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Health and Science: Lab-grown blood to start clinical trials in UK

25th Nov 2022
Health and Science: Lab-grown blood to start clinical trials in UK

(Photo credit: Pixbay Commons)

For years, scientists have been trying to create blood cells that can be used to treat people for a variety of medical conditions. Now in the UK, the first trial of laboratory-grown blood has got underway, with a few blood cells, around five to ten millilitres worth, being tested in healthy volunteers to see how they perform inside the body.
The manufactured blood cells were grown from stem cells from donors.

In the RESTORE randomised controlled clinical trial, the red cells were then transfused into volunteers. Red blood cells are critical cells within the blood as they transport oxygen from the lungs around the body.

 

 

The oxygen attaches to a molecule called haemoglobin in the red blood cells and is then transported via the blood vessels to all the cells in the body, where it is used in important chemical reactions. Currently, the blood used in medical treatments comes from blood donated by volunteers, making it a valuable resource that saves lives daily.

However, some people have exceedingly rare blood groups, and finding a donor match can be difficult. So, one aim of laboratory-grown blood is to manufacture vital, ultra-rare blood groups. These are necessary to treat patients who require a rare blood type for transfusions, as well as to treat other conditions such as sickle cell anaemia.

In sickle cell anaemia, the haemoglobin molecule has a different shape and cannot bind oxygen as well. This results in tiredness and fatigue as not enough oxygen is being carried to the cells. People with sickle cell disease require regular blood transfusions. Recipients of blood products must have a matching blood group type, or the body will reject the blood cells and the treatment will fail.

The main blood groups are A, B, AB and O, but over the years other very rare blood groups have been identified —so rare that there may only be tens of people in the country with a similar blood type.

Getting blood for these rare groups is therefore problematic, and even more so if they need regular transfusions, such as for sickle cell anaemia.

The process to make the blood cells starts with a blood donation from a volunteer, which is around one pint of blood. Within the blood are special cell types called stem cells, which are cells that have not fully turned into blood cells yet and can become red blood cells. These cells are isolated from the blood and then grown in large numbers and guided to become red blood cells.

This process takes about three weeks, and from an initial pool of around half a million stem cells, around 50 billion red blood cells can be produced. These are then filtered to get around 15 billion red blood cells at the right stage of development for transplantation into the body. The first volunteers have now been enrolled in the study to see the effects of the lab-grown blood cells on the body.

The research project combines teams in Bristol, Cambridge, London, and NHS Blood and Transplant. Each volunteer will receive a small amount of normal blood from a donor and be monitored for four months. They will then receive a small dose of lab-grown cells and be monitored.

The blood has been tagged with a radioactive substance, often used in medical procedures, so scientists can see how long it lasts in the body. While this is a significant step forward in the development of laboratory-grown blood, the process is still in its infancy. Growing blood takes time and incurs extra costs compared to blood donations.

The stem cells used to create red blood cells only multiply and divide for a limited time, which limits the amount of blood that can be made from each donation. More research is required to scale up the process to produce the volumes that would be needed clinically.

However, the start of this trial is a crucial step and a major hope for people with rare blood groups or conditions such as sickle cell anaemia, which affects around 15,000 people in the UK. Dr Farrukh Shah, Medical Director of Transfusion at NHS Blood and Transplant, said: “This world-leading research lays the groundwork for the manufacture of red blood cells that can safely be used to transfuse people with disorders like sickle cell.”

John James OBE, Chief Executive of the Sickle Cell Society, said, “This research offers real hope for those difficult-to-transfuse sickle cell patients who have developed antibodies against most donor blood types.”
“However, we should remember that the NHS still needs 250 blood donations every day to treat people with sickle cell, and the figure is rising.

The need for normal blood donations to provide the vast majority of blood transfusions will remain. “We strongly encourage people with African and Caribbean heritage to keep registering as blood donors and start giving blood regularly.”

Rachel Kayani


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