Inhibition of XPO1 by selinexor enhances terminal erythroid maturation through modulation of HSP70 trafficking in severe β0-thalassemia/HbE. (PubMed, PLoS One)
In this study, we screened nine XPO1 inhibitors, including the natural compounds curcumin, piperlongumine, plumbagin, and oridonin, as well as the synthetic agents KPT-185, KPT-276, selinexor, verdinexor, and eltanexor, in erythroid progenitors from patients with severe β0-thalassemia/HbE to identify the most effective inducer of TEM and to investigate the downstream molecular mechanisms involved...Combination treatments with hydroxyurea (a γ-globin inducer) and SIS3 (a SMAD3 inhibitor) confirmed selinexor's dominant effect...These findings suggest that cytoplasmic HSP70 trafficking may contribute to erythroid maturation in severe β0-thalassemia/HbE, implicating regulatory pathways beyond nuclear GATA1 stabilization. Collectively, our findings highlight the therapeutic potential of repurposing selinexor to enhance erythroid maturation in β-thalassemia and suggest that cytoplasmic HSP70 trafficking warrants further investigation as a contributor to terminal erythroid maturation in β-thalassemia.