The first attempts to identify the potential targets for methylxanthines reported four different mechanisms.
They were identified for caffeine acting on the central nervous system (reviewed [32]),but they may be extended to both other systems and other methylxanthines.
They consist of: regulation of intracellular calcium level, phosphodiesterase inhibition, modulation of GABAA receptor action, and antagonism of adenosine receptors. Caffeine and probably other methylxanthines stimulate calcium release from intracellular stores but at a high μM threshold concentration and with a maximal effect at 5–20 mM [33].
In addition, high concentrations are required for inhibition of phosphodiesterases [34], which are a family of enzymes that degrade cAMP and cGMP.
It therefore seems that at the concentrations reached in dietary intake, these compounds are not effectively acting on phosphodiesterases or on calcium release.
In addition, the low affinity of caffeine for GABAA receptors [35] suggested that normal human caffeine consumption is unlikely to produce doses high enough to produce anxiogenic effects by inhibiting these receptors.
In summary methylxanthines are mainly acting as adenosine receptor blockers, although other mechanisms may also operate, especially under the intake of caffeine supplements or methylxanthine-enriched medications