1. Efficacy of Rapamycin as Inducer of Hb F in Primary Erythroid Cultures from Sickle Cell Disease and β-Thalassemia Patients.
- Author
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Pecoraro A, Troia A, Calzolari R, Scazzone C, Rigano P, Martorana A, Sacco M, Maggio A, and Di Marzo R
- Subjects
- Adolescent, Adult, Aged, Anemia, Sickle Cell drug therapy, Anemia, Sickle Cell metabolism, Cells, Cultured, Female, Fetal Hemoglobin metabolism, Genotype, Humans, Hydroxyurea pharmacology, Hydroxyurea therapeutic use, Male, Middle Aged, Mutation, Young Adult, alpha-Globins genetics, alpha-Globins metabolism, beta-Globins genetics, beta-Globins metabolism, beta-Thalassemia drug therapy, beta-Thalassemia metabolism, gamma-Globins genetics, gamma-Globins metabolism, Anemia, Sickle Cell genetics, Erythroid Precursor Cells drug effects, Erythroid Precursor Cells metabolism, Fetal Hemoglobin genetics, Gene Expression Regulation drug effects, Sirolimus pharmacology, beta-Thalassemia genetics
- Abstract
Phenotypic improvement of hemoglobinopathies such as sickle cell disease and β-thalassemia (β-thal) has been shown in patients with high levels of Hb F. Among the drugs proposed to increase Hb F production, hydroxyurea (HU) is currently the only one proven to improve the clinical course of these diseases. However, Hb F increase and patient's response are highly variable, indicating that new pharmacological agents could be useful for patients not responding to HU or showing a reduction of response during long-term therapy. In this study we evaluated the efficacy of rapamycin, a lypophilic macrolide used for the prevention of acute rejection in renal transplant recipients, as an inducer of Hb F production. The analyses were performed in cultured erythroid progenitors from 25 sickle cell disease and 25 β-thal intermedia (β-TI) patients. The use of a quantitative Real-Time-polymerase chain reaction ReTi-PCR technique and high performance liquid chromatography (HPLC) allowed us to determine the increase in γ-globin mRNA expression and Hb F production in human erythroid cells treated with rapamycin. The results of our study demonstrated an increase in vitro of γ-globin mRNA expression in 15 sickle cell disease and 14 β-TI patients and a corresponding Hb F increase. The induction by rapamycin, even if lower or similar in most of samples analyzed, in some cases was higher than HU. These data suggest that rapamycin could be a good candidate to be used in vivo for the treatment of hemoglobinopathies.
- Published
- 2015
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