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A ribonucleotide analog of adenosine monophosphate that is an intermediate in the synthesis of inosine monophosphate with potential cardioprotective activity. During myocardial ischemia, AICA-ribotide activates AMP-dependent protein kinase (AMPK), inhibits adenosine deaminase (ADA) and causes increased synthesis of both adenosine and adenosine triphosphate (ATP). These activities prevent calcium overload, increase AMPK-dependent glucose uptake and improve blood flow to the heart. AMPK, a protein kinase complex, regulates several cellular systems including the uptake of glucose, the beta-oxidation of fatty acids, protein synthesis, and the biogenesis of both glucose transporter 4 (GLUT4) and mitochondria. ADA is a key enzyme involved in purine metabolism.
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