ADORA2A and gout: Inosine is assigned to Tier 2 for its ability to sustain glycolytic function in CD8+ T cells within glucose-deprived TMEs (119) and early Phase II clinical trial data (NCT05809336) showing a 50% disease control rate, though this classification also highlights risks such as biphasic A2aR signaling (which suppresses Th1 immune responses in IFN-γ-deficient contexts; 169) and potential hyperuricemia in gout patients (122).