular domain through two-way balanced nucleoside transporter to regulate intracellular and extracellular adenosine levels (<xref ref-type="bibr" rid="B66">Liu Y. J. et al., 2019</xref>). 3) Adenosine kinase (ADK), which is mainly found in astrocytes, generates AMP and ADP by phosphorylating adenosine in the presence of ATP. This metabolic pathway can only occur in cells, so extracellular adenosine must enter cells to complete the cycle (<xref ref-type="bibr" rid="B50">Huang et al., 2011</xref>; <xref ref-type="bibr" rid="B51">Huang et al., 2014</xref>; <xref ref-type="bibr" rid="B37">Garcia-Gil et al., 2021</xref>).</p>
</sec>
</sec>
<sec id="s4">
<title>4 Excitatory and inhibitory effects of various adenosine receptors</title>
<p>The physiological functions of adenosine is mediated by four purinergic type 1 receptors, known as A<sub>1</sub>, A<sub>2A</sub>, A<sub>2B,</sub> and A<sub>3</sub> receptors, which belong to GPCR family. A<sub>1</sub>Rs and A<sub>3</sub>Rs belong to the inhibitory adenylate cyclase G protein (Gi) family, whereas A<sub>2A</sub>Rs and A<sub>2B</sub>Rs belong to the stimulatory adenylate cyclase G protein (Gs) family (<xref ref-type="bibr" rid="B127">Wall and Dale, 2008</xref>; <xref ref-type="bibr" rid="B70">Lopes et al., 2011</xref>).</p>
<sec id="s4-1">
<title>4.1 A<sub>1</sub> receptors</title>
<p>A<sub>1</sub>Rs have the highest affinity for adenosine and can be activated when the concentration of adenosine is in the pM range. They are the most prominent adenosine receptor in the CNS, distributed mainly in the cerebral cortex, hippocampus, and thalamus. A<sub>1</sub>Rs are located primarily in the excitatory nerve terminals (<xref ref-type="bibr" rid="B57">Kashfi et al., 2017</xref>). Activation of A<sub>1</sub>Rs can inhibit the activity of adenylate cyclase (AC), decrease the cAMP content, and regulate the activity of cAMP-dependent protein kinase. A<sub>1</sub>R activation can increase the release of intracellular Ca<sup>2&#x2b;</sup>, inhibit N-, Q- and P-type calcium channels, decrease the influx of extracellular Ca<sup>2&#x2b;</sup>, block the release of neurotransmitters, and reduce neuronal discharge to regulate neuronal activity (<xref ref-type="bibr" rid="B127">Wall and Dale, 2008</xref>). In the postsynaptic membrane, A<sub>1</sub>Rs are activated to open K<sup>&#x2b;</sup> channels and increase K<sup>&#x2b;</sup> outflow, resulting in membrane hyperpolarization, which reduces excitability and protects neurons. When activated, A1Rs can also open the ATP-sensitive potassium channel (KATP) of substantia nigra neurons, increasing outward currents and decreasing membrane excitability (<xref ref-type="bibr" rid="B109">Stockwell et al., 2017</xref>).</p>
</sec>
<sec id="s4-2">
<title>4.2 A<sub>2A</sub> receptors</title>
<p>The affinity of A<sub>2A</sub>Rs for adenosine is lower than that of A<sub>1</sub>Rs, and the activation concentration of adenosine is in the nM range. A<sub>2A</sub>Rs are mainly distributed in dopaminergic areas, such as striatum, nucleus accumbens (NAc), olfactory nodules and so on (<xref ref-type="bibr" rid="B28">Fang et al., 2017</xref>; <xref ref-type="bibr" rid="B21">Dong et al., 2022</xref>). When A<sub>2A</sub>Rs are activated, they are coupled with Gs protein in the brain to increase the activity of AC and cAMP in striatal cells. In the hippocampus, A<sub>2A</sub>Rs appear to be coupled with Gi/Go protein (<xref ref-type="bibr" rid="B20">Di&#xf3;genes et al., 2004</xref>). A<sub>2A</sub>Rs are mainly expressed in D<sub>2</sub> dopamine receptor cells and are particularly abundant in the plasma membrane of dendrites and dendritic spines, but less so in axons, axon terminals, and glial cells, and has an antagonistic effect with dopamine D<sub>2</sub> receptors (D<sub>2</sub>Rs) (<xref ref-type="bibr" rid="B30">Ferre et al., 1991</xref>; <xref ref-type="bibr" rid="B112">Str&#xf6;mberg et al., 2000</xref>). Presynaptic A<sub>2A</sub>Rs can regulate the inhibition of A<sub>1</sub>Rs. In contrast to A<sub>1</sub>Rs, adenosine promotes the release of excitatory transmitters by activating A<sub>2A</sub>Rs. In astrocytes, A<sub>2A</sub>Rs are involved in the regulation of glutamate release and &#x3b3;-aminobutyric acid (GABA) uptake (<xref ref-type="bibr" rid="B18">Crist&#xf3;v&#xe3;o-Ferreira et al., 2009</xref>). The balance between A<sub>1</sub> and A<sub>2A</sub>Rs is crucial to the adenosine response, and this close interaction between them can produce a response that is different from the sum of the two (<xref ref-type="bibr" rid="B16">Chiu and Freund, 2014</xref>).</p>
</sec>
<sec id="s4-3">
<title>4.3 A<sub>2B</sub> receptors</title>
<p>A<sub>2B</sub>Rs have a low affinity for adenosine, and the activation concentration of adenosine should reach &#x3bc;M, suggesting that A<sub>2B</sub>Rs mainly play a role under pathological conditions with increased extracellular adenosine concentration. A<sub>2B</sub>Rs are primarily distributed in hippocampal neurons and glial cells, and a small amount is also found in the thalamus, lateral ventricle, and striatum. A<sub>2B</sub>Rs can activate AC <italic>via</italic> Gs or phospholipase C (PLC) <italic>via</italic> Gq. Activation of A<sub>2B</sub>Rs can increase intracellular cAMP, promote glycogen decomposition, and increase the energy supply of neurons to resist the pathological state of ischemia and hypoxia (<xref ref-type="bibr" rid="B124">van Calker et al., 1979</xref>; <xref ref-type="bibr" rid="B46">H&#xf6;sli and H&#xf6;sli, 1988</xref>; <xref ref-type="bibr" rid="B22">Dos Santos-Rodrigues et al., 2015</xref>).</p>
</sec>
<sec id="s4-4">
<title>4.4 A<sub>3</sub> receptors</title>
<p>A<sub>3</sub>Rs have the lowest sensitivity compared to other adenosine receptors, but activation of A<sub>3</sub>Rs has neuroprotective and neurotrophic effects. Although A<sub>3</sub>Rs are distributed throughout the brain, their content varies greatly in different brain regions, especially in the hippocampus and cerebellum. A<sub>3</sub>Rs act through Gi-mediated AC inhibition and Gq-mediated PLC activation. A<sub>3</sub>Rs can regulate hippocampal synaptic plasticity and decrease adenylate cyclase activity. In short, A<sub>3</sub>Rs activation is closely related to inflammation inhibition and cell protection (<xref ref-type="bibr" rid="B69">Lopes et al., 2003</xref>; <xref ref-type="bibr" rid="B126">Vlajkovic et al., 2007</xref>; <xref ref-type="bibr" rid="B70">Lopes et al., 2011</xref>).</p>
</sec>
</sec>
<sec id="s5">
<title>5 The roles and neurobiological mechanisms of adenosine and P1 receptors in sleep, torpor, and hibernation</title>
<sec id="s5-1">
<title>5.1 Increased levels of extracellular adenosine lead to drowsiness</title>
<p>Thanks to neurobiology and molecular biology advances, we are beginning to understand how sleep is initiated and maintained. Sustained wakefulness causes the body to produce and accumulate one or more endogenous somnogenic factors that induce sleep after reaching a certain threshold. The hypnotic effect of adenosine, an endogenous somnogenic factor, was discovered in 1954 (<xref ref-type="bibr" rid="B29">Feldberg and Sherwood, 1954</xref>). Typically, extracellular adenosine concentrations in the cerebral cortex and basal forebrain (BF) gradually increase during prolonged arousal, reaching a certain threshold that leads to drowsiness, while slowly decreasing during recovery sleep (<xref ref-type="bibr" rid="B86">Porkka-Heiskanen et al., 1997</xref>; <xref ref-type="bibr" rid="B17">Clasadonte et al., 2014</xref>; <xref ref-type="bibr" rid="B51">Huang et al., 2014</xref>; <xref ref-type="bibr" rid="B118">Tartar et al., 2021</xref>; <xref ref-type="bibr" rid="B84">Omond et al., 2022</xref>). Extracellular adenosine levels may be partially regulated by glutamatergic neurons (<xref ref-type="bibr" rid="B85">Peng et al., 2020</xref>; <xref ref-type="bibr" rid="B113">Sun and Tang, 2020</xref>). This is because activation of the glutamatergic BF neurons causes a large increase in extracellular adenosine, and specific ablation of glutamatergic BF neurons reduces the level of extracellular adenosine and significantly impairs sleep homeostasis regulation (<xref ref-type="bibr" rid="B85">Peng et al., 2020</xref>). Although adenosine is known to act on four evolutionarily conserved receptors, it is currently thought to regulate sleep-wake states by acting on the A<sub>1</sub>Rs and A<sub>2A</sub>Rs (<xref ref-type="bibr" rid="B51">Huang et al., 2014</xref>; <xref ref-type="bibr" rid="B63">Lazarus et al., 2019b</xref>).</p>
</sec>
<sec id="s5-2">
<title>5.2 Regulation of sleep homeostasis by A<sub>1</sub>Rs is brain region-dependent</title>
<p>A<sub>1</sub>Rs are required for normal sleep homeostasis because the conditional knockout of A<sub>1</sub>Rs in the CNS during sleep restriction results in a reduced rebound slow-wave activity response (<xref ref-type="bibr" rid="B9">Bjorness et al., 2009</xref>). Mainstream research suggests that activation of A<sub>1</sub>Rs promotes sleep, as A<sub>1</sub>Rs agonists increase sleep (<xref ref-type="bibr" rid="B90">Radulovacki et al., 1984</xref>; <xref ref-type="bibr" rid="B7">Benington et al., 1995</xref>), whereas A<sub>1</sub>Rs antagonists decrease sleep (<xref ref-type="bibr" rid="B74">Methippara et al., 2005</xref>; <xref ref-type="bibr" rid="B119">Thakkar et al., 2008</xref>). For example, when <xref ref-type="bibr" rid="B81">Oishi et al. (2008)</xref> injected the A<sub>1</sub>Rs-selective agonist N6-cyclopentyladenosine (CPA) into the rat tuberomammillary nucleus (TMN), this significantly increased NREM sleep. A<sub>1</sub>Rs may mediate sleep through three pathways (<xref ref-type="bibr" rid="B63">Lazarus et al., 2019b</xref>): 1) A<sub>1</sub>Rs promote sleep by inhibiting wake-promoting neurons. A<sub>1</sub>Rs are expressed in hypocretin/orexin neurons of the lateral hypothalamus (LH) and histaminergic neurons of the TMN, which are typical arousal centers. Activation of A<sub>1</sub>Rs inhibits excitatory neurotransmission, including cholinergic arousal systems in the brainstem (<xref ref-type="bibr" rid="B91">Rainnie et al., 1994</xref>) and BF (<xref ref-type="bibr" rid="B2">Alam et al., 1999</xref>; <xref ref-type="bibr" rid="B120">Thakkar et al., 2003</xref>), the hypocretin/orexin neurons in the LH (<xref ref-type="bibr" rid="B121">Thakkar et al., 2002</xref>; <xref ref-type="bibr" rid="B68">Liu and Gao, 2007</xref>), and histaminergic systems in the TMN (<xref ref-type="bibr" rid="B81">Oishi et al., 2008</xref>). 2) A<sub>1</sub>Rs promote sleep by disinhibiting sleep-active neurons in the ventrolateral preoptic nucleus (VLPO) and anterior hypothalamic area (<xref ref-type="bibr" rid="B15">Chamberlin et al., 2003</xref>; <xref ref-type="bibr" rid="B78">Morairty et al., 2004</xref>). 3) A<sub>1</sub>Rs mediate homeostatic sleep pressure based on astrocytic gliotransmission (<xref ref-type="bibr" rid="B42">Halassa et al., 2009</xref>).</p>
<p>Moreover, A1Rs do not appear to fully promote sleep because A<sub>1</sub>R knockout mice did not differ from wide-type mice in basal sleep amount and sleep-wake behavior after sleep deprivation (<xref ref-type="bibr" rid="B108">Stenberg et al., 2003</xref>). Infusion of CPA into the lateral ventricle of mice did not significantly alter NREM and REM sleep (<xref ref-type="bibr" rid="B123">Urade et al., 2003</xref>). However, microdialysis of the adenosine transporter inhibitor nitrobenzyl-thio-inosine (NBTIs) or A<sub>1</sub>R agonists into the lateral preoptic area (LPO) increased the amount of wakefulness in rats (<xref ref-type="bibr" rid="B74">Methippara et al., 2005</xref>). Thus, A<sub>1</sub>Rs may exert different sleep-wake effects by acting on different brain regions.</p>
</sec>
<sec id="s5-3">
<title>5.3 A<sub>2A</sub>Rs are important receptors that mediate the sleep-promoting effect of adenosine</title>
<p>A<sub>2A</sub>Rs are important targets in the regulation of sleep. A<sub>2A</sub>Rs mediate the effects of many sleep-promoting substances, such as ethanol and sake yeast (<xref ref-type="bibr" rid="B27">El Yacoubi et al., 2003</xref>; <xref ref-type="bibr" rid="B79">Nakamura et al., 2016</xref>; <xref ref-type="bibr" rid="B28">Fang et al., 2017</xref>; <xref ref-type="bibr" rid="B80">Nishimon et al., 2021</xref>). The selective A<sub>2A</sub>R agonist CGS21680 injected into the subarachnoid space adjacent to the BF and LPO of rats or the lateral ventricle of mice significantly increased NREM and REM sleep (<xref ref-type="bibr" rid="B98">Satoh et al., 1998</xref>; <xref ref-type="bibr" rid="B100">Scammell et al., 2001</xref>; <xref ref-type="bibr" rid="B123">Urade et al., 2003</xref>; <xref ref-type="bibr" rid="B74">Methippara et al., 2005</xref>). Immediately after the cessation of CGS21680 perfusion, there is a strong rebound in wakefulness (<xref ref-type="bibr" rid="B39">Gerashchenko et al., 2000</xref>). However, the sleep-promoting effect induced by CGS21680 was abolished entirely in A<sub>2A</sub>R knockout mice.</p>
<p>In addition, intraperitoneal administration of a positive A<sub>2A</sub>R allosteric modulator {3, 4-difluoro-2-[(2-fluoro-4-iodophenyl) amino] benzoic acid} in WT mice but not A<sub>2A</sub>R knockout mice enhanced A<sub>2A</sub>R signaling and promoted NREM sleep in a dose-dependent manner (<xref ref-type="bibr" rid="B60">Korkutata et al., 2019</xref>). Several studies suggested that A<sub>2A</sub>Rs mediated the sleep-regulating effects of prostaglandin D2 (PGD2). After administration of PGD2 or CGS21680 into the rostral BF, c-fos-positive cells were significantly increased in the VLPO, a sleep center, resulting in enhanced induction of NREM sleep, and in contrast, c-fos-positive neurons significantly decreased in the TMN of the posterior hypothalamus, a wake center (<xref ref-type="bibr" rid="B99">Satoh et al., 1999</xref>; <xref ref-type="bibr" rid="B100">Scammell et al., 2001</xref>). In <italic>in-vivo</italic> microdialysis experiments, infusion of CGS21680 into the BF dose-dependently decreased histamine release in the frontal cortex and medial preoptic area and increased GABA release in the TMN, but not in the frontal cortex (<xref ref-type="bibr" rid="B45">Hong et al., 2005</xref>). Furthermore, VLPO neurons have been divided into two types according to their different responses to serotonin and adenosine: Type-1 neurons were inhibited by serotonin, and type-2 neurons were excited. A<sub>2A</sub>R agonists excited postsynaptic type-2 neurons in the VLPO but not type-1 neurons. Type-2 neurons were involved in sleep initiation, whereas type-1 neurons may contribute to sleep consolidation because type-1 neurons were activated only when the inhibitory effects of the arousal system were absent (<xref ref-type="bibr" rid="B36">Gallopin et al., 2005</xref>). In addition to the VLPO, injection of CGS21680 into the rostral BF also increased c-fos expression in the shell of the NAc and the medial portion of the olfactory tubercle (OT) (<xref ref-type="bibr" rid="B99">Satoh et al., 1999</xref>; <xref ref-type="bibr" rid="B100">Scammell et al., 2001</xref>). Microinjection of CGS21680 into the NAc shell also induced sleep-promoting effects (<xref ref-type="bibr" rid="B99">Satoh et al., 1999</xref>). A<sub>2A</sub>Rs are highly expressed in the caudate putamen, NAc, and OT. Our recent series of studies have shown that activation of A<sub>2A</sub>R neurons in these nuclei can strongly promote sleep (<xref ref-type="bibr" rid="B82">Oishi et al., 2017</xref>; <xref ref-type="bibr" rid="B131">Yuan et al., 2017</xref>; <xref ref-type="bibr" rid="B65">Li et al., 2020</xref>). Activation of the A<sub>2A</sub>R neurons of the NAc core projecting to the ventral pallidum (VP) strongly induced NREM sleep. Conversely, inhibiting these neurons reduced sleep but did not affect the sleep homeostasis rebound (<xref ref-type="bibr" rid="B82">Oishi et al., 2017</xref>). Yuan et al. demonstrated the important role of the striatal A<sub>2A</sub>R neurons projecting to the external globus pallidus (GPe) parvalbumin (PV) neurons in sleep control. Chemogenetic inhibition of striatal A<sub>2A</sub>R neurons significantly decreased NREM sleep in the active period, which was mediated by the formation of inhibitory circuits between striatal A<sub>2A</sub>R neurons and GPe PV neurons (<xref ref-type="bibr" rid="B131">Yuan et al., 2017</xref>). The OT A<sub>2A</sub>R neurons project to the VP and LH <italic>via</italic> inhibitory innervations, and pharmacological or chemogenetic activation of OT A<sub>2A</sub>R neurons resulted in increased NREM sleep in mice (<xref ref-type="bibr" rid="B65">Li et al., 2020</xref>). Moreover, A<sub>2A</sub>Rs are co-localized with dopamine D<sub>2</sub>Rs in these nuclei (<xref ref-type="bibr" rid="B76">Missale et al., 1998</xref>). Our studies demonstrated that D<sub>2</sub>R-expressing neurons are essential for the induction and maintenance of wakefulness (<xref ref-type="bibr" rid="B88">Qu et al., 2008</xref>; <xref ref-type="bibr" rid="B87">Qiu et al., 2009</xref>; <xref ref-type="bibr" rid="B89">Qu et al., 2010</xref>; <xref ref-type="bibr" rid="B67">Liu Y. Y. et al., 2019</xref>; <xref ref-type="bibr" rid="B130">Yang et al., 2021</xref>). Thus, A<sub>2A</sub>Rs and D<sub>2</sub>Rs may jointly influence the sleep-wake cycle by balancing their activity.</p>
<p>Caffeine, unlike adenosine, is a wake-promoting substance abundant in refreshing beverages such as coffee and tea. Caffeine is an antagonist of A<sub>1</sub>Rs and A<sub>2A</sub>Rs, with similar affinity for both at low doses (<xref ref-type="bibr" rid="B34">Fredholm et al., 2001</xref>). Using A<sub>1</sub>R knockout and A<sub>2A</sub>R knockout mice, Huang et al. demonstrated that caffeine-induced wakefulness is dependent on A<sub>2A</sub>Rs, as caffeine dose-dependently increased wakefulness in both wild-type and A<sub>1</sub>R knockout but not A<sub>2A</sub>R knockout mice (<xref ref-type="bibr" rid="B49">Huang et al., 2005</xref>). Similarly, selective silencing of A<sub>2A</sub>Rs in the NAc shell inhibited caffeine-induced wakefulness (<xref ref-type="bibr" rid="B64">Lazarus et al., 2011</xref>).</p>
<p>In conclusion, the regulatory effect of A<sub>1</sub>Rs on sleep-wake regulation is brain region-dependent. The excitation of A<sub>1</sub>Rs in wake-promoting nuclei induces sleep and, conversely, causes arousal on sleep-promoting neurons. The A<sub>2A</sub>Rs are the major sleep-regulating receptors that mediate the wake-promoting effects of caffeine, and activation of A<sub>2A</sub>Rs promotes sleep by inhibiting major arousal systems (<xref ref-type="fig" rid="F2">Figure 2</xref>).</p>
<fig id="F2" position="float">
<label>FIGURE 2</label>
<caption>
<p>Neurobiological mechanisms of the A<sub>2A</sub>Rs regulate sleep-wake states. A<sub>2A</sub>Rs are important targets in sleep regulation, promoting sleep by inhibiting major arousal systems. Activation of A<sub>2A</sub>R neurons in the NAc core, striatum, and OT promotes sleep, with A<sub>2A</sub>Rs neurons in the NAc core projecting to the VP, striatal A<sub>2A</sub>R neurons, and GPe PV neurons forming inhibitory circuits, and OT A<sub>2A</sub>R neurons projecting to the VP and LH. Furthermore, BF glutamatergic neurons may regulate extracellular adenosine levels, and A<sub>2A</sub>Rs rather than A<sub>1</sub>Rs mediate the wake-promoting effects of caffeine. A<sub>2A</sub>Rs, adenosine A<sub>2A</sub> receptors; A<sub>1</sub>Rs, adenosine A<sub>1</sub> receptors; NAc, nucleus accumbens; VP, ventral pallidum; GPe, external globus pallidus; OT, olfactory tubercle; LH, lateral hypothalamus; Glu, glutamic acid; GABA, &#x3b3;-aminobutyric acid.</p>
</caption>
<graphic xlink:href="fphar-14-1098976-g002.tif"/>
</fig>
</sec>
<sec id="s5-4">
<title>5.4 Adenosine A<sub>1</sub>Rs and A<sub>3</sub>Rs play important roles in torpor</title>
<p>Adenosine may play a key role in torpor, as pyruvate induces torpor in obese mice based on adenosine signaling (<xref ref-type="bibr" rid="B107">Soto et al., 2018</xref>). In mice lacking all four adenosine receptors, adenosine does not cause hypothermia, bradycardia, or hypotension typical of the torpor state (<xref ref-type="bibr" rid="B128">Xiao et al., 2019</xref>). Peripheral or central infusion of adenosine or AMP results in a decrease in metabolic rate and body temperature similar to that observed in natural torpor, even in rats that do not naturally enter torpor (<xref ref-type="bibr" rid="B116">Swoap et al., 2007</xref>; <xref ref-type="bibr" rid="B56">Jinka et al., 2011</xref>; <xref ref-type="bibr" rid="B52">Iliff and Swoap, 2012</xref>; <xref ref-type="bibr" rid="B83">Olson et al., 2013</xref>; <xref ref-type="bibr" rid="B122">Tupone et al., 2013</xref>; <xref ref-type="bibr" rid="B11">Carlin et al., 2017</xref>; <xref ref-type="bibr" rid="B125">Vicent et al., 2017</xref>). Furthermore, the administration of A<sub>1</sub>R or A<sub>3</sub>R agonists to mice induces several features of daily torpor, including hypothermia (<xref ref-type="bibr" rid="B4">Anderson et al., 1994</xref>; <xref ref-type="bibr" rid="B52">Iliff and Swoap, 2012</xref>; <xref ref-type="bibr" rid="B11">Carlin et al., 2017</xref>; <xref ref-type="bibr" rid="B114">Swoap, 2017</xref>; <xref ref-type="bibr" rid="B125">Vicent et al., 2017</xref>), whereas A<sub>2A</sub>Rs and A<sub>2B</sub>Rs agonists do not (<xref ref-type="bibr" rid="B4">Anderson et al., 1994</xref>).</p>
<p>Currently, there are three ways to mimic the induction of torpor: 1) inhibition of the raphe pallidus (rPA) neurons in the brainstem (<xref ref-type="bibr" rid="B13">Cerri et al., 2021</xref>); 2) activation of A<sub>1</sub>Rs or A<sub>3</sub>Rs in the brain; 3) activation of glutamatergic Adcyap1&#x2b; neurons in the hypothalamus (<xref ref-type="bibr" rid="B47">Hrvatin et al., 2020</xref>). Here, we will discuss the induction of synthetic torpor by controlling A<sub>1</sub>Rs and A<sub>3</sub>Rs through pharmacological experiments. Although neither A<sub>1</sub>Rs nor A<sub>3A</sub>Rs are required for fasting-induced torpor (<xref ref-type="bibr" rid="B11">Carlin et al., 2017</xref>), administration of A<sub>1</sub>R or A<sub>3</sub>R agonists such as N6-cyclohexyladenosine (CHA) induces torpor-like states in some animals (<xref ref-type="bibr" rid="B56">Jinka et al., 2011</xref>; <xref ref-type="bibr" rid="B83">Olson et al., 2013</xref>; <xref ref-type="bibr" rid="B122">Tupone et al., 2013</xref>; <xref ref-type="bibr" rid="B125">Vicent et al., 2017</xref>; <xref ref-type="bibr" rid="B32">Frare et al., 2018</xref>), while antagonist administration prevents torpor or causes arousal from torpor during torpor phases (<xref ref-type="bibr" rid="B56">Jinka et al., 2011</xref>; <xref ref-type="bibr" rid="B52">Iliff and Swoap, 2012</xref>; <xref ref-type="bibr" rid="B117">Tamura et al., 2012</xref>). It is not yet certain whether adenosine action triggers the occurrence of natural torpor, but adenosine mediates at least some of the physiological features during torpor. For example, A<sub>3</sub>R stimulation leads to hypothermia <italic>via</italic> peripheral mast cell degranulation, histamine release, and activation of central histamine H<sub>1</sub> receptors. However, A<sub>1</sub>R agonist-induced hypothermia occurs <italic>via</italic> central sites, and the rPA, nucleus of the solitary tract (NTS) and the hypothalamic-pituitary-thyroid axis gate appear to play a pivotal role (<xref ref-type="bibr" rid="B122">Tupone et al., 2013</xref>; <xref ref-type="bibr" rid="B11">Carlin et al., 2017</xref>; <xref ref-type="bibr" rid="B32">Frare et al., 2018</xref>).</p>
<p>In the future, further efforts should be made to confirm the role of adenosine in torpor and its possible neurobiological and molecular mechanisms. First, microdialysis experiments, adenosine probes, and chemogenetic and optogenetic techniques should be used to confirm whether there is an accumulation and dynamic change of adenosine concentration during the initiation and maintenance of torpor and to reveal the possible mechanisms.</p>
</sec>
<sec id="s5-5">
<title>5.5 Central activation of A<sub>1</sub>Rs is sufficient to induce and maintain a hibernation-like state</title>
<p>Seasonal changes in brain adenosine levels may contribute to an increase in A1R sensitivity leading to the onset of hibernation (<xref ref-type="bibr" rid="B31">Frare and Drew, 2021</xref>). Although the mechanisms controlling hibernation are currently unclear, activation of A<sub>1</sub>Rs signaling in the CNS appears to be required for the onset of this phenomenon, as activation of the A<sub>1</sub>Rs in the CNS can induce hibernation or some hibernation-like states in obligate, facultative, or non-hibernating animals (<xref ref-type="bibr" rid="B23">Drew et al., 2017</xref>; <xref ref-type="bibr" rid="B102">Shimaoka et al., 2018</xref>; <xref ref-type="bibr" rid="B31">Frare and Drew, 2021</xref>). In addition, <xref ref-type="bibr" rid="B102">Shimaoka et al. (2018)</xref> activated central A<sub>1</sub>Rs in rats, a non-hibernating animal, which induced a hypothermia response similar to hibernation.</p>
<p>It is worth noting that activation of A<sub>1</sub>Rs maintains core body temperature at a low level. In hibernators, core body temperature and metabolic rate reduction occur before hibernation, which may be the key to the A<sub>1</sub>R-mediated hibernation (<xref ref-type="bibr" rid="B6">Barros et al., 2006</xref>). A<sub>1</sub>Rs are highly expressed throughout the CNS, including the NTS. The NTS is the center that controls cardiovascular, respiratory, and metabolic functions, and the NTS neurons are responsible for the integration of central and peripheral signals related to energy expenditure-related (<xref ref-type="bibr" rid="B6">Barros et al., 2006</xref>). A<sub>1</sub>Rs act as inhibitory receptors whose activation prevents the release of GABA to the NTS neurons that inhibit thermogenesis (<xref ref-type="bibr" rid="B10">Cao et al., 2010</xref>). Furthermore, the administration of CHA to the arctic ground squirrel increased c-fos expression in the NTS in both summer and winter (<xref ref-type="bibr" rid="B33">Frare et al., 2019</xref>). After the microinjection of CHA into the NTS, it inhibited brown adipose tissue (BAT) thermogenesis and shivering responses. In contrast, inhibition of A<sub>1</sub>Rs counteracted BAT thermogenesis induced by intracerebroventricular injection of CHA (<xref ref-type="bibr" rid="B122">Tupone et al., 2013</xref>). In addition to inhibiting BAT thermogenesis, activation of A<sub>1</sub>Rs in the NTS increases vasopressin secretion, which constricts blood vessels, including skin vessels, thereby increasing arterial blood pressure (<xref ref-type="bibr" rid="B73">McClure et al., 2005</xref>; <xref ref-type="bibr" rid="B72">McClure et al., 2011</xref>) and causing bradycardia, one of the initial physiological features of natural hibernation (<xref ref-type="bibr" rid="B55">Jinka, 2012</xref>). The rPA, the median preoptic area (MnPO) and the supraoptic nucleus (SON) also appear to mediate the effect of A<sub>1</sub>Rs in BAT thermogenic, as the rPA and MnPO c-fos expression is lower in winter than in summer after CHA administration, and inhibition of rPA neurons produces hypothermia, however the SON is related to the seasonal increase in vasoconstriction (<xref ref-type="bibr" rid="B14">Cerri et al., 2013</xref>; <xref ref-type="bibr" rid="B33">Frare et al., 2019</xref>). Therefore, A<sub>1</sub>Rs could mediate hypothermia similar to hibernation by inhibiting BAT thermogenesis <italic>via</italic> the NTS and rPA or by inhibiting cardiovascular function. In addition, as previously mentioned, in contrast to sleep, EEG amplitudes are significantly reduced during hibernation (<xref ref-type="bibr" rid="B41">Golanov and Reis, 2001</xref>; <xref ref-type="bibr" rid="B71">Magdaleno-Madrigal et al., 2010</xref>). Central activation of A<sub>1</sub>Rs synchronized the EEG, whereas activation in the thalamus significantly reduced EEG amplitude (<xref ref-type="bibr" rid="B97">Saper et al., 2005</xref>). After central administration of CHA in rats, the EEG amplitude was greatly reduced, the delta wave amplitude was significantly reduced, and the theta wave almost disappeared (<xref ref-type="bibr" rid="B122">Tupone et al., 2013</xref>). Thus, the change in EEG amplitude may be another way A<sub>1</sub>Rs mediate hibernation.</p>
<p>As with torpor, it is currently unclear whether adenosine accumulation is necessary for the initiation of hibernation, so further efforts are needed to address these scientific questions.</p>
</sec>
</sec>
<sec id="s6">
<title>6 Conclusion and future perspective</title>
<p>In this review, we summarize the roles and neurobiological mechanisms of adenosine and its receptors in sleep-wake regulation, torpor, and hibernation (<xref ref-type="table" rid="T2">Table 2</xref>, <xref ref-type="fig" rid="F3">Figure 3</xref>). The first step toward translating adenosine and P1 receptors into targets for medical applications is to understand their roles and mechanisms underlying these states of diminished metabolism and body temperature. We now know that A<sub>1</sub>Rs and A<sub>2A</sub>Rs jointly mediate sleep-wake regulation (<xref ref-type="bibr" rid="B51">Huang et al., 2014</xref>; <xref ref-type="bibr" rid="B63">Lazarus et al., 2019b</xref>), that activation of A<sub>1</sub>Rs and A<sub>3</sub>Rs is important for torpor (<xref ref-type="bibr" rid="B11">Carlin et al., 2017</xref>) and that hibernation requires A<sub>1</sub>Rs rather than other adenosine receptors (<xref ref-type="bibr" rid="B102">Shimaoka et al., 2018</xref>; <xref ref-type="bibr" rid="B31">Frare and Drew, 2021</xref>).</p>
<table-wrap id="T2" position="float">
<label>TABLE 2</label>
<caption>
<p>Roles of adenosine receptors in sleep, torpor, and hibernation.</p>
</caption>
<table>
<thead valign="top">
<tr>
<th align="left"/>
<th align="left">Sleep</th>
<th align="left">Torpor</th>
<th align="left">Hibernation</th>
<th align="left">References</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td align="left">Adenosine accumulation</td>
<td align="left">Yes</td>
<td align="left">Unknow</td>
<td align="left">Unknow</td>
<td align="left">
<xref ref-type="bibr" rid="B86">Porkka-Heiskanen et al. (1997),</xref> <xref ref-type="bibr" rid="B17">Clasadonte et al. (2014),</xref> <xref ref-type="bibr" rid="B51">Huang et al. (2014),</xref> <xref ref-type="bibr" rid="B118">Tartar et al. (2021),</xref> <xref ref-type="bibr" rid="B84">Omond et al. (2022)</xref>
</td>
</tr>
<tr>
<td align="left">Key receptors</td>
<td align="left">A<sub>1</sub>Rs, A<sub>2A</sub>Rs</td>
<td align="left">A<sub>1</sub>Rs, A<sub>3</sub>Rs</td>
<td align="left">A<sub>1</sub>Rs</td>
<td align="left"/>
</tr>
<tr>
<td align="left">Related brain regions</td>
<td align="left">TMN, LH, Brain stem, BF, VLPO, LPO, NAc, OT, Striatum</td>
<td align="left">NTS, rPA, hypothalamus</td>
<td align="left">NTS, rPA, MnPO, SON, thalamus</td>
<td align="left">
<xref ref-type="bibr" rid="B51">Huang et al. (2014)</xref>, <xref ref-type="bibr" rid="B131">Yuan et al. (2017)</xref>, <xref ref-type="bibr" rid="B82">Oishi et al. (2017)</xref>, <xref ref-type="bibr" rid="B102">Shimaoka et al. (2018)</xref>, <xref ref-type="bibr" rid="B104">Silvani et al., 2018</xref>, <xref ref-type="bibr" rid="B65">Li et al., 2020</xref>
</td>
</tr>
<tr>
<td align="left">Roles of adenosine receptors</td>
<td align="left">A<sub>1</sub>R-mediated sleep-wake effects are brain region-dependent; A<sub>2A</sub>Rs promote sleep by inhibiting arousal systems</td>
<td align="left">Activation of A<sub>1</sub>Rs or A<sub>3</sub>Rs mimic the induction of torpor</td>
<td align="left">A<sub>1</sub>Rs may mediate hibernation <italic>via</italic> regulating core body temperature</td>
<td align="left">
<xref ref-type="bibr" rid="B51">Huang et al. (2014)</xref>, <xref ref-type="bibr" rid="B23">Drew et al. (2017)</xref>, <xref ref-type="bibr" rid="B104">Silvani et al. (2018)</xref>, <xref ref-type="bibr" rid="B62">Lazarus et al. (2019a)</xref>
</td>
</tr>
</tbody>
</table>
</table-wrap>
<fig id="F3" position="float">
<label>FIGURE 3</label>
<caption>
<p>The relevant brain regions about adenosine and P1 receptors mediate sleep, torpor, and hibernation. The CNS adenosine and P1 receptors are important for the regulation of sleep-wake, torpor and hibernation. The roles and mechanisms of several brain regions and nuclei have been gradually revealed, such as the A<sub>2A</sub>Rs-expressing neurons in the NAc, striatum, OT and other structures have a significant effect on sleep-wake regulation. The NTS and rPA may be the key brain regions of adenosine and P1 receptors mediating torpor and hibernation. NAc, nucleus accumbens; OT, olfactory tubercle; LH, lateral hypothalamus; BF, basal forebrainvlpo; VLPO, ventrolateral preoptic nucleus; LPO, lateral preoptic area; MnPO, median preoptic area; SON, supraoptic nucleus; TMN, tuberomammillary nucleus; rPA, raphe pallidus; NTS, nucleus tractus solitarius.</p>
</caption>
<graphic xlink:href="fphar-14-1098976-g003.tif"/>
</fig>
<p>It is worth noting that the adenosine system is also altered in various sleep disorders, for example, sleeping sickness and chronic insomnia disorder (<xref ref-type="bibr" rid="B93">Rijo-Ferreira et al., 2020</xref>; <xref ref-type="bibr" rid="B92">Ren et al., 2021</xref>). Some agonists, antagonists, or allosteric modulators targeting adenosine receptors have the potential to be used for treating sleep disorders (<xref ref-type="bibr" rid="B53">Jenner et al., 2020</xref>; <xref ref-type="bibr" rid="B59">Korkutata et al., 2022</xref>) or inducing synthetic torpor or hibernation for therapeutic hypothermia, organ preservation, space exploration or longevity promotion (<xref ref-type="bibr" rid="B54">Jinka et al., 2015</xref>; <xref ref-type="bibr" rid="B12">Cerri, 2017</xref>; <xref ref-type="bibr" rid="B106">Sisa et al., 2017</xref>; <xref ref-type="bibr" rid="B43">Hadj-Moussa and Storey, 2019</xref>; <xref ref-type="bibr" rid="B1">Al-Attar and Storey, 2020</xref>; <xref ref-type="bibr" rid="B13">Cerri et al., 2021</xref>), showing that the pharmacological importance of targeting adenosine receptors in the future. However, much work remains to be done because small-molecule drugs targeting adenosine receptors have side effects (<xref ref-type="bibr" rid="B59">Korkutata et al., 2022</xref>) and can only mimic some physiological properties of torpor or hibernation by activating adenosine receptors, which is different from natural torpor or hibernation (<xref ref-type="bibr" rid="B114">Swoap, 2017</xref>; <xref ref-type="bibr" rid="B125">Vicent et al., 2017</xref>). Therefore, it is necessary to explore further the roles and mechanisms of adenosine and its receptors in sleep, torpor, and hibernation and gain more adenosine receptor modulators by structure- and function-based drug discovery. It is important to investigate the neural networks and molecular mechanisms that sleep torpor and hibernation have in common. The first step in conducting these studies is to confirm adenosine accumulation before torpor or hibernation and the dynamic changes in adenosine concentrations during torpor or hibernation using available technologies such as microdialysis, adenosine probes, and chemogenetic and optogenetic methods. Subsequently, several key technologies, from conditional knockout mice based on Cre/lox technology and RNA interference to modulation of neuronal activity with genetic or pharmacological techniques, can be used to confirm neuronal networks of sleep, torpor, and hibernation.</p>
</sec>
</body>
<back>
<sec id="s7">
<title>Author contributions</title>
<p>W-XM, P-CY, and HZ wrote the manuscript. L-XK provided some advices and drew figures. Z-LH, W-MQ, Y-QW, and ML edited and revised the manuscript. All the authors have read and agreed to the content of the manuscript.</p>
</sec>
<sec id="s8">
<title>Funding</title>
<p>This study was supported by the STI 2030-major project (2021ZD0203400 to Z-LH), the China National Key R&#x26;D Program; National Key Research and Development Program (2022YFA1604504 to Y-QW), the National Natural Science Foundation of China (82171479, 81871037 to Y-QW; 82020108014 and 32070984 to Z-LH), the Shanghai Science and Technology Innovation Action Plan Laboratory Animal Research Project (201409001800 to Z-LH), Program for Shanghai Outstanding Academic Leaders (to Z-LH), the Shanghai Municipal Science and Technology Major Project, and ZJ Lab, and Shanghai Center for Brain Science and Brain-inspired Technology (2018SHZDZX01 to Z-LH), Japan Society for the Promotion of Science [Grants-in-Aid for Scientific Research B (grant number 21H02802) and RECONNECT Initiative (grant number JP22K21351) to ML]; the Japan Science and Technology Agency [CREST (grant number JPMJCR1655) to ML]; Japan Agency for Medical Research and Development (AMED) [Moonshot Program (grant number JP21zf0127005) to ML]; the project &#x201C;Social Application of Mobility Innovation and Future Social Engineering Research Phase IV (grant number CRI04006),&#x201D; a joint research project between Toyota Motor Corporation and the University of Tsukuba to ML; and the World Premier International Research Center Initiative (WPI) from MEXT to ML.</p>
</sec>
<sec sec-type="COI-statement" id="s9">
<title>Conflict of interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
<sec sec-type="disclaimer" id="s10">
<title>Publisher&#x2019;s note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
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<sec id="s11">
<title>Glossary</title>
<def-list>
<def-item>
<term id="G1-fphar.2023.1098976">
<bold>A</bold>
<sub>
<bold>1</bold>
</sub>
<bold>Rs</bold>
</term>
<def>
<p>adenosine A<sub>1</sub> receptors</p>
</def>
</def-item>
<def-item>
<term id="G2-fphar.2023.1098976">
<bold>A</bold>
<sub>
<bold>2A</bold>
</sub>
<bold>Rs</bold>
</term>
<def>
<p>adenosine A<sub>2A</sub> receptors</p>
</def>
</def-item>
<def-item>
<term id="G3-fphar.2023.1098976">
<bold>A</bold>
<sub>
<bold>2B</bold>
</sub>
<bold>Rs</bold>
</term>
<def>
<p>adenosine A<sub>2B</sub> receptors</p>
</def>
</def-item>
<def-item>
<term id="G4-fphar.2023.1098976">
<bold>A</bold>
<sub>
<bold>3</bold>
</sub>
<bold>Rs</bold>
</term>
<def>
<p>adenosine A<sub>3</sub> receptors</p>
</def>
</def-item>
<def-item>
<term id="G5-fphar.2023.1098976">
<bold>AC</bold>
</term>
<def>
<p>adenylate cyclase</p>
</def>
</def-item>
<def-item>
<term id="G6-fphar.2023.1098976">
<bold>ADK</bold>
</term>
<def>
<p>adenosine kinase</p>
</def>
</def-item>
<def-item>
<term id="G7-fphar.2023.1098976">
<bold>ADP</bold>
</term>
<def>
<p>adenosine diphosphate</p>
</def>
</def-item>
<def-item>
<term id="G8-fphar.2023.1098976">
<bold>AMP</bold>
</term>
<def>
<p>adenosine monophosphate</p>
</def>
</def-item>
<def-item>
<term id="G9-fphar.2023.1098976">
<bold>ATP</bold>
</term>
<def>
<p>adenosine triphosphate</p>
</def>
</def-item>
<def-item>
<term id="G10-fphar.2023.1098976">
<bold>BAT</bold>
</term>
<def>
<p>brown adipose tissue</p>
</def>
</def-item>
<def-item>
<term id="G11-fphar.2023.1098976">
<bold>BF</bold>
</term>
<def>
<p>basal forebrain</p>
</def>
</def-item>
<def-item>
<term id="G12-fphar.2023.1098976">
<bold>BMR</bold>
</term>
<def>
<p>basal metabolic rate</p>
</def>
</def-item>
<def-item>
<term id="G13-fphar.2023.1098976">
<bold>BP</bold>
</term>
<def>
<p>blood pressure</p>
</def>
</def-item>
<def-item>
<term id="G14-fphar.2023.1098976">
<bold>cAMP</bold>
</term>
<def>
<p>cyclic adenosine-3,5 monophosphate</p>
</def>
</def-item>
<def-item>
<term id="G15-fphar.2023.1098976">
<bold>CHA</bold>
</term>
<def>
<p>N6-cyclohexyladenosine</p>
</def>
</def-item>
<def-item>
<term id="G16-fphar.2023.1098976">
<bold>CNS</bold>
</term>
<def>
<p>central nervous system</p>
</def>
</def-item>
<def-item>
<term id="G17-fphar.2023.1098976">
<bold>CPA</bold>
</term>
<def>
<p>N6-cyclopentyladenosine</p>
</def>
</def-item>
<def-item>
<term id="G18-fphar.2023.1098976">
<bold>EEG</bold>
</term>
<def>
<p>electroencephalographic</p>
</def>
</def-item>
<def-item>
<term id="G19-fphar.2023.1098976">
<bold>EMG</bold>
</term>
<def>
<p>electromyography</p>
</def>
</def-item>
<def-item>
<term id="G20-fphar.2023.1098976">
<bold>E-NTPDase</bold>
</term>
<def>
<p>ecto-nucleoside triphosphate diphosphohydrolase</p>
</def>
</def-item>
<def-item>
<term id="G21-fphar.2023.1098976">
<bold>Gi</bold>
</term>
<def>
<p>inhibitory adenylate cyclase G protein</p>
</def>
</def-item>
<def-item>
<term id="G22-fphar.2023.1098976">
<bold>GPCR</bold>
</term>
<def>
<p>G protein coupled receptor</p>
</def>
</def-item>
<def-item>
<term id="G23-fphar.2023.1098976">
<bold>GPe</bold>
</term>
<def>
<p>external globus pallidus</p>
</def>
</def-item>
<def-item>
<term id="G24-fphar.2023.1098976">
<bold>Gs</bold>
</term>
<def>
<p>stimulating adenylate cyclase G protein</p>
</def>
</def-item>
<def-item>
<term id="G25-fphar.2023.1098976">
<bold>HP</bold>
</term>
<def>
<p>heart period</p>
</def>
</def-item>
<def-item>
<term id="G26-fphar.2023.1098976">
<bold>HR</bold>
</term>
<def>
<p>heart rate</p>
</def>
</def-item>
<def-item>
<term id="G27-fphar.2023.1098976">
<bold>KATP</bold>
</term>
<def>
<p>ATP sensitive potassium channel</p>
</def>
</def-item>
<def-item>
<term id="G28-fphar.2023.1098976">
<bold>LH</bold>
</term>
<def>
<p>lateral hypothalamus</p>
</def>
</def-item>
<def-item>
<term id="G29-fphar.2023.1098976">
<bold>MR</bold>
</term>
<def>
<p>metabolic rates</p>
</def>
</def-item>
<def-item>
<term id="G30-fphar.2023.1098976">
<bold>NAc</bold>
</term>
<def>
<p>nucleus accumbens</p>
</def>
</def-item>
<def-item>
<term id="G31-fphar.2023.1098976">
<bold>NBTIs</bold>
</term>
<def>
<p>nitrobenzyl-thio-inosine</p>
</def>
</def-item>
<def-item>
<term id="G32-fphar.2023.1098976">
<bold>NREM</bold>
</term>
<def>
<p>non-rapid eye movement</p>
</def>
</def-item>
<def-item>
<term id="G33-fphar.2023.1098976">
<bold>NTS</bold>
</term>
<def>
<p>nucleus tractus solitarius</p>
</def>
</def-item>
<def-item>
<term id="G34-fphar.2023.1098976">
<bold>OT</bold>
</term>
<def>
<p>olfactory tubercle</p>
</def>
</def-item>
<def-item>
<term id="G35-fphar.2023.1098976">
<bold>PAM</bold>
</term>
<def>
<p>positive allosteric modulator</p>
</def>
</def-item>
<def-item>
<term id="G36-fphar.2023.1098976">
<bold>PLC</bold>
</term>
<def>
<p>phospholipase C</p>
</def>
</def-item>
<def-item>
<term id="G37-fphar.2023.1098976">
<bold>PV</bold>
</term>
<def>
<p>parvalbumin</p>
</def>
</def-item>
<def-item>
<term id="G38-fphar.2023.1098976">
<bold>REM</bold>
</term>
<def>
<p>rapid eye movement</p>
</def>
</def-item>
<def-item>
<term id="G39-fphar.2023.1098976">
<bold>rPA</bold>
</term>
<def>
<p>raphe pallidus</p>
</def>
</def-item>
<def-item>
<term id="G40-fphar.2023.1098976">
<bold>MnPO</bold>
</term>
<def>
<p>median preoptic</p>
</def>
</def-item>
<def-item>
<term id="G41-fphar.2023.1098976">
<bold>SON</bold>
</term>
<def>
<p>supraoptic</p>
</def>
</def-item>
<def-item>
<term id="G42-fphar.2023.1098976">
<bold>SAH</bold>
</term>
<def>
<p>S-adenosylhomocysteine</p>
</def>
</def-item>
<def-item>
<term id="G43-fphar.2023.1098976">
<bold>SAHH</bold>
</term>
<def>
<p>S-adenosylhomocysteine hydrolase</p>
</def>
</def-item>
<def-item>
<term id="G44-fphar.2023.1098976">
<bold>SAM</bold>
</term>
<def>
<p>S-adenosylmethionine</p>
</def>
</def-item>
<def-item>
<term id="G45-fphar.2023.1098976">
<bold>SWS</bold>
</term>
<def>
<p>slow-wave sleep</p>
</def>
</def-item>
<def-item>
<term id="G46-fphar.2023.1098976">
<bold>Ta</bold>
</term>
<def>
<p>ambient temperature</p>
</def>
</def-item>
<def-item>
<term id="G47-fphar.2023.1098976">
<bold>T</bold>
<sub>
<bold>b</bold>
</sub>
</term>
<def>
<p>body temperature</p>
</def>
</def-item>
<def-item>
<term id="G48-fphar.2023.1098976">
<bold>TMN</bold>
</term>
<def>
<p>tuberomammillary nucleus</p>
</def>
</def-item>
<def-item>
<term id="G49-fphar.2023.1098976">
<bold>VLPO</bold>
</term>
<def>
<p>ventrolateral preoptic nucleus lateral preoptic area</p>
</def>
</def-item>
<def-item>
<term id="G50-fphar.2023.1098976">
<bold>LPO </bold>
</term>
<def>
<p>lateral preoptic</p>
</def>
</def-item>
<def-item>
<term id="G51-fphar.2023.1098976">
<bold>VP</bold>
</term>
<def>
<p>ventral pallidum &#x3b3;-aminobutyric acid</p>
</def>
</def-item>
<def-item>
<term id="G52-fphar.2023.1098976">
<bold>GABA</bold>
</term>
<def>
<p>&#x3b3;-aminobutyric acid</p>
</def>
</def-item>
<def-item>
<term id="G53-fphar.2023.1098976">
<bold>5&#x2032;-NT</bold>
</term>
<def>
<p>5&#x2032;-nucleotidase</p>
</def>
</def-item>
</def-list>
</sec>
</back>
</article>