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Updated: Mar 5, 2026

Characterization of Sickling During Controlled Automated Deoxygenation with Oxygen Gradient Ektacytometry
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Discovery of GBT440, an Orally Bioavailable R-State Stabilizer of Sickle Cell Hemoglobin

Brian Metcalf1, Chihyuan Chuang2, Kobina Dufu1

  • 1Global Blood Therapeutics, Inc. , South San Francisco, California 94080, United States.

ACS Medicinal Chemistry Letters
|March 25, 2017
PubMed

We report the discovery of a new potent allosteric effector of sickle cell hemoglobin, GBT440 (36), that increases the affinity of hemoglobin for oxygen and consequently inhibits its polymerization when subjected to hypoxic conditions. Unlike earlier allosteric activators that bind covalently to hemoglobin in a 2:1 stoichiometry, 36 binds with a 1:1 stoichiometry. Compound 36 is orally bioavailable and partitions highly and favorably into the red blood cell with a RBC/plasma ratio of ∼150. This partitioning onto the target protein is anticipated to allow therapeutic concentrations to be achieved in the red blood cell at low plasma concentrations. GBT440 (36) is in Phase 3 clinical trials for the treatment of sickle cell disease (NCT03036813).

Keywords:
Schiff-base formationSickle cell diseasealdehydeallosteric modulatoroxygen affinityred blood cell partitioningsickle cell hemoglobin

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