Iron overload is the main cause of morbidity and mortality in hereditary hemochromatosis, 2-thalassemia and various anemias that require chronic transfusions. Alternatives to current treatments of iron overload are a high priority, as reflected in a recent NIH initiative (PAS-10-046). Hepcidin deficiency is the direct cause of iron overload in nearly all cases of hereditary hemochromatosis and in ?-thalassemia intermedia, and may contribute to iron overload and maldistribution in ?-thalassemia major. Hepcidin therapy is a rational experimental approach to the prevention and treatment of iron overload in these disorders. Natural hepcidin is expensive, rapidly cleared from circulation and not orally absorbable. We developed 7-9 amino acid peptides, "minihepcidins" that mimic the activity of hepcidin and exceed its potency. Some have been engineered for oral absorption, and have shown considerable activity by oral route in mice. We will determine the potential of minihepcidins to prevent iron overload or reverse its toxic effects in hemochromatosis and ?-thalassemia, and examine the effects of hepcidin agonists on ?-thalassemic erythropoiesis in mouse models and in bone marrow cultures and identify those mechanisms that could ameliorate anemia. Specifically, we will: 1. Select a parenteral and an oral minihepcidin for subsequent studies based on the dose-response relationship and duration of hypoferremic effect in C57BL/6 mice and hepcidin knockout mice. 2. Define the effects of minihepcidins in animal models of hereditary hemochromatosis. a. Can minihepcidins started after weaning prevent the development of iron overload in mouse models of severe (hepcidin knockout) or moderate (HFE knockout) hereditary hemochromatosis? b. Can minihepcidin treatment of mice with established iron overload (hepcidin or HFE knockouts) redistribute iron away from vulnerable cells and tissues (hepatocytes, pancreatic islet cells, cardiomyocytes) to relatively iron-resistant macrophages? c. Can minihepcidins reverse iron overload-related liver damage in the gerbil model of iron-induced hepatic cirrhosis? 3. Define the effects of minihepcidins in animal models of ?-thalassemia. a. Can minihepcidins prevent iron overload in a mouse model of ?-thalassemia intermedia, while improving (or not worsening) anemia? b. Can minihepcidins ameliorate iron overload in transfused mice with ?-thalassemia major and redistribute iron to less vulnerable locations, without worsening anemia? c. Identify mechanisms by which minihepcidins can improve ?-thalassemic erythropoiesis. This project would establish minihepcidins as viable drug leads for further development, and would eventually help patients with iron overload disorders by providing them with improved therapeutic options.

Public Health Relevance

Iron overload diseases are an important medical problem in need of new treatments. Building on recent advances in the understanding of iron metabolism, we propose to develop and test new kinds of medications for the treatment of iron overload in hereditary hemochromatosis and Cooley's anemia.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project (R01)
Project #
5R01DK090554-03
Application #
8335193
Study Section
Special Emphasis Panel (ZRG1-VH-E (02))
Program Officer
Wright, Daniel G
Project Start
2010-09-30
Project End
2015-07-31
Budget Start
2012-08-01
Budget End
2013-07-31
Support Year
3
Fiscal Year
2012
Total Cost
$594,013
Indirect Cost
$117,949
Name
Weill Medical College of Cornell University
Department
Pediatrics
Type
Schools of Medicine
DUNS #
060217502
City
New York
State
NY
Country
United States
Zip Code
10065
Casu, Carla; Oikonomidou, Paraskevi Rea; Chen, Huiyong et al. (2016) Minihepcidin peptides as disease modifiers in mice affected by β-thalassemia and polycythemia vera. Blood 128:265-76
Oikonomidou, P R; Casu, C; Yang, Z et al. (2016) Polycythemia is associated with bone loss and reduced osteoblast activity in mice. Osteoporos Int 27:1559-68
Oikonomidou, Paraskevi Rea; Casu, Carla; Rivella, Stefano (2016) New strategies to target iron metabolism for the treatment of beta thalassemia. Ann N Y Acad Sci 1368:162-8
Casu, Carla; Aghajan, Mariam; Oikonomidou, Paraskevi Rea et al. (2016) Combination of Tmprss6- ASO and the iron chelator deferiprone improves erythropoiesis and reduces iron overload in a mouse model of beta-thalassemia intermedia. Haematologica 101:e8-e11
Yien, Yvette Y; Gnanapragasam, Merlin Nithya; Gupta, Ritama et al. (2015) Alternative splicing of EKLF/KLF1 in murine primary erythroid tissues. Exp Hematol 43:65-70
Kim, Airie; Nemeth, Elizabeta (2015) New insights into iron regulation and erythropoiesis. Curr Opin Hematol 22:199-205
Michels, Kathryn; Nemeth, Elizabeta; Ganz, Tomas et al. (2015) Hepcidin and Host Defense against Infectious Diseases. PLoS Pathog 11:e1004998
Guimarães, Jacqueline S; Cominal, Juçara G; Silva-Pinto, Ana Cristina et al. (2015) Altered erythropoiesis and iron metabolism in carriers of thalassemia. Eur J Haematol 94:511-8
Rivella, Stefano (2015) β-thalassemias: paradigmatic diseases for scientific discoveries and development of innovative therapies. Haematologica 100:418-30
Chua, Kristine; Fung, Eileen; Micewicz, Ewa D et al. (2015) Small cyclic agonists of iron regulatory hormone hepcidin. Bioorg Med Chem Lett 25:4961-9

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