GMI-1070, a novel pan-selectin antagonist, reverses acute vascular occlusions in sickle cell mice

J Chang, JT Patton, A Sarkar, B Ernst… - Blood, the Journal of …, 2010 - ashpublications.org
J Chang, JT Patton, A Sarkar, B Ernst, JL Magnani, PS Frenette
Blood, the Journal of the American Society of Hematology, 2010ashpublications.org
Leukocyte adhesion in the microvasculature influences blood rheology and plays a key role
in vaso-occlusive manifestations of sickle cell disease. Notably, polymorphonuclear
neutrophils (PMNs) can capture circulating sickle red blood cells (sRBCs) in inflamed
venules, leading to critical reduction in blood flow and vaso-occlusion. Recent studies have
suggested that E-selectin expression by endothelial cells plays a key role by sending
activating signals that lead to the activation of Mac-1 at the leading edge of PMNs, thereby …
Abstract
Leukocyte adhesion in the microvasculature influences blood rheology and plays a key role in vaso-occlusive manifestations of sickle cell disease. Notably, polymorphonuclear neutrophils (PMNs) can capture circulating sickle red blood cells (sRBCs) in inflamed venules, leading to critical reduction in blood flow and vaso-occlusion. Recent studies have suggested that E-selectin expression by endothelial cells plays a key role by sending activating signals that lead to the activation of Mac-1 at the leading edge of PMNs, thereby allowing RBC capture. Thus, the inhibition of E-selectin may represent a valuable target in this disease. Here, we have tested the biologic properties of a novel synthetic pan-selectin inhibitor, GMI-1070, with in vitro assays and in a humanized model of sickle cell vaso-occlusion analyzed by intravital microscopy. We have found that GMI-1070 predominantly inhibited E-selectin–mediated adhesion and dramatically inhibited sRBC-leukocyte interactions, leading to improved microcirculatory blood flow and improved survival. These results suggest that GMI-1070 may represent a valuable novel therapeutic intervention for acute sickle cell crises that should be further evaluated in a clinical trial.
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