Numerous diseases, including obesity, diabetes, cardiovascular disorders, dementia-associated cognitive decline and sarcopenia are characterized by underlying inflammatory processes that contribute to disease progression. Purinergic signalling is widely recognized as a key modulator of inflammation. This system involves extracellular nucleotides (i.e., ATP, ADP, UTP, and UDP) and nucleosides (i.e., adenosine), which are detected by two receptor families: P2 receptors (for nucleotides) and P1 receptors (for nucleosides), expressed on various cell types. The regulation of extracellular ATP and adenosine levels is mediated by ecto-enzymes, particularly NTPDase1/CD39 and 5’-Nucleotidase/CD73, which sequentially degrade ATP to adenosine, as well as by nucleotide/nucleoside transporters. Generally, ATP-activated P2 receptors promote pro-inflammatory responses, whereas adenosine, acting via P1 receptors, exerts predominantly anti-inflammatory and immunosuppressive effects. Consequently, modulating inflammatory conditions through purinergic signalling may represent a promising therapeutic strategy for these diseases.In this research topic we have compiled 6 original research articles that provide up-to-date insights into the role of purinergic signalling in inflammatory diseases.Purinergic signalling in metabolic disordersMetabolic disorders represent a major cause of morbidity and mortality in developed countries. These disorders are often associated to obesity that is closely linked to chronic low-grade inflammation, primarily originating from dysfunctional adipose tissue. As adipose tissue expands, adipocytes become hypertrophic, leading to mechanical and metabolic stress that promotes the release of inflammatory mediators such as tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), interleukin-1apha (IL-1α) and monocyte chemoattractant protein-1 (MCP-1)These signals attract immune cells, particularly macrophages, that infiltrate the adipose tissue and shift toward a pro-inflammatory M1 phenotype [1]. The immune activation further amplifies inflammation through secretion of additional cytokines, production of reactive oxygen species (ROS), and activation of transcription factors like NF-κB. The inflammatory milieu disrupts insulin signalling pathways, contributing to insulin resistance and metabolic syndrome, thereby linking inflammation in obesity to a broad range of systemic dysfunctions [2].The low-grade inflammation that accompanies obesity very likely implies the activation of P2X7R, a main receptor for extracellular ATP (eATP) [3], contributing to adipose tissue dysfunction. Among the regulatory mechanisms of P2X7R expression, the role of sex steroids remains unclear. Authors described that under non-inflammatory (basal) conditions, treatment of human adipocytes with either testosterone (T) or 17β-estradiol (E2) did not significantly alter the P2X7R gene expression [4]. In contrast, exposure to dihydrotestosterone (DHT), a non-aromatizable androgen, led to a notable downregulation of P2X7R gene expression. Exposure of adipocytes to LPS, significantly increased P2X7R expression compared to baseline levels. Remarkably, pre-treatment with DHT prior to LPS exposure further enhanced the P2X7R gene expression, indicating that DHT sensitizes adipocytes to inflammatory activation. A similar enhancement was observed when adipocytes were pre-treated with testosterone in combination with anastrozole, an aromatase inhibitor that prevents conversion of testosterone into estradiol. While this combination had no significant effect on P2X7R expression at rest, it led to a pronounced upregulation following LPS stimulation. These findings highlight the modulatory role of sex steroids, particularly non-aromatizable androgens like DHT, on purinergic signaling in adipocytes. The results suggest that androgens can exert dual effects depending on the inflammatory state of the tissue and point to a sex-dependent regulation of adipose tissue inflammation via the P2X7R, a key component of the immune response machinery.Obesity can contribute to inflammatory evolution in different tissues and organs. Supernatants from the periprostatic adipose tissue (PPAT) of obese mice showed significantly elevated levels of total nitrate and nitrite (NOx⁻) and adenosine compared to controls, and diminished phenylephrine (PE)-induced contractions, but only in prostate tissues from obese mice [5]. This anticontractile effect was mitigated when the PPAT was co-incubated with NO pathway inhibitors or adenosine receptor (AR) antagonists, suggesting these pathways as mediators of the observed effects. PPAT supernatants from obese animals also enhanced the viability of PNT1-A normal human epithelial cells and suppressed caspase-3 expression, indicating anti-apoptotic activity. Moreover, BPH-1 (hyperplasic human epithelial) cells exhibited increased proliferation at all time points when exposed to PPAT supernatant, an effect significantly blunted by blocking NO signaling or AR activation. These findings highlight a functional role for NO and adenosine released from PPAT in modulating prostate contractility and epithelial cell proliferation. In obesity, this paracrine interaction may contribute to prostate dysfunction and disease progression. Further studies are warranted to explore the therapeutic potential of targeting PPAT-derived NO and adenosine in prostate-related pathologies.An established model for obesity-induced type 2 diabetes, represented by Zucker Diabetic Fatty (ZDF) rats was employed to investigate the impact of Cannabidiol (CBD), a nonpsychoactive compound derived from the cannabis plant with a wide range of reported therapeutic properties, on the adenosinergic signalling pathway within the myocardium, specifically focused on the left atria [6]. The animals, fed with a diabetogenic diet, received daily oral administration of CBD (60 mg/kg) or vehicle for four weeks. The...