Endotoxemia (Sepsis) affects horses of all breeds and ages and is the leading causes of death in adult horses and foals. Consequently, its economic impact on the equine industry in the United States is devastating. This project seeks to develop new treatments for this disease. OBJECTIVES: Endotoxemia is associated with the leading causes of death in horses and foals, and has a huge economic impact on the US equine industry. The deleterious effects of endotoxin are due to pro-inflammatory mediators released by the horses white blood cells, and current methods of treatment fail to adequately modulate production of these mediators. Based on recent studies showing that adenosine A2A receptor agonists protect laboratory animals against lethal effects of endotoxins, in Phase I we showed that A2A receptor agonists synthesized by Adenosine Therapeutics avidly bind equine A2A receptors, significantly reduce the pro-inflammatory effects of endotoxin in vitro, and exert these anti-inflammatory effects at remarkably low dosages. APPROACH: This Phase II study proposes to address the following objectives: 1) Screen newly synthesized A2A agonists for receptor binding selectivity and anti-inflammatory effects, and scale-up synthesis of selected agonists for administration to horses, 2) Perform in vivo studies to identify dosages that can be administered safely to horses, 3) Determine the duration of anti-inflammatory effects, and 4) Test the most selective and longest acting compound in an in vivo model of equine endotoxemia. Successful completion of these studies will provide the basis for a new efficacious method of treating endotoxemia in horses.