In vivo activation of the human δ-globin gene: the therapeutic potential in β-thalassemic mice

Haematologica. 2014 Jan;99(1):76-84. doi: 10.3324/haematol.2012.082768. Epub 2013 Jul 19.

Abstract

β-thalassemia and sickle cell disease are widespread fatal genetic diseases. None of the existing clinical treatments provides a solution for all patients. Two main strategies for treatment are currently being investigated: (i) gene transfer of a normal β-globin gene; (ii) reactivation of the endogenous γ-globin gene. To date, neither approach has led to a satisfactory, commonly accepted standard of care. The δ-globin gene produces the δ-globin of hemoglobin A2. Although expressed at a low level, hemoglobin A2 is fully functional and could be a valid substitute of hemoglobin A in β-thalassemia, as well as an anti-sickling agent in sickle cell disease. Previous in vitro results suggested the feasibility of transcriptional activation of the human δ-globin gene promoter by inserting a Kruppel-like factor 1 binding site. We evaluated the activation of the Kruppel-like factor 1 containing δ-globin gene in vivo in transgenic mice. To evaluate the therapeutic potential we crossed the transgenic mice carrying a single copy activated δ-globin gene with a mouse model of β-thalassemia intermedia. We show that the human δ-globin gene can be activated in vivo in a stage- and tissue-specific fashion simply by the insertion of a Kruppel-like factor 1 binding site into the promoter. In addition the activated δ-globin gene gives rise to a robust increase of the hemoglobin level in β-thalassemic mice, effectively improving the thalassemia phenotype. These results demonstrate, for the first time, the therapeutic potential of the δ-globin gene for treating severe hemoglobin disorders which could lead to novel approaches, not involving gene addition or reactivation, to the cure of β-hemoglobinopathies.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Disease Models, Animal
  • Erythrocytes / cytology
  • Erythrocytes / metabolism
  • Erythropoiesis / genetics
  • Gene Expression
  • Gene Order
  • Genes, Reporter
  • Genetic Loci
  • Humans
  • Iron / metabolism
  • Mice
  • Mice, Transgenic
  • Phenotype
  • Promoter Regions, Genetic
  • Transcriptional Activation*
  • beta-Thalassemia / genetics*
  • beta-Thalassemia / therapy
  • delta-Globins / chemistry
  • delta-Globins / genetics*
  • delta-Globins / metabolism

Substances

  • delta-Globins
  • Iron