Figure 7.
Proposed model for A2AR activation and activation of autophagy. CGS21680 or adenosine binds the A2AR, a Gs-associated GPCR which signals via cAMP to activate PKA or EPAC1/2 (not shown) leading to activation of downstream signaling culminating in nuclear transport and activation of FoxO1/3. There is also nearly simultaneous export of initially nuclearly-located inactive AKT-phosphorylated FoxO1/3 that exits the nucleus on its way to proteosomal degradation. Active FoxO1/3 are known to lead to up-regulation of autophagy genes in addition to participation in other homeostatic pathways as listed in the box on the left. These processes lead to a reduction of OA with improved health of articular cartilage.