Cited by 114Hemoglobinopathies and Related DisordersHemoglobin structure and functionKruppel-like factors research

Recent progress in understanding and manipulating haemoglobin switching for the haemoglobinopathies

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Vinjamur, Divya S., Bauer, Daniel E., Orkin, Stuart H.·2018·British Journal of Haematology

Abstract

Summary: The major β‐haemoglobinopathies, sickle cell disease and β‐thalassaemia, represent the most common monogenic disorders worldwide and a steadily increasing global disease burden. Allogeneic haematopoietic stem cell transplantation, the only curative therapy, is only applied to a small minority of patients. Common clinical management strategies act mainly downstream of the root causes of disease. The observation that elevated fetal haemoglobin expression ameliorates these disorders has motivated longstanding investigations into the mechanisms of haemoglobin switching. Landmark studies over the last decade have led to the identification of two potent transcriptional repressors of γ‐globin, BCL 11A and ZBTB 7A. These regulators act with additional trans‐acting epigenetic repressive complexes, lineage‐defining factors and developmental programs to silence fetal haemoglobin by working on cis‐acting sequences at the globin gene loci. Rapidly advancing genetic technology is enabling researchers to probe deeply the interplay between the molecular players required for γ‐globin (HBG 1/HBG 2) silencing. Gene therapies may enable permanent cures with autologous modified haematopoietic stem cells that generate persistent fetal haemoglobin expression. Ultimately rational small molecule pharmacotherapies to reactivate HbF could extend benefits widely to patients.

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  • Inactivation and activation of genes within the b-globin gene cluster holds the keys to reactivating the usually dormant HbF genes for therapeutic gain.

    “Inactivation and activation of genes within the b-globin gene cluster holds the keys to reactivating for therapeutic gain the usually dormant HbF genes.[6][7][8][9][10][11][12]”

    From Fetal hemoglobin in sickle cell anemia (2020) · cites this paper as [7]

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Research works printed but not linked: 2

  1. [77]77. Modell, B. & Darlison, M. (2008) Global epidemi- ology of haemoglobin disorders and derived ser- vice indicators. Bulletin of the World Health Organization, 86, 480-487.
  2. [139]139. Yoshida, M., Nakashima, M., Okanishi, T., Kanai, S., Fujimoto, A., Itomi, K., Morimoto, M., Saitsu, H., Kato, M., Matsumoto, N. & Chiy- onobu, T. (2017) Identification of novel BCL11A variants in patients with epileptic encephalopathy: expanding the phenotypic spec- trum. Clinical Genetics. https://doi.org/10.1111/ cge.13067

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Authors
Vinjamur, D. S., Bauer, D. E., & Orkin, S. H.
Affiliations
Boston Children's Hospital (US)
Corresponding author
Bauer, Daniel E.
Venue
British Journal of Haematology
Publisher
Wiley
Published
2017-11-28
Volume
180
Issue
5
Pages
630-643
ISSN
  • 0007-1048 (ISSN-L)
  • 1365-2141
OpenAlex
W2769524667
Cited by
114
References
143
Citations by year
2026: 9 · 2025: 6 · 2024: 12 · 2023: 15 · 2022: 10 · 2021: 17 · 2020: 24 · 2019: 13 · 2018: 8
FWCI
1.74
Type
journal article
Language
en
Open access
Locations
  • British Journal of Haematology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Genetics › Hemoglobinopathies and Related Disorders
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Hemoglobin structure and function
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Kruppel-like factors research
Keywords
sickle cell disease, beta-thalassemia, fetal hemoglobin, BCL11A, ZBTB7A, globin gene regulation, gene therapy, hemoglobinopathies
MeSH terms
Animals, Carrier Proteins, Disease Models, Animal, DNA-Binding Proteins, Genes, Switch, Globins, Hemoglobinopathies, Hemoglobins, Humans, Nuclear Proteins, Repressor Proteins, Transcription Factors, Oncogene Proteins v-myb, Epigenesis, Genetic, Mice, Kruppel-Like Transcription Factors, Fetal Globulins

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