Literature DB >> 26327494

A systematic review of known mechanisms of hydroxyurea-induced fetal hemoglobin for treatment of sickle cell disease.

Gift D Pule1, Shaheen Mowla, Nicolas Novitzky, Charles S Wiysonge, Ambroise Wonkam.   

Abstract

AIM: To report on molecular mechanisms of fetal hemoglobin (HbF) induction by hydroxyurea (HU) for the treatment of sickle cell disease. STUDY
DESIGN: Systematic review.
RESULTS: Studies have provided consistent associations between genomic variations in HbF-promoting loci and variable HbF level in response to HU. Numerous signal transduction pathways have been implicated, through the identification of key genomic variants in BCL11A, HBS1L-MYB, SAR1 or XmnI polymorphism that predispose the response to the treatment, and signal transduction pathways that modulate γ-globin expression (cAMP/cGMP; Giα/c-Jun N-terminal kinase/Jun; methylation and miRNA). Three main molecular pathways have been reported: i) Epigenetic modifications, transcriptional events and signaling pathways involved in HU-mediated response, ii) Signaling pathways involving HU-mediated response and iii) Post-transcriptional pathways (regulation by miRNAs).
CONCLUSIONS: The complete picture of HU-mediated mechanisms of HbF production in Sickle Cell Disease remains elusive. Research on post-transcriptional mechanisms could lead to therapeutic targets that may minimize alterations to the cellular transcriptome.

Entities:  

Keywords:  BCL11A; HBS1L-MYB and SAR1; fetal hemoglobin; hydroxyurea; molecular mechanism; sickle cell disease

Mesh:

Substances:

Year:  2015        PMID: 26327494      PMCID: PMC4829639          DOI: 10.1586/17474086.2015.1078235

Source DB:  PubMed          Journal:  Expert Rev Hematol        ISSN: 1747-4094            Impact factor:   2.819


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