Recent progress in understanding and manipulating haemoglobin switching for the haemoglobinopathies
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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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Fetal hemoglobin in sickle cell anemia
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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
- bronze
- doi.org
- 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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