Raena Morgan: Hi, I'm Raena Morgan with iHealthTube, talking with Dr. Rapaport today. Dr. Rapaport, could you talk to us about ATP, and how it affects blood flow, and how it affects heart health? Dr. Eliezer Rapaport: Yes. It's a very, very important question. The Extracellular ATP in the blood stimulates blood flow by interacting with receptors on vascular endothelial cells. Vascular endothelial cells are the layer of the cells that lines up the blood vessels. Now, by interacting with vascular endothelial cells through the receptors, ATP produces vasodilation. Now, the vasodilation is in the level of about 8 to 10% increase in the blood vessel diameter, but this can achieve up to 17% increase in blood flow. Raena Morgan: 17%? That's considerable, isn't it? Dr. Eliezer Rapaport: Oh, it is, very considerable, especially when it's not, when it does not involve an increase in heart rate or blood pressure. Raena Morgan: Oh, okay. Dr. Eliezer Rapaport: In other words, a reduction in blood pressure. It does involve what's called a reduction in systemic and pulmonary vascular resistance. Now, the reduction in pulmonary vascular resistance which stimulates the flow through the lungs, is also extremely important, because it enables the blood to gather more oxygen that is then utilized in the extremities and the skeletal muscles. Now the stimulation of blood flow -- if there are two take home messages that I'd like people to take, one is the stimulation of blood flow with all its consequences, and the other one is glycemic control, the control of blood sugar with all its consequences. Raena Morgan: And these are good consequences? Positive? Dr. Eliezer Rapaport: These are excellent consequences. Now, let's talk about stimulation of blood flow. Stimulation of blood flow stimulates the disposal of oxygen, nutrients, such as glucose, which is the main sugar, into skeletal muscles mostly. Skeletal muscles take about 70% of the sugar in the blood. Raena Morgan: The skeletal muscles take 70% of the sugar in the blood? Dr. Eliezer Rapaport: Yes. And that is done through a specific transporter that is expressed under the effect of ATP and adenosine. Now, in addition, adenosine also improves the interaction of insulin with insulin receptor, and that interaction also stimulates the expression of the major glucose transporter, and that's called GLUT-4. But basically, stimulation of blood flow means quicker enhancement of delivery of nutrients, oxygen into organs, mostly skeletal muscles, along with the removal of waste products such as lactic acid and ammonia. I should take the opportunity to mention that ATP is now an approved drug in France and goes under the brand name of Adipogen. Raena Morgan: Oh it is? Adipogen. Dr. Eliezer Rapaport: Yeah, it's the indication is that lower back pain, or sub acute lower back pain, which is called also lumbago, and this is again a case of muscular pain, because they selected patients only by the fact that they had muscular pain and not pain due to fractures or tumors or so forth. And again, the removal of waste products and the stimulation of nutrients, disposal into the muscle causes this highly positive effect. Raena Morgan: Okay. Well, thank you Dr. Rapaport for giving us that valuable information.