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Proteogenomic analysis in sickle cell disease identifies 560 pQTL and prioritizes five proteins for HbF investigationStudy maps genetic links to blood proteins in sickle cell disease patients

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Key Takeaway
Consider five prioritized proteins as potential, non-validated targets for increasing fetal hemoglobin in sickle cell disease.

This observational proteogenomic analysis measured 5,411 plasma proteins in 343 sickle cell disease (SCD) patients to identify protein quantitative trait loci (pQTL) associated with common genetic variation. The study compared pQTL effect sizes to those in non-SCD African American individuals from the Million Veteran Program. The primary outcome was the identification of pQTL associated with plasma protein levels.

After conditional analyses, the study identified 560 pQTL, of which 58 (approximately 10%) were novel. The effect sizes of these pQTL were reported to be largely concordant between the SCD cohort and the non-SCD controls. However, evidence of heterogeneity in pQTL effect was noted for two specific proteins: APOL1 and haptoglobin. Using Mendelian randomization, the analysis prioritized five proteins—ENPP5, LBP, NAAA, PT3X, and ZP3—as potentially increasing fetal hemoglobin (HbF) production.

Safety and tolerability data were not reported. Key limitations include the observational nature of the analysis, which establishes association, not causation. The clinical relevance of the pQTL associations in non-SCD individuals was not quantified, and specific effect sizes for the pQTL were not numerically reported. The practice relevance is currently limited, as the findings represent a prioritization of proteins for further functional investigation rather than a direct therapeutic implication.

Researchers conducted a study to understand how common genetic variations affect protein levels in the blood of people with sickle cell disease (SCD). They measured over 5,400 different proteins in 343 SCD patients and looked for connections between genetic variations and protein amounts. They compared these findings to data from non-SCD individuals to see if the relationships were similar.

The study identified 560 genetic links to protein levels, with 58 being newly discovered. Most of these links worked similarly in people with and without SCD, though a few showed differences. The researchers used a statistical method to prioritize five specific proteins that might be involved in increasing fetal hemoglobin production, which is beneficial for SCD patients.

No safety concerns were reported because this was an observational study that only involved looking at existing blood samples and genetic data. The main reason to be careful is that this research shows associations, not proof of cause and effect. The prioritized proteins might influence fetal hemoglobin, but the study doesn't prove they actually do.

Readers should understand this is early-stage research that helps scientists know where to look next. The findings create a map of genetic-protein relationships in SCD that can guide future studies, but they don't lead to any immediate changes in treatment. More research will be needed to test whether influencing these proteins could help people with sickle cell disease.

What this means for you:
Early research identifies genetic links to blood proteins in sickle cell disease; more study needed to understand potential benefits.

Study Details

EvidenceLevel 5
PublishedApr 2026
View Original Abstract ↓
There are few therapeutic options to treat patients with sickle cell disease (SCD), a blood disorder caused by mutations in the {beta}-globin gene that affects >7M individuals worldwide. Combining human genetics and high-throughput proteomics can help identify new drug targets. Here, we present results from a proteogenomic analysis of the plasma proteome in SCD patients. We measured the levels of 5,411 plasma proteins and tested their associations with common genetic variation in 343 SCD patients. After conditional analyses, we identified 560 protein quantitative trait loci (pQTL), including 58 (10%) that are novel. Many of these pQTL are not specific to SCD patients and associate with clinically relevant traits in non-SCD African Americans from the Million Veteran Program (e.g. hemoglobin concentration, triglycerides). The effect sizes of the pQTL is largely concordant between SCD and non-SCD individuals, although we found examples (e.g. APOL1, haptoglobin) with evidence of heterogeneity that suggests an interaction between the plasma proteome and the SCD genotype. Finally, we combine pQTL and genome-wide association study results for fetal hemoglobin (HbF) in a Mendelian randomization analysis to prioritize five proteins that may increase HbF production (ENPP5, LBP, NAAA, PT3X, ZP3).
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