Manipulation of Developmental Gamma-Globin Gene Expression: an Approach for Healing Hemoglobinopathies

Mol Cell Biol. 2020 Dec 21;41(1):e00253-20. doi: 10.1128/MCB.00253-20. Print 2020 Dec 21.

Abstract

β-Hemoglobinopathies are the most common monogenic disorders, and a century of research has provided us with a better understanding of the attributes of these diseases. Allogenic stem cell transplantation was the only potentially curative option available for these diseases until the discovery of gene therapy. The findings on the protective nature of fetal hemoglobin in sickle cell disease (SCD) and thalassemia patients carrying hereditary persistence of fetal hemoglobin (HPFH) mutations has given us the best evidence that the cure for β-hemoglobinopathies remains hidden in the hemoglobin locus. The detailed understanding of the developmental gene regulation of gamma-globin (γ-globin) and the emergence of gene manipulation strategies offer us the opportunity for developing a γ-globin gene-modified autologous stem cell transplantation therapy. In this review, we summarize different therapeutic strategies that reactivate fetal hemoglobin for the gene therapy of β-hemoglobinopathies.

Keywords: gene editing; hematopoietic stem cells; hemoglobinopathies.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Fetal Hemoglobin / genetics
  • Gene Expression / genetics
  • Gene Expression Regulation, Developmental / genetics
  • Genetic Therapy / methods*
  • Hematopoietic Stem Cell Transplantation / methods
  • Hemoglobinopathies / metabolism
  • Hemoglobinopathies / therapy*
  • Humans
  • Stem Cell Transplantation / methods
  • Transplantation, Autologous / methods
  • beta-Globins / genetics
  • gamma-Globins / genetics*

Substances

  • beta-Globins
  • gamma-Globins
  • Fetal Hemoglobin