Cellular regulation of fetal hemoglobin production

In this paper, we put together several observations from studies in erythroid cultures that suggest that the major regulatory events determining Hb F and Hb A formation in the red cells are taken at the level of erythroid stem cells. We outlined the evidence that suggests that the program of Hb F expression changes during the differentiation of the primitive progenitors, known as burst-forming units, and we raised several possibilities on how this differentiation-dependent change in developmental programs could be accomplished. Although many questions remain still unanswered, the work done so far suggests that the mechanisms of regulation of Hb F at the cellular level can be successfully probed with existing methodologies. Delineation of the cellular mechanism of Hb F regulation is required in order to find out whether the therapeutic manipulation of Hb F in the patient with Cooley's anemia is possible or not.