HbE/β-Thalassemia and Oxidative Stress: The Key to Pathophysiological Mechanisms and Novel Therapeutics

Rhoda Elison Hirsch, Nathawut Sibmooh, Suthat Fucharoen, Joel M. Friedman

Research output: Contribution to journalReview article

10 Citations (Scopus)

Abstract

Significance: Oxidative stress and generation of free radicals are fundamental in initiating pathophysiological mechanisms leading to an inflammatory cascade resulting in high rates of morbidity and death from many inherited point mutation-derived hemoglobinopathies. Hemoglobin (Hb)E is the most common point mutation worldwide. The βE-globin gene is found in greatest frequency in Southeast Asia, including Thailand, Malaysia, Indonesia, Vietnam, Cambodia, and Laos. With the wave of worldwide migration, it is entering the gene pool of diverse populations with greater consequences than expected. Critical Issues: While HbE by itself presents as a mild anemia and a single gene for β-thalassemia is not serious, it remains unexplained why HbE/β-thalassemia (HbE/β-thal) is a grave disease with high morbidity and mortality. Patients often exhibit defective physical development, severe chronic anemia, and often die of cardiovascular disease and severe infections. Recent Advances: This article presents an overview of HbE/β-thal disease with an emphasis on new findings pointing to pathophysiological mechanisms derived from and initiated by the dysfunctional property of HbE as a reduced nitrite reductase concomitant with excess α-chains exacerbating unstable HbE, leading to a combination of nitric oxide imbalance, oxidative stress, and proinflammatory events. Future Directions: Additionally, we present new therapeutic strategies that are based on the emerging molecular-level understanding of the pathophysiology of this and other hemoglobinopathies. These strategies are designed to short-circuit the inflammatory cascade leading to devastating chronic morbidity and fatal consequences. Antioxid. Redox Signal. 26, 794-813.

Original languageEnglish (US)
Pages (from-to)794-813
Number of pages20
JournalAntioxidants and Redox Signaling
Volume26
Issue number14
DOIs
StatePublished - May 10 2017

Fingerprint

Oxidative stress
Thalassemia
Hemoglobinopathies
Oxidative Stress
Genes
Morbidity
Point Mutation
Anemia
Hemoglobin E
Laos
Nitrite Reductases
Cambodia
Gene Pool
Southeastern Asia
Globins
Indonesia
Mortality
Vietnam
Graves Disease
Malaysia

Keywords

  • hemoglobin E
  • hypoxia
  • inflammation
  • nitric oxide
  • oxidative stress
  • β-thalassemia

ASJC Scopus subject areas

  • Physiology
  • Biochemistry
  • Molecular Biology
  • Clinical Biochemistry
  • Cell Biology

Cite this

HbE/β-Thalassemia and Oxidative Stress : The Key to Pathophysiological Mechanisms and Novel Therapeutics. / Hirsch, Rhoda Elison; Sibmooh, Nathawut; Fucharoen, Suthat; Friedman, Joel M.

In: Antioxidants and Redox Signaling, Vol. 26, No. 14, 10.05.2017, p. 794-813.

Research output: Contribution to journalReview article

Hirsch, Rhoda Elison ; Sibmooh, Nathawut ; Fucharoen, Suthat ; Friedman, Joel M. / HbE/β-Thalassemia and Oxidative Stress : The Key to Pathophysiological Mechanisms and Novel Therapeutics. In: Antioxidants and Redox Signaling. 2017 ; Vol. 26, No. 14. pp. 794-813.
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