After a brief initial description of some of the important steps in the establishment of purinergic signalling, the talk will focus on some of the exciting developments relating to purinergic pathophysiology and potential therapeutic applications. There will be discussion of the long-term trophic effects of purines and pyrimidines in blood vessel remodelling in restenosis; plasticity of purinergic cotransmission of diseased urinary bladder and hypertensive rats; sperm motility in IVF; purinergic mechanosensory transduction in visceral pain and the role of spinal microglial purinoceptors in neuropathic pain; the potential for P2X₇ receptor antagonists in osteoporosis and kidney failure; the growing literature about the roles of purinergic signalling of disorders of the central nervous system; and the role of ATP in the treatment of cancer. Finally, a novel hypothesis will be presented for the involvement of purinergic signalling in acupuncture.