Mechanism for fetal globin gene expression: role of the soluble guanylate cyclase-cGMP-dependent protein kinase pathway.

Despite considerable concerns with pharmacological stimulation of fetal hemoglobin (Hb F) as a therapeutic option for the beta-globin disorders, the molecular basis of action of Hb F-inducing agents remains unclear. Here we show that an intracellular pathway including soluble guanylate cyclase (sGC) and cGMP-dependent protein kinase (PKG) plays a role in induced expression of the gamma-globin gene. sGC, an obligate heterodimer of alpha- and beta-subunits, participates in a variety of physiological processes by converting GTP to cGMP. Northern blot analyses with erythroid cell lines expressing different beta-like globin genes showed that, whereas the beta-subunit is expressed at similar levels, high-level expression of the alpha-subunit is preferentially observed in erythroid cells expressing gamma-globin but not those expressing beta-globin. Also, the levels of expression of the gamma-globin gene correlate to those of the alpha-subunit. sGC activators or cGMP analogs increased expression of the gamma-globin gene in erythroleukemic cells as well as in primary erythroblasts from normal subjects and patients with beta-thalassemia. Nuclear run-off assays showed that the sGC activator protoporphyrin IX stimulates transcription of the gamma-globin gene. Furthermore, increased expression of the gamma-globin gene by well known Hb F-inducers such as hemin and butyrate was abolished by inhibiting sGC or PKG activity. Taken together, these results strongly suggest that the sGC-PKG pathway constitutes a mechanism that regulates expression of the gamma-globin gene. Further characterization of this pathway should permit us to develop new therapeutics for the beta-globin disorders.