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Zurlo M, Zuccato C, Cosenza LC, Gamberini MR, Finotti A, Gambari R. Increased Expression of α-Hemoglobin Stabilizing Protein (AHSP) mRNA in Erythroid Precursor Cells Isolated from β-Thalassemia Patients Treated with Sirolimus (Rapamycin). J Clin Med 2024; 13:2479. [PMID: 38731008 PMCID: PMC11084795 DOI: 10.3390/jcm13092479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 04/18/2024] [Accepted: 04/20/2024] [Indexed: 05/13/2024] Open
Abstract
Background/Objectives: in β-thalassemia, important clinical complications are caused by the presence of free α-globin chains in the erythroid cells of β-thalassemia patients. These free α-globin chains are present in excess as a result of the lack of β-globin chains to bind with; they tend to aggregate and precipitate, causing deleterious effects and overall cytotoxicity, maturation arrest of the erythroid cells and, ultimately, ineffective erythropoiesis. The chaperone protein α-hemoglobin-stabilizing protein (AHSP) reversibly binds with free α-globin; the resulting AHSP-αHb complex prevents aggregation and precipitation. Sirolimus (rapamycin) has been previously demonstrated to induce expression of fetal hemoglobin and decrease the excess of free α-globin chain in the erythroid cells of β-thalassemia patients. The objective of this study was to verify whether sirolimus is also able to upregulate AHSP expression in erythroid precursor cells (ErPCs) isolated from β-thalassemia patients. Methods: the expression of AHSP genes was analyzed by measuring the AHSP mRNA content by real-time quantitative PCR (RT-qPCR) and the AHSP protein production by Western blotting. Results: AHSP gene expression was found to be higher in ErPCs of β-thalassemia patients in comparison to ErPCs isolated from healthy subjects. In addition, AHSP expression was further induced by treatment of β-thalassemia ErPCs with sirolimus. Finally, AHSP mRNA was expressed at an increased level in ErPCs of sirolimus-treated β-thalassemia patients participating in the NCT03877809 Sirthalaclin clinical trial. Conclusions: this exploratory study suggests that AHSP expression should be considered as an endpoint in clinical trials based on sirolimus.
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Affiliation(s)
- Matteo Zurlo
- Department of Life Sciences and Biotechnology, Ferrara University, 44121 Ferrara, Italy; (M.Z.); (C.Z.); (L.C.C.)
| | - Cristina Zuccato
- Department of Life Sciences and Biotechnology, Ferrara University, 44121 Ferrara, Italy; (M.Z.); (C.Z.); (L.C.C.)
- Center “Chiara Gemmo and Elio Zago” for the Research on Thalassemia, Department of Life Sciences and Biotechnology, Ferrara University, 44121 Ferrara, Italy;
| | - Lucia Carmela Cosenza
- Department of Life Sciences and Biotechnology, Ferrara University, 44121 Ferrara, Italy; (M.Z.); (C.Z.); (L.C.C.)
| | - Maria Rita Gamberini
- Center “Chiara Gemmo and Elio Zago” for the Research on Thalassemia, Department of Life Sciences and Biotechnology, Ferrara University, 44121 Ferrara, Italy;
| | - Alessia Finotti
- Department of Life Sciences and Biotechnology, Ferrara University, 44121 Ferrara, Italy; (M.Z.); (C.Z.); (L.C.C.)
- Center “Chiara Gemmo and Elio Zago” for the Research on Thalassemia, Department of Life Sciences and Biotechnology, Ferrara University, 44121 Ferrara, Italy;
| | - Roberto Gambari
- Department of Life Sciences and Biotechnology, Ferrara University, 44121 Ferrara, Italy; (M.Z.); (C.Z.); (L.C.C.)
- Center “Chiara Gemmo and Elio Zago” for the Research on Thalassemia, Department of Life Sciences and Biotechnology, Ferrara University, 44121 Ferrara, Italy;
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Chauhan W, Zennadi R. Keap1-Nrf2 Heterodimer: A Therapeutic Target to Ameliorate Sickle Cell Disease. Antioxidants (Basel) 2023; 12:antiox12030740. [PMID: 36978988 PMCID: PMC10045360 DOI: 10.3390/antiox12030740] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/04/2023] [Accepted: 03/15/2023] [Indexed: 03/19/2023] Open
Abstract
Sickle cell disease (SCD) is a monogenic inheritable disease characterized by severe anemia, increased hemolysis, and recurrent, painful vaso-occlusive crises due to the polymerization of hemoglobin S (HbS)-generated oxidative stress. Up until now, only four drugs are approved for SCD in the US. However, each of these drugs affects only a limited array of SCD pathologies. Importantly, curative therapies, such as gene therapy, or hematopoietic stem cell transplantation are not available for every patient because of their high costs, availability of donor matching, and their serious adverse effects. Therefore, there is an unmet medical need for novel therapeutic strategies that target broader SCD sequelae. SCD phenotypic severity can be alleviated by increasing fetal hemoglobin (HbF) expression. This results in the inhibition of HbS polymerization and thus sickling, and a reduction in oxidative stress. The efficacy of HbF is due to its ability to dilute HbS levels below the threshold required for polymerization and to influence HbS polymer stability in RBCs. Nuclear factor-E2-related factor 2 (Nrf2)/Kelch-like ECH-associated protein-1 (Keap1)-complex signaling is one of the most important cytoprotective signaling controlling oxidative stress. Nrf2 is present in most organs and, after dissociation from Keap1, it accumulates in the cytoplasm, then translocates to the nucleus where it binds to the antioxidant response element (ARE) sequences and increases the expression of various cytoprotective antioxidant genes. Keeping this in mind, various researchers have proposed a role of multiple agents, more importantly tert-Butylhydroquinone (tBHQ), curcumin, etc., (having electrophilic properties) in inhibiting keap1 activity, so that Nrf2 can translocate to the nucleus to activate the gamma globin gene, thus maintaining alpha-hemoglobin-stabilizing protein (AHSP) and HbF levels. This leads to reduced oxidative stress, consequently minimizing SCD-associated complications. In this review, we will discuss the role of the Keap-1–Nrf2 complex in hemoglobinopathies, especially in SCD, and how this complex might represent a better target for more effective treatment options.
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Bou-Fakhredin R, De Franceschi L, Motta I, Eid AA, Taher AT, Cappellini MD. Redox Balance in β-Thalassemia and Sickle Cell Disease: A Love and Hate Relationship. Antioxidants (Basel) 2022; 11:antiox11050967. [PMID: 35624830 PMCID: PMC9138068 DOI: 10.3390/antiox11050967] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/11/2022] [Accepted: 05/11/2022] [Indexed: 11/16/2022] Open
Abstract
β-thalassemia and sickle cell disease (SCD) are inherited hemoglobinopathies that result in both quantitative and qualitative variations in the β-globin chain. These in turn lead to instability in the generated hemoglobin (Hb) or to a globin chain imbalance that affects the oxidative environment both intracellularly and extracellularly. While oxidative stress is not among the primary etiologies of β-thalassemia and SCD, it plays a significant role in the pathogenesis of these diseases. Different mechanisms exist behind the development of oxidative stress; the result of which is cytotoxicity, causing the oxidation of cellular components that can eventually lead to cell death and organ damage. In this review, we summarize the mechanisms of oxidative stress development in β-thalassemia and SCD and describe the current and potential antioxidant therapeutic strategies. Finally, we discuss the role of targeted therapy in achieving an optimal redox balance.
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Affiliation(s)
- Rayan Bou-Fakhredin
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (R.B.-F.); (I.M.)
| | - Lucia De Franceschi
- Department of Medicine, University of Verona, and Azienda Ospedaliera Universitaria Verona, 37128 Verona, Italy;
| | - Irene Motta
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (R.B.-F.); (I.M.)
- UOC General Medicine, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Assaad A. Eid
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon;
| | - Ali T. Taher
- Division of Hematology-Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon;
| | - Maria Domenica Cappellini
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; (R.B.-F.); (I.M.)
- UOC General Medicine, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Correspondence:
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Vasseur C, Domingues-Hamdi E, Pakdaman S, Galactéros F, Baudin-Creuza V. Alpha haemoglobin-stabilising protein concentration in the red blood cells of patients with sickle cell anaemia with and without hydroxycarbamide treatment. Br J Haematol 2021; 196:183-192. [PMID: 34378186 DOI: 10.1111/bjh.17728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 07/02/2021] [Accepted: 07/12/2021] [Indexed: 11/27/2022]
Abstract
Alpha haemoglobin-stabilising protein (AHSP) is a key chaperone synthesised in red blood cell (RBC) precursors. Many studies have reported AHSP as a potential biomarker of various diseases. AHSP gene expression has been studied in detail, but little is known about AHSP protein levels in RBCs. We investigated the AHSP concentration of RBC lysates from control subjects (n = 10) and patients with sickle cell anaemia (SCA) with (n = 10) and without (n = 12) hydroxycarbamide (HC) treatment, to evaluate the clinical relevance of AHSP in SCA. We developed a sandwich enzyme-linked immunosorbent assay method, with which we were able, for the first time, to determine the mean AHSP concentration in control RBC lysates (0·82 µg/ml). The AHSP concentration (2·23 µg/ml) was significantly higher in untreated patients with the SS genotype than in controls. The AHSP concentration decreased significantly on HC treatment (1·50 µg/ml) but remained significantly higher than that in controls. A strong positive correlation was observed between the AHSP concentration and the α-haemoglobin pool with the three groups of subjects pooled into a single group. Our present findings indicate that AHSP concentration can be considered a candidate biomarker for monitoring HC responses in patients with SCA and suggest a role for AHSP in various RBC diseases.
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Affiliation(s)
- Corinne Vasseur
- Inserm U955-IMRB Team Pirenne, Univ Paris Est Créteil, Créteil, France.,Laboratory of Excellence GR-Ex, Paris, France
| | - Elisa Domingues-Hamdi
- Inserm U955-IMRB Team Pirenne, Univ Paris Est Créteil, Créteil, France.,Laboratory of Excellence GR-Ex, Paris, France
| | - Sadaf Pakdaman
- Inserm U955-IMRB Team Pirenne, Univ Paris Est Créteil, Créteil, France.,Laboratory of Excellence GR-Ex, Paris, France.,Etablissement Français du Sang (EFS) Ile de France-Mondor, Créteil, France
| | - Frédéric Galactéros
- Inserm U955-IMRB Team Pirenne, Univ Paris Est Créteil, Créteil, France.,Laboratory of Excellence GR-Ex, Paris, France.,Unité des Maladies Génétiques du Globule Rouge, Hôpital Universitaire Henri Mondor (AP-HP), Créteil, France
| | - Véronique Baudin-Creuza
- Inserm U955-IMRB Team Pirenne, Univ Paris Est Créteil, Créteil, France.,Laboratory of Excellence GR-Ex, Paris, France
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5
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Domingues‐Hamdi E, Vasseur C, Pakdaman S, Moutereau S, Habibi A, Bartolucci P, Galactéros F, Baudin‐Creuza V. Hydroxycarbamide decreases the free alpha-hemoglobin pool in red blood cells of adult patients with sickle cell anemia. Am J Hematol 2020; 95:E302-E305. [PMID: 32720721 DOI: 10.1002/ajh.25947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/23/2020] [Accepted: 07/24/2020] [Indexed: 12/18/2022]
Affiliation(s)
- Elisa Domingues‐Hamdi
- Inserm U955‐ IMRB, Team « Transfusion et Maladies du Globule Rouge » Université Paris Est Créteil Créteil France
- Laboratory of Excellence GR‐Ex Paris France
| | - Corinne Vasseur
- Inserm U955‐ IMRB, Team « Transfusion et Maladies du Globule Rouge » Université Paris Est Créteil Créteil France
- Laboratory of Excellence GR‐Ex Paris France
| | - Sadaf Pakdaman
- Inserm U955‐ IMRB, Team « Transfusion et Maladies du Globule Rouge » Université Paris Est Créteil Créteil France
- Laboratory of Excellence GR‐Ex Paris France
- Etablissement Français du Sang (EFS) Créteil France
| | - Stéphane Moutereau
- Inserm U955‐ IMRB, Team « Transfusion et Maladies du Globule Rouge » Université Paris Est Créteil Créteil France
- Laboratory of Excellence GR‐Ex Paris France
- Département de Biochimie‐Biologie Moléculaire, Pharmacologie, Génétique Médicale AP‐HP, Hôpitaux Universitaires Henri Mondor Créteil France
| | - Anoosha Habibi
- Inserm U955‐ IMRB, Team « Transfusion et Maladies du Globule Rouge » Université Paris Est Créteil Créteil France
- Laboratory of Excellence GR‐Ex Paris France
- Unité des Maladies Génétiques du Globule Rouge Hôpital Universitaire Henri Mondor (AP‐HP) Créteil France
| | - Pablo Bartolucci
- Inserm U955‐ IMRB, Team « Transfusion et Maladies du Globule Rouge » Université Paris Est Créteil Créteil France
- Laboratory of Excellence GR‐Ex Paris France
- Unité des Maladies Génétiques du Globule Rouge Hôpital Universitaire Henri Mondor (AP‐HP) Créteil France
| | - Frédéric Galactéros
- Inserm U955‐ IMRB, Team « Transfusion et Maladies du Globule Rouge » Université Paris Est Créteil Créteil France
- Laboratory of Excellence GR‐Ex Paris France
- Unité des Maladies Génétiques du Globule Rouge Hôpital Universitaire Henri Mondor (AP‐HP) Créteil France
| | - Véronique Baudin‐Creuza
- Inserm U955‐ IMRB, Team « Transfusion et Maladies du Globule Rouge » Université Paris Est Créteil Créteil France
- Laboratory of Excellence GR‐Ex Paris France
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Che Yaacob NS, Islam MA, Alsaleh H, Ibrahim IK, Hassan R. Alpha-hemoglobin-stabilizing protein (AHSP): a modulatory factor in β-thalassemia. Int J Hematol 2020; 111:352-359. [PMID: 31894534 DOI: 10.1007/s12185-019-02806-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 12/11/2019] [Accepted: 12/12/2019] [Indexed: 11/30/2022]
Abstract
Hemoglobin (Hb) is an iron-containing metalloprotein that transports oxygen molecules from the lungs to the rest of the human body. Among the different variants of Hb, HbA1 is the most common and is composed of two alpha (αHb) and two beta globin chains (βHb) constructing a heterotetrameric protein complex (α2β2). Due to the higher number of AHSP genes, there is a tendency to produce approximately twice as much of α subunit as β subunit. Therefore, there is a chance of presenting excess α subunit leftover in human blood plasma; excess subunits subsequently bind with each other and aggregates β-thalassemia occurs due to lack of or reduced numbers of βHb subunit. Alpha-hemoglobin-stabilizing protein (AHSP) is a scavenger protein which acts as a molecular chaperon by reversibly binding with free αHb forming a complex (AHSP-αHb) that prevents aggregation and precipitation preventing deleterious effects towards developing serious human diseases including β-thalassemia. Clinical severity worsens if mutations in AHSP gene co-occur in patients with β-thalassemia. Considering the mechanism of action of AHSP and its contribution to ameliorating β-thalassemia severity, it could potentially be used as a modulatory agent in the treatment of β-thalassemia.
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Affiliation(s)
- Nur Suraya Che Yaacob
- Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Md Asiful Islam
- Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Heba Alsaleh
- Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Ibrahim Khidir Ibrahim
- Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia.,Department of Haematology, Faculty of Medical Laboratory Sciences, Al-Neelain University, Khartoum, Sudan
| | - Rosline Hassan
- Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia.
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Vasseur C, Domingues-Hamdi E, Ledudal K, Le Corvoisier P, Barau C, Ghaleh B, Rialland A, Pissard S, Galactéros F, Baudin-Creuza V. Red blood cells free α-haemoglobin pool: a biomarker to monitor the β-thalassemia intermedia variability. The ALPHAPOOL study. Br J Haematol 2017. [DOI: 10.1111/bjh.14800] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Corinne Vasseur
- Institut National de la Santé et de la Recherche Médicale (Inserm)-U955; équipe 2 : Transfusion et Maladies du Globule Rouge; Institut Mondor de Recherche Biomédicale (IMRB); Université de Paris Est Créteil (UPEC); Créteil France
- Laboratory of Excellence GR-Ex; Paris France
| | - Elisa Domingues-Hamdi
- Institut National de la Santé et de la Recherche Médicale (Inserm)-U955; équipe 2 : Transfusion et Maladies du Globule Rouge; Institut Mondor de Recherche Biomédicale (IMRB); Université de Paris Est Créteil (UPEC); Créteil France
- Laboratory of Excellence GR-Ex; Paris France
| | - Katia Ledudal
- Inserm; Centre d'Investigation Clinique 1430; Hôpital Universitaire Henri Mondor Assistance Publique Hôpitaux de Paris (AP-HP); Créteil France
| | - Philippe Le Corvoisier
- Inserm; Centre d'Investigation Clinique 1430; Hôpital Universitaire Henri Mondor Assistance Publique Hôpitaux de Paris (AP-HP); Créteil France
| | - Caroline Barau
- Plateforme de Ressources Biologiques; Hôpital Universitaire Henri Mondor (AP-HP); Créteil France
| | - Bijan Ghaleh
- Plateforme de Ressources Biologiques; Hôpital Universitaire Henri Mondor (AP-HP); Créteil France
| | - Amandine Rialland
- Unité de Recherche Clinique; Hôpital Universitaire Henri Mondor (AP-HP); Créteil France
| | - Serge Pissard
- Institut National de la Santé et de la Recherche Médicale (Inserm)-U955; équipe 2 : Transfusion et Maladies du Globule Rouge; Institut Mondor de Recherche Biomédicale (IMRB); Université de Paris Est Créteil (UPEC); Créteil France
- Laboratory of Excellence GR-Ex; Paris France
- Laboratoire de Génétique; Hôpital Universitaire Henri Mondor (AP-HP); Créteil France
| | - Frédéric Galactéros
- Institut National de la Santé et de la Recherche Médicale (Inserm)-U955; équipe 2 : Transfusion et Maladies du Globule Rouge; Institut Mondor de Recherche Biomédicale (IMRB); Université de Paris Est Créteil (UPEC); Créteil France
- Laboratory of Excellence GR-Ex; Paris France
- Unité des Maladies Génétiques du Globule Rouge; Hôpital Universitaire Henri Mondor (AP-HP); Créteil France
| | - Véronique Baudin-Creuza
- Institut National de la Santé et de la Recherche Médicale (Inserm)-U955; équipe 2 : Transfusion et Maladies du Globule Rouge; Institut Mondor de Recherche Biomédicale (IMRB); Université de Paris Est Créteil (UPEC); Créteil France
- Laboratory of Excellence GR-Ex; Paris France
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