Phase 1 Study of a Sulforaphane-Containing Broccoli Sprout Homogenate for Sickle Cell Disease.

Sickle cell disease (SCD) is the most common inherited hemoglobinopathy worldwide. Our previous results indicate that the reduced oxidative stress capacity of sickle erythrocytes may be caused by decreased expression of NRF2 (Nuclear factor (erythroid-derived 2)-like 2), an oxidative stress regulato...

Full description

Bibliographic Details
Main Authors: Jennifer F Doss, Jude C Jonassaint, Melanie E Garrett, Allison E Ashley-Koch, Marilyn J Telen, Jen-Tsan Chi
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2016-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC4829228?pdf=render
_version_ 1811276860257992704
author Jennifer F Doss
Jude C Jonassaint
Melanie E Garrett
Allison E Ashley-Koch
Marilyn J Telen
Jen-Tsan Chi
author_facet Jennifer F Doss
Jude C Jonassaint
Melanie E Garrett
Allison E Ashley-Koch
Marilyn J Telen
Jen-Tsan Chi
author_sort Jennifer F Doss
collection DOAJ
description Sickle cell disease (SCD) is the most common inherited hemoglobinopathy worldwide. Our previous results indicate that the reduced oxidative stress capacity of sickle erythrocytes may be caused by decreased expression of NRF2 (Nuclear factor (erythroid-derived 2)-like 2), an oxidative stress regulator. We found that activation of NRF2 with sulforaphane (SFN) in erythroid progenitors significantly increased the expression of NRF2 targets HMOX1, NQO1, and HBG1 (subunit of fetal hemoglobin) in a dose-dependent manner. Therefore, we hypothesized that NRF2 activation with SFN may offer therapeutic benefits for SCD patients by restoring oxidative capacity and increasing fetal hemoglobin concentration. To test this hypothesis, we performed a Phase 1, open-label, dose-escalation study of SFN, contained in a broccoli sprout homogenate (BSH) that naturally contains SFN, in adults with SCD. The primary and secondary study endpoints were safety and physiological response to NRF2 activation, respectively. We found that BSH was well tolerated, and the few adverse events that occurred during the trial were not likely related to BSH consumption. We observed an increase in the mean relative whole blood mRNA levels for the NRF2 target HMOX1 (p = 0.02) on the last day of BSH treatment, compared to pre-treatment. We also observed a trend toward increased mean relative mRNA levels of the NRF2 target HBG1 (p = 0.10) from baseline to end of treatment, but without significant changes in HbF protein. We conclude that BSH, in the provided doses, is safe in stable SCD patients and may induce changes in gene expression levels. We therefore propose investigation of more potent NRF2 inducers, which may elicit more robust physiological changes and offer clinical benefits to SCD patients. Trial registration: ClinicalTrials.gov NCT01715480.
first_indexed 2024-04-13T00:05:23Z
format Article
id doaj.art-099564c7e84140db997875fdd537adb1
institution Directory Open Access Journal
issn 1932-6203
language English
last_indexed 2024-04-13T00:05:23Z
publishDate 2016-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj.art-099564c7e84140db997875fdd537adb12022-12-22T03:11:14ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-01114e015289510.1371/journal.pone.0152895Phase 1 Study of a Sulforaphane-Containing Broccoli Sprout Homogenate for Sickle Cell Disease.Jennifer F DossJude C JonassaintMelanie E GarrettAllison E Ashley-KochMarilyn J TelenJen-Tsan ChiSickle cell disease (SCD) is the most common inherited hemoglobinopathy worldwide. Our previous results indicate that the reduced oxidative stress capacity of sickle erythrocytes may be caused by decreased expression of NRF2 (Nuclear factor (erythroid-derived 2)-like 2), an oxidative stress regulator. We found that activation of NRF2 with sulforaphane (SFN) in erythroid progenitors significantly increased the expression of NRF2 targets HMOX1, NQO1, and HBG1 (subunit of fetal hemoglobin) in a dose-dependent manner. Therefore, we hypothesized that NRF2 activation with SFN may offer therapeutic benefits for SCD patients by restoring oxidative capacity and increasing fetal hemoglobin concentration. To test this hypothesis, we performed a Phase 1, open-label, dose-escalation study of SFN, contained in a broccoli sprout homogenate (BSH) that naturally contains SFN, in adults with SCD. The primary and secondary study endpoints were safety and physiological response to NRF2 activation, respectively. We found that BSH was well tolerated, and the few adverse events that occurred during the trial were not likely related to BSH consumption. We observed an increase in the mean relative whole blood mRNA levels for the NRF2 target HMOX1 (p = 0.02) on the last day of BSH treatment, compared to pre-treatment. We also observed a trend toward increased mean relative mRNA levels of the NRF2 target HBG1 (p = 0.10) from baseline to end of treatment, but without significant changes in HbF protein. We conclude that BSH, in the provided doses, is safe in stable SCD patients and may induce changes in gene expression levels. We therefore propose investigation of more potent NRF2 inducers, which may elicit more robust physiological changes and offer clinical benefits to SCD patients. Trial registration: ClinicalTrials.gov NCT01715480.http://europepmc.org/articles/PMC4829228?pdf=render
spellingShingle Jennifer F Doss
Jude C Jonassaint
Melanie E Garrett
Allison E Ashley-Koch
Marilyn J Telen
Jen-Tsan Chi
Phase 1 Study of a Sulforaphane-Containing Broccoli Sprout Homogenate for Sickle Cell Disease.
PLoS ONE
title Phase 1 Study of a Sulforaphane-Containing Broccoli Sprout Homogenate for Sickle Cell Disease.
title_full Phase 1 Study of a Sulforaphane-Containing Broccoli Sprout Homogenate for Sickle Cell Disease.
title_fullStr Phase 1 Study of a Sulforaphane-Containing Broccoli Sprout Homogenate for Sickle Cell Disease.
title_full_unstemmed Phase 1 Study of a Sulforaphane-Containing Broccoli Sprout Homogenate for Sickle Cell Disease.
title_short Phase 1 Study of a Sulforaphane-Containing Broccoli Sprout Homogenate for Sickle Cell Disease.
title_sort phase 1 study of a sulforaphane containing broccoli sprout homogenate for sickle cell disease
url http://europepmc.org/articles/PMC4829228?pdf=render
work_keys_str_mv AT jenniferfdoss phase1studyofasulforaphanecontainingbroccolisprouthomogenateforsicklecelldisease
AT judecjonassaint phase1studyofasulforaphanecontainingbroccolisprouthomogenateforsicklecelldisease
AT melanieegarrett phase1studyofasulforaphanecontainingbroccolisprouthomogenateforsicklecelldisease
AT allisoneashleykoch phase1studyofasulforaphanecontainingbroccolisprouthomogenateforsicklecelldisease
AT marilynjtelen phase1studyofasulforaphanecontainingbroccolisprouthomogenateforsicklecelldisease
AT jentsanchi phase1studyofasulforaphanecontainingbroccolisprouthomogenateforsicklecelldisease