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The fetal globin gene refers to the HBG1 and HBG2 genes, encoding the gamma (γ) subunits of fetal hemoglobin (HbF). HbF is the predominant hemoglobin in human fetuses, facilitating efficient oxygen transport from mother to fetus. After birth, γ-globin expression is normally downregulated, and β-globin becomes dominant. Reactivation of γ-globin expression is a therapeutic strategy for treating beta-thalassemia and sickle cell disease.
Drugs like hydroxyurea increase fetal globin expression by various mechanisms, including inducing DNA damage and activating stress erythropoiesis. Other drugs, like decitabine and 5-azacytidine, are DNA methyltransferase inhibitors that can reactivate fetal globin gene expression by demethylating the gene locus.
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