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Triterpenoid inducers of Nrf2 signaling as potential therapeutic agents in sickle cell disease： a review

Frontiers of Medicine 2015年第1期9卷 46-56页

作者： Amma Owusu-Ansah Sung Hee Choi Agne Petrosiute John J. Letterio Alex Yee-Chen Huang Division of Pediatric Hematology-Oncology Department of Pediatrics Case Western Reserve University School of Medicine Cleveland OH 44106 USA the angie fowler adolescent & young adult cancer institute at university hospitals Rainbow Babies & Children 's Hospital Cleveland OH 44106 USA

Sickle cell disease （SCD） is an inherited disorder of hemoglobin in which the abnormal hemoglobin S polymerizes when deoxygenated. This polymerization of hemoglobin S not only results in hemolysis and vaso- occlusion but also precipitates inflammation, oxidative stress and chronic organ dysfunction. Oxidative stress is increasingly recognized as an important intermediate in these pathophysiological processes and is therefore an important target for therapeutic intervention. The transcription factor nuclear erythroid derived- 2 related factor 2 （Nrf2） controls the expression of anti-oxidant enzymes and is emerging as a protein whose function can be exploited with therapeutic intent. This review article is focused on triterpenoids that activate Nrf2, and their potential for reducing oxidative stress in SCD as an approach to prevent organ dysfunction associated with this disease. A brief overview of oxidative stress in the clinical context of SCD is accompanied by a discussion of several pathophysiological mechanisms contributing to oxidative stress. Finally, these mechanisms are then related to current management strategies in SCD that are either utilized currently or under evaluation. The article concludes with a perspective on the potential of the various therapeutic interventions to reduce oxidative stress and morbidity associated with SCD.

关键词： oxidative stress Nrf2 triterpenoids sickle cell disease vaso-occlusion CDDO-Me

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