title: Fetal hemoglobin in sickle cell anemia.
abstract: Fetal hemoglobin (HbF) is the major genetic modulator of the hematologic and clinical features of sickle cell disease, an effect mediated by its exclusion from the sickle hemoglobin polymer. Fetal hemoglobin genes are genetically regulated, and the level of HbF and its distribution among sickle erythrocytes is highly variable. Some patients with sickle cell disease have exceptionally high levels of HbF that are associated with the Senegal and Saudi-Indian haplotype of the HBB-like gene cluster; some patients with different haplotypes can have similarly high HbF. In these patients, high HbF is associated with generally milder but not asymptomatic disease. Studying these persons might provide additional insights into HbF gene regulation. HbF appears to benefit some complications of disease more than others. This might be related to the premature destruction of erythrocytes that do not contain HbF, even though the total HbF concentration is high. Recent insights into HbF regulation have spurred new efforts to induce high HbF levels in sickle cell disease beyond those achievable with the current limited repertory of HbF inducers.
authors.affiliation: Department of Medicine, Boston University School of Medicine, Boston, MA, USA.
authors.forename: Idowu
authors.initials: I
authors.lastname: Akinsheye
authors.forename: Abdulrahman
authors.initials: A
authors.lastname: Alsultan
authors.forename: Nadia
authors.initials: N
authors.lastname: Solovieff
authors.forename: Duyen
authors.initials: D
authors.lastname: Ngo
authors.forename: Clinton T
authors.initials: CT
authors.lastname: Baldwin
authors.forename: Paola
authors.initials: P
authors.lastname: Sebastiani
authors.forename: David H K
authors.initials: DH
authors.lastname: Chui
authors.forename: Martin H
authors.initials: MH
authors.lastname: Steinberg
mesh_terms: D000755:Anemia, Sickle Cell / Q000097:blood* / Q000235:genetics / Q000473:pathology*; D004912:Erythrocytes / Q000378:metabolism* / Q000473:pathology*; D005319:Fetal Hemoglobin / Q000235:genetics / Q000378:metabolism*; D006239:Haplotypes; D006801:Humans; D012720:Severity of Illness Index
chemical_list: D005319:Fetal Hemoglobin