PGC-1α agonism induces fetal hemoglobin and exerts antisickling effects in sickle cell disease

Sci Adv. 2024 Aug 2;10(31):eadn8750. doi: 10.1126/sciadv.adn8750. Epub 2024 Jul 31.

Abstract

Sickle cell disease is a growing health burden afflicting millions around the world. Clinical observation and laboratory studies have shown that the severity of sickle cell disease is ameliorated in individuals who have elevated levels of fetal hemoglobin. Additional pharmacologic agents to induce sufficient fetal hemoglobin to diminish clinical severity is an unmet medical need. We recently found that up-regulation of peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α) can induce fetal hemoglobin synthesis in human primary erythroblasts. Here, we report that a small molecule, SR-18292, increases PGC-1α leading to enhanced fetal hemoglobin expression in human erythroid cells, β-globin yeast artificial chromosome mice, and sickle cell disease mice. In SR-18292-treated sickle mice, sickled red blood cells are significantly reduced, and disease complications are alleviated. SR-18292, or agents in its class, could be a promising additional therapeutic for sickle cell disease.

MeSH terms

  • Anemia, Sickle Cell* / drug therapy
  • Anemia, Sickle Cell* / metabolism
  • Anemia, Sickle Cell* / pathology
  • Animals
  • Antisickling Agents* / pharmacology
  • Antisickling Agents* / therapeutic use
  • Disease Models, Animal
  • Fetal Hemoglobin* / genetics
  • Fetal Hemoglobin* / metabolism
  • Humans
  • Mice
  • Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-alpha* / genetics
  • Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-alpha* / metabolism
  • beta-Globins / genetics
  • beta-Globins / metabolism

Substances

  • Fetal Hemoglobin
  • Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-alpha
  • Antisickling Agents
  • PPARGC1A protein, human
  • beta-Globins