The BACH1 inhibitor ASP8731 inhibits inflammation and vaso-occlusion and induces fetal hemoglobin in sickle cell disease

John D. Belcher, Selvaraj Nataraja, Fuad Abdulla, Ping Zhang, Chunsheng Chen, Julia Nguyen, Conglin Ruan, Maneet Singh, Shilpa Demes, Lyndsay Olson, Domi Stickens, Jeff Stanwix, Emer Clarke, Yongzhao Huang, Margaret Biddle, Gregory M. Vercellotti

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


In sickle cell disease (SCD), heme released during intravascular hemolysis promotes oxidative stress, inflammation, and vaso-occlusion. Conversely, free heme can also activate expression of antioxidant and globin genes. Heme binds to the transcription factor BACH1, which represses NRF2-mediated gene transcription. ASP8731, is a selective small molecule inhibitor of BACH1. We investigated the ability of ASP8731 to modulate pathways involved in SCD pathophysiology. In HepG2 liver cells, ASP8731 increased HMOX1 and FTH1 mRNA. In pulmonary endothelial cells, ASP8731 decreased VCAM1 mRNA in response to TNF-α and blocked a decrease in glutathione in response to hemin. Townes-SS mice were gavaged once per day for 4 weeks with ASP8731, hydroxyurea (HU) or vehicle. Both ASP8731 and HU inhibited heme-mediated microvascular stasis and in combination, ASP8731 significantly reduced microvascular stasis compared to HU alone. In Townes-SS mice, ASP8731 and HU markedly increased heme oxygenase-1 and decreased hepatic ICAM-1, NF-kB phospho-p65 protein expression in the liver, and white blood cell counts. In addition, ASP8731 increased gamma-globin expression and HbF+ cells (F-cells) as compared to vehicle-treated mice. In human erythroid differentiated CD34+ cells, ASP8731 increased HGB mRNA and increased the percentage of F-cells 2-fold in manner similar to HU. ASP8731 and HU when given together induced more HbF+ cells compared to either drug alone. In CD34+ cells from one donor that was non-responsive to HU, ASP8731 induced HbF+ cells ~2-fold. ASP8731 and HU also increased HBG and HBA, but not HBB mRNA in erythroid differentiated CD34+ cells derived from SCD patients. These data indicate that BACH1 may offer a new therapeutic target to treat SCD.

Original languageEnglish (US)
Article number1101501
JournalFrontiers in Medicine
StatePublished - 2023

Bibliographical note

Funding Information:
This study was funded by Astellas Pharma Inc. and investigators received funding to conduct this study from the study sponsor.

Funding Information:
JB and GV are consultants and receive research funding from Astellas Pharma/Mitobridge. SN, SD, LO, and JS are employees of Astellas Pharma US Inc. MS, DS, and MB were employees of Astellas Pharma US Inc./Mitobridge at the time the study was conducted. EC and YH were employed by company ReachBio.

Publisher Copyright:
Copyright © 2023 Belcher, Nataraja, Abdulla, Zhang, Chen, Nguyen, Ruan, Singh, Demes, Olson, Stickens, Stanwix, Clark, Huang, Biddle and Vercellotti.


  • BACH1
  • HMOX1
  • NF-kappa B
  • Nrf2
  • gamma globin
  • hemoglobin F
  • sickle cell disease
  • vaso-occlusion

PubMed: MeSH publication types

  • Journal Article


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