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Publication : Non-hematopoietic deficiency of proprotein convertase subtilisin/kexin type 9 deficiency leads to more severe anemia in a murine model of sickle cell disease.

First Author  Venugopal J Year  2020
Journal  Sci Rep Volume  10
Issue  1 Pages  16514
PubMed ID  33020528 Mgi Jnum  J:299080
Mgi Id  MGI:6472387 Doi  10.1038/s41598-020-73463-9
Citation  Venugopal J, et al. (2020) Non-hematopoietic deficiency of proprotein convertase subtilisin/kexin type 9 deficiency leads to more severe anemia in a murine model of sickle cell disease. Sci Rep 10(1):16514
abstractText  Proprotein convertase subtilisin/kexin type 9 (PCSK9) deficiency leads to lower cholesterol and is associated with reduced vascular complications in the general population. Cholesterol lowering may also have beneficial effects in sickle cell disease (SCD). The objective of this study was to determine effects of PCSK9 deficiency in a mouse model of SCD. Bone marrow transplantation (BMT) was performed from donor SCD mice to wild-type, PCSK9-deficient, and LDLR-deficient recipients to generate SCD controls (Pcsk9(+/+), SCD(bmt)) with preserved PCSK9 status, SCD mice with deficiency of PCSK9 (Pcsk9(-/-), SCD(bmt)), and SCD mice with deficiency of LDLR (Ldlr(-/-), SCD(bmt)). Although cholesterol levels were lower in Pcsk9(-/-), SCD(bmt) mice compared to Pcsk9(+/+), SCD(bmt) mice, anemia was more severe in Pcsk9(-/-), SCD(bmt) mice. Increased reticulocytosis, enhanced ex vivo erythrocyte sickling, and increased erythrocyte phosphatidylserine exposure was also observed. Livers, spleens, and kidneys contained increased iron in Pcsk9(-/-), SCD(bmt) mice compared to Pcsk9(+/+), SCD(bmt) mice consistent with greater hemolysis. SCD mice with deficiency of LDLR (Ldlr(-/-), SCD(bmt) mice) had similar anemia as Ldlr(+/+), SCD(bmt) mice despite higher serum cholesterol. In conclusion, deficiency of PCSK9 is associated with worsened anemia in SCD mice due to increased hemolysis. These findings may have implications for lipid-lowering strategies in patients with SCD, as well as for potential novel modifiers of anemia severity.
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