Besides its capacity to regulate the local inflammatory context through consumption of ATP and generation of adenosine, the expression of CD39/CD73 by endothelial cells can regulate homeostasis by preventing high local concentrations of ATP that promote thrombosis and generating adenosine which instead, contributes to an antithrombotic microenvironment [
44]. The CD39/CD73 axis also regulates leukocyte migration induced by chemokines [
68,
69] and immune cell adhesion to endothelial cells. Such adhesion is favored by high ATP concentrations and limited by adenosine, with mutant mice lacking CD39 or CD73 having augmented level of leukocyte adhesion to endothelial cells [
70,
71]. Thus, adenosine contributes to restraining leukocyte recruitment and platelet aggregation and might be important to control vascular inflammation.
We have observed that CD73-generated adenosine promotes the entry of inflammatory lymphocytes into the CNS during EAE development [
43]. Genetically manipulated mice unable to generate extracellular adenosine due to deficiency in the ectonucleotidase CD73 (CD73
−/−) are resistant to lymphocyte entry into the CNS and EAE development relative to wild type animals and such a phenotype could be recapitulated in regular mice by using either the broad spectrum AR antagonist, caffeine or the SCH58261 that selectively antagonizes the signaling induced by adenosine-bound A
2A receptor [
43,
72‐
74]. This effect was remarkable since auto-reactive lymphocytes from CD73
−/− mice indeed harbor an enhanced inflammatory potential. In addition, the expression of CD73 (and presumably its enzymatic activity) on either T cells or CNS cells was sufficient to support lymphocyte entry into the CNS since CD4 T cells from wild type donors (i.e. CD73
+) could mediate a milder yet substantial level of EAE pathogenesis in CD73
−/− recipient mice [
43].
Since CD73 and the A
1/A
2A receptors are expressed at the level of the choroid plexus, locally produced extracellular adenosine is likely to act in an autocrine manner. Given that A
1 and A
2A receptor recruitment are functionally opposed to each other and harbor some differences in their affinity for adenosine [
26], the regional extracellular concentration of adenosine may strongly influence the response of neighboring cells expressing both receptors. A
1 receptor signaling may be involved at low adenosine concentrations while A
2A receptor signaling is likely to become prominent at elevated adenosine concentrations. Thus, CD73 enzymatic activity at the choroid plexus and the regional adenosine levels are likely to influence local inflammatory events. Interestingly, the choroid plexus is suspected to represent a primary entry site for immune cells during neuroinflammation [
3‐
5] and for steady state immunosurveillance [
6,
75]. By combining the gene expression pattern of chemokines and chemokine receptors relevant to EAE in CD73 null mutant versus control mice developing EAE and the effect of the broad spectrum AR agonist NECA on the expression profile of these molecules in unmanipulated animals, it was possible to identify CX3CL1/fractalkine, a chemokine/adhesion molecule [
76], as the major factor induced by extracellular adenosine in the brain of mice developing EAE [
77]. The cleavage of the cell surface-expressed form of CX3CL1 by ADAM-10 and −17 factors generates a local CX3CL1 gradient [
78]. The selective A
2A AR agonist CGS21680 caused an increase in CX3CL1 level in the brain of treated mice. Conversely, the A
2A AR antagonist SCH58261 protected mice from CNS lymphocyte infiltration and EAE induction recapitulating the phenotype of CD73 null mutant mice. Thus, the augmented CX3CL1 expression level seen in the brain of EAE developing mice can be regulated by A
2A AR signaling. During EAE, the greatest increase in CX3CL1 occurred at the choroid plexus and returned to normal when mice recovered from disease. As choroid plexus cells express both CD73 and A
2A AR, they have the intrinsic capacity to generate and respond to extracellular adenosine. In vitro, A
2A AR engagement on the choroid plexus epithelial cell line CPLacZ-2 by CGS21680 induced CX3CL1 expression and promoted lymphocyte transmigration suggesting that CX3CL1 induction by extracellular adenosine contributes to lymphocyte migration into the brain parenchyma during EAE. In agreement with an important role for CX3CL1 in EAE pathogenesis is the fact that CX3CL1 blockade by neutralizing antibodies prevented lymphocyte entry into the CNS and EAE development [
77]. This notion is in line with the elevated serum level of CX3CL1 which can be observed during CNS inflammation including MS patient brain lesions [
79‐
81]. Importantly, there was a positive correlation between CX3CL1 expression levels and the relative frequency of lymphocytes present in the CSF of inflamed brains [
80,
82]. Moreover, relative to BBB endothelial cells, choroid plexus epithelial cells constitutively express high levels of CD73. Blockade of CD73 or A
2A AR inhibits inflammatory cells entry into the CNS [
43,
77]. Thus, at the level of the choroid plexus, induction of A
2A receptor signaling by elevated local adenosine concentrations is likely to contribute to immune cell entry into the brain parenchyma.
Among immune cells, the CX3CL1 receptor (CX3CR1) was detected on a sizable fraction of CD4 T cells, CD8 T cells, macrophages and NK cells in mice [
33]. CNS CX3CL1 might also modulate neuroinflammation by recruiting a subset of CNS resident NK cells able to attenuate the aggressiveness of autoreactive CD4 T cells of the Th17 effector type [
83,
84]. Interestingly, while the frequency of inflammatory immune cells is significantly decreased in the CNS of A
2A AR
−/−, CD73
−/− or mice treated with A
2A AR antagonist, the numbers/frequency of CD4
+CD25
+ T regulatory cells in these mice were similar to WT. This suggests that CD73/A
2A AR signaling may preferentially regulate inflammatory immune cells entry into the CNS but confers less stringency on these suppressor T cells.