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2017 ; 129
(13
): 1823-1830
Nephropedia Template TP
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English Wikipedia
Momelotinib inhibits ACVR1/ALK2, decreases hepcidin production, and ameliorates
anemia of chronic disease in rodents
#MMPMID28188131
Asshoff M
; Petzer V
; Warr MR
; Haschka D
; Tymoszuk P
; Demetz E
; Seifert M
; Posch W
; Nairz M
; Maciejewski P
; Fowles P
; Burns CJ
; Smith G
; Wagner KU
; Weiss G
; Whitney JA
; Theurl I
Blood
2017[Mar]; 129
(13
): 1823-1830
PMID28188131
show ga
Patients with myelofibrosis (MF) often develop anemia and frequently become
dependent on red blood cell transfusions. Results from a phase 2 study for the
treatment of MF with the Janus kinase 1/2 (JAK1/2) inhibitor momelotinib (MMB)
demonstrated that MMB treatment ameliorated anemia, which was unexpected for a
JAK1/2 inhibitor, because erythropoietin-mediated JAK2 signaling is essential for
erythropoiesis. Using a rat model of anemia of chronic disease, we demonstrated
that MMB treatment can normalize hemoglobin and red blood cell numbers. We found
that this positive effect is driven by direct inhibition of the bone morphogenic
protein receptor kinase activin A receptor, type I (ACVR1), and the subsequent
reduction of hepatocyte hepcidin production. Of note, ruxolitinib, a JAK1/2
inhibitor approved for the treatment of MF, had no inhibitory activity on this
pathway. Further, we demonstrated the effect of MMB is not mediated by direct
inhibition of JAK2-mediated ferroportin (FPN1) degradation, because neither MMB
treatment nor myeloid-specific deletion of JAK2 affected FPN1 expression. Our
data support the hypothesis that the improvement of inflammatory anemia by MMB
results from inhibition of ACVR1-mediated hepcidin expression in the liver, which
leads to increased mobilization of sequestered iron from cellular stores and
subsequent stimulation of erythropoiesis.
|Activin Receptors, Type I/antagonists & inhibitors
[MESH]
|Anemia/*drug therapy
[MESH]
|Animals
[MESH]
|Benzamides/pharmacology/*therapeutic use
[MESH]
|Bone Morphogenetic Protein Receptors, Type I/*antagonists & inhibitors
[MESH]