Migliaccio Anna Rita, Whitsett Carolyn, Migliaccio Giovanni
Tisch Cancer Institute, Mount Sinai School of Medicine, ew York, NY 10029, USA.
Curr Opin Hematol. 2009 Jul;16(4):259-68. doi: 10.1097/MOH.0b013e32832bcaa2.
Red blood cells (RBCs) transfusion plays a critical role in numerous therapies. Disruption of blood collection by political unrest, natural disasters and emerging infections and implementation of restrictions on the use of erythropoiesis-stimulating agents in cancer may impact blood availability in the near future. These considerations highlight the importance of developing alternative blood products.
Knowledge about the processes that control RBC production has been applied to the establishment of culture conditions allowing ex-vivo generation of RBCs in numbers close to those (2.5 x 10 cells/ml) present in a transfusion, from cord blood, donated blood units or embryonic stem cells. In addition, experimental studies demonstrate that such cells protect mice from lethal bleeding. Therefore, erythroid cells generated ex vivo may be suitable for transfusion provided they can be produced safely in adequate numbers. However, much remains to be done to translate a theoretical production of approximately 2.5 x 10 RBCs in the laboratory into a 'clinical grade production process'.
This review summarizes the state-of-the-art in establishing ex-vivo culture conditions for erythroid cells and discusses the most compelling issues to be addressed to translate this progress into a clinical grade transfusion product.
红细胞输血在众多治疗中起着关键作用。政治动荡、自然灾害和新出现的感染对采血的干扰，以及癌症治疗中对促红细胞生成素使用的限制，可能在不久的将来影响血液供应。这些因素凸显了开发替代血液制品的重要性。
关于控制红细胞生成过程的知识已应用于建立培养条件，从而能够从脐带血、献血单位或胚胎干细胞中体外生成数量接近输血时（2.5×10个细胞/毫升）的红细胞。此外，实验研究表明，这些细胞能保护小鼠免于致命性出血。因此，只要能安全地大量生产，体外生成的红系细胞可能适合用于输血。然而，要将实验室中理论上约2.5×10个红细胞的产量转化为“临床级生产工艺”，仍有许多工作要做。
本综述总结了建立红系细胞体外培养条件的最新进展，并讨论了将这一进展转化为临床级输血产品需要解决的最紧迫问题。
