Benefit # 44 (of 71) of the California Stem Cell Research Program: A UNIVERSAL BLOOD SUPPLY?
By Don C. Reed
As a child with asthma-bronchitis I spent entirely too much time in hospital. I swallowed utterly vile medicines, some which burned like liquid fire, others that seemed determined to choke me as they went down.
There was also one huge mean nurse: the very opposite of Florence Nightingale—or maybe she was just overworked, underpaid and had a backache from lifting patients all day-- I don’t know. But I feared her, and with reason.
Once she packed me in ice to bring my fever down. She told me, before she left: “Don’t you move. If you do, that will melt the ice, and I’ll have to come back and do you again.”
She yanked the oxygen tent’s plastic curtains together, and I was alone.
For a while it was mildly interesting watching the steam of my breath congeal on the plastic curtain, beading into water droplets, rivuleting down. But I was six.
What had she said? if I moved, she would have to come back… How would she know? I shifted position just a little bit. Nothing happened. I moved again, then more and more, thrashing around like a skinny whale. Sure enough, the ice began to melt. I heard it splashing onto the floor. I was giggling, having fun.
Then the squeak of rubber-soled shoes, coming fast. The curtains ripped open.
Big red face up close to mine, then BAM she slapped me side of the head.
“I told you not to move,” she explained.
I never told my parents about it, being reasonably certain they would side with vested authority.
There would be one more encounter with the evil nurse, which will bring us (I promise!) to the point of this story.
A newcomer on a wheeled bed was shoved in next to mine: a pale little boy with his eyes shut. But what interested me was the glass jar of red liquid suspended above him, and a plastic tube going down into his arm.
I was scared of the nurse. But I was eaten up with curiosity.
“What is that?” I finally asked about the red jar, bracing myself for an explosion.
The nurse looked over at the pale kid, then back to me. And she smiled…
“He gave trouble”, she said, “So we’re taking his blood out. You’re not going to give trouble, are you?”
In a couple days the pale boy went away. I never knew what happened to him. But I had nightmares about that nurse, and her vampiric blood jar…
You know, of course, what I did not: the child was just having a transfusion. They were putting blood in, not taking it out. (This was 1951, and some hospitals still used glass jars instead of blood bags.)
But what if there was no way of storing blood to use in the transfusions? Everything would depend on compatible donors: no match, no transfusion.
Numerous countries worked years on the problem. At the Battle of Leningrad in World War I, the Russians systematically stored blood for wounded soldiers. One Russian surgeon, Sergei Yudin, worked 20 years on the study of taking blood from cadavers. Unfortunately, he was jailed for political reasons in the Stalinist regime, and his last two books were written in prison—on toilet paper!
https://www.dhzb.de/fileadmin/user_upload/deutsche_Seite/wissenschaft_forschung/Historie/Yudin_Surgery.pdf
The Russian work was studied by a wonderfully kind man, Dr. Bernard Fantus. In the early 1930’s he worked at the Cook County Hospital in Chicago, Illinois. He married a nurse (one of the nice ones!) named Emily Senn, and they adopted a little girl, Ruth.
https://en.wikipedia.org/wiki/Bernard_Fantus#The_Blood_Bank[6]
Fantus began thinking about the need for blood, portable and storable, for all those wounded soldiers. He brooded about the possibilities.
He talked about it with his daughter, and one day little Ruth said:
“Why not call it a blood bank?”
In 1937, Dr. Fantus developed the world’s first blood bank. In World War Two many lives were saved, because of stored and transfused blood.
But what if there was no match between donor and recipient? Or if the blood was tainted by disease? Testing could detect much unsafe blood, but maybe not all.
What if, instead of borrowing blood from others, it was made-- from stem cells?
Dr. Tannishtha Reya of UC San Diego wanted to take on that challenge—if the funding could be found.
One of the most interesting grants given by the California stem cell program is the “Inception” award.
This award “provides seed funding for great ideas that have the potential to impact human stem cell research, but need some initial support. It is hoped this will enable the researchers to test their ideas, and give them the data they need to compete for more substantial funding.”—CIRM Stem Cell Agency, May 25, 2017.
Dr. Reya was given an “Inception” Award, relatively small as grants go, $223,200, and she focused on developing O-negative type, red blood cells, which can be used by the vast majority of patients.
A universally acceptable donor blood source would meet a serious need. Because?
“Every two seconds someone in the U.S. needs a blood transfusion, But sometimes, due to a shortage of donors, there is not enough blood… and surgeries…have to be canceled.” –ibid.
“Creating a safe, unlimited supply of universal donor blood cells could have a huge impact, not just in the U.S., but worldwide,” said Jonathan Thomas, Ph.D, J.D., Chair of the CIRM board of directors.
So how does Dr. Reya hope to meet this need?
Below is my layman’s understanding: from reading all the available papers, and a half-hour talk on the phone: how she can (maybe!) make a universal blood supply.
First, bone marrow is where the blood is made, so she will need to take some from a healthy person, just one– and that person’s contribution may be all we ever need.
Then Dr. Reya will apply one specific gene to take the cells half-way to becoming blood. They are now a stem cell-derived line of erythroblasts (urr-reeth-row-blasts), what I call “the E-line”.
They must stay as they are, and not change (differentiate) into Red Blood Cells (RBCs)—not yet.
Here’s why. Erythroblasts can be multiplied cleanly; RBCs cannot.
She will multiply the “E-line”, making lots. Then, differentiate it—into clean, non-rejectable red blood cells. Inject where needed; it is ready to be used.
Of course, it is easier for me to say than for Dr. Reya to do! But the idea seems sound, and we wish her all success—if she wins, everybody wins.
P.S. One more story about the aforementioned Dr. Fantus. He hated to see children suffering, struggling as they were forced to swallow hateful-tasting medicine. He kept thinking—why should medicine have to taste loathsome?
So, he contacted confectioners, professional candy-makers-- and came up with flavors and coatings more acceptable to kids!
Medical research: organized kindness: to save lives and ease suffering…
Don C. Reed is the author of the forthcoming book, “CALIFORNIA CURES: How the California Stem Cell Program is Fighting Your Incurable Disease!”, from World Scientific Publishing, Inc., available for pre-order at:
https://www.worldscientific.com/worldscibooks/10.1142/10747
