Blood transfusions are of growing
importance as every two seconds someone in the United States needs blood. In just one car accident a victim could need
as much as 100 pints of blood. One part of the blood that is often transfused
is the platelets. Of the 1.6 million people who were diagnosed with cancer last
year, many of them have low platelet counts due to chemotherapy or radiation.
These patients rely on platelet transfusions on a regular basis.
Platelets
are cell fragments that are produced in the bone marrow from parent cells
called megakaryocytes. The outer edges of megakaryocytes extend through the
endothelium where parts of their cytoplasm turns into turn into disk-like extensions
that become platelets. When someone gets a cut or injury, platelets are the
first cells to respond and help the blood clot, preventing further blood loss.
The process of blood clotting occurs through a coagulation cascade that
includes many different enzymes. The steps of hemostasis, or the process to
stop bleeding, are vasoconstriction in which blood flow to the injury site is
decreased, temporary blockage of the break, and then finally coagulation, or
the formation of a clot to seal the hole into the tissue can be repaired. This
process of clot formation is an example of a positive feedback loop. As more
and more platelets aggregate, they recruit other platelets to do the same. Additionally,
platelets will work in conjunction with white blood cells from the immune
system to repair the wound. Platelets can store and release chemokines and
cytokines (as seen in the image below), allowing them to interact with immune
system cells in order to respond to inflammation.
Created by Jodi Forward
Recently, scientists at Brigham and
Women’s Hospital in Boston engineered a source of human blood without the need
for a human donor. The scientists developed a platelet bioreactor that can make
functional human platelets in vitro. According to the researchers, donors provide more than 2.17
million platelet units each year in the United States to give blood
transfusions for major trauma victims as well as for those undergoing
chemotherapy, organ transplantation and surgery. However, the demand for blood
is increasing and the number of donors is not enough to keep up with that demand.
Making
platelets has proven difficult in the past, but through biological engineering
techniques, the scientists were able to successfully produce platelets. By
mimicking the biological environment of the bone marrow, the bioreactor has
shown to successfully make platelets at a high rate. They were able to recreate
bone marrow stiffness, extracellular matrix composition, and blood flow
stability. When the scientists applied shear forces in the bioreactor that are
similar to the blood flow platelets face in
vivo, the initiation of platelet production increased from 10 percent to 90
percent.
American Society of Hematology. Digital Image. http://www.hematology.org. Accessed March 2015.
The
use of a bioreactor to make platelets has many advantages over human donors. When
blood transfusions come from human donors, there is a risk of contamination or
rejection. By creating the technology to make platelets in a lab, these risks
can be minimized. With no disease transmission dangers, the platelets created by this bioreactor have the
potential to transform the way blood is transfused around the world. In
addition, platelets only have a five-day shelf life, preventing the possibility
of storing donated platelets for long periods of time. The bioreactor allows
for the production of platelets on an industrial scale. In the
future, the researchers would like to determine the success of these platelets
in a human clinical trial so that they could be considered an alternative
source for platelet transfusions.
Ref:
American
Cancer Society: http://www.cancer.org
American
Red Cross: http://www.redcrossblood.org/learn-about-blood/blood-facts-and-statistics
Thon JN, Maxutis L, Wu S,
Sylman JL, Ehrlicher A, Machlus KR, Feng Q, Lu S, Lanza R,
Neeves KB,
Weitz DA, and Italiano Jr JE. Platelet bioreactor-on-a-chip. Blood, 124:(12)
1857-
66
(2014).
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ReplyDeleteThis is such a great idea! I am extremely curious how they managed to create platelets that won't induce immune rejection. Do they have engineer the platelets slightly differently depending on blood type? I also wonder if they have used tested the effectiveness and immunogenicity of the platelets on an animal model or human.
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