Few developments in medical science have been as important as blood transfusions. Despite their life-saving potential, challenges remain, particularly related to blood compatibility. However, recent advances in hematology offer a promising solution: the development of “universal” donor blood.
Blood group compatibility
The suitability of blood for transfusion depends on the presence or absence of certain antigens on the red blood cells. Traditionally, individuals with type O blood are considered universal donors due to the absence of A and B antigens. In contrast, individuals with AB blood are universal recipients as they can accept all blood types. However, for those with type A, B or AB blood, finding a suitable donor can be difficult due to antigenic differences.
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Overcoming this challenge has been a long-standing goal in transfusion medicine. Early efforts focused on enzymatically converting type B blood to type O, but faced limitations due to sugar chains remaining in the red blood cells. However, recent research has taken a new approach by utilizing enzymes from gut bacteria to remove these sugar stretches.
In a study published in , researchers identified enzymes from Akkermansia muciniphila, a species of gut bacteria, that can metabolize mucus. These enzymes redesigned red blood cells and effectively increased compatibility between blood types.1
People with group B blood have an advantage
Preliminary findings show significant improvements in compatibility, especially for type B blood. Initial tests showed up to 80% compatibility with type O plasma, increasing to 91-96% after sugar extensions were removed. While type A blood initially showed lower compatibility, refining enzyme cocktails holds promise for further improvements.
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Despite these promising results, challenges remain on the path to universal donor blood. Ensuring the safety and efficacy of this method in clinical settings is of utmost importance. Furthermore, continued research is needed to optimize enzyme cocktails for type A blood and address potential complications.
References
- Jensen, M. C., Stenfelt, L., Hagman, J. R., Pichler, M. J., Weikum, J., Nielsen, T. S., Hult, A. K., Morth, J. P., Olsson, M. L., & Hachem, M. A. (2024, April 29). Akkermansia muciniphila exoglycosidases target extended blood group antigens to generate ABO-universal blood. Nature Microbiology. https://doi.org/10.1038/s41564-024-01663-4 ↩︎
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