Division of Hematology, Department of Medicine, and Stem Cell Program, Institute for Cell Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Stem Cells Transl Med. 2014 Mar;3(3):346-55. doi: 10.5966/sctm.2013-0054. Epub 2013 Dec 20.
Blood transfusion is a common procedure in modern medicine, and it is practiced throughout the world; however, many countries report a less than sufficient blood supply. Even in developed countries where the supply is currently adequate, projected demographics predict an insufficient supply as early as 2050. The blood supply is also strained during occasional widespread disasters and crises. Transfusion of blood components such as red blood cells (RBCs), platelets, or neutrophils is increasingly used from the same blood unit for multiple purposes and to reduce alloimmune responses. Even for RBCs and platelets lacking nuclei and many antigenic cell-surface molecules, alloimmunity could occur, especially in patients with chronic transfusion requirements. Once alloimmunization occurs, such patients require RBCs from donors with a different blood group antigen combination, making it a challenge to find donors after every successive episode of alloimmunization. Alternative blood substitutes such as synthetic oxygen carriers have so far proven unsuccessful. In this review, we focus on current research and technologies that permit RBC production ex vivo from hematopoietic stem cells, pluripotent stem cells, and immortalized erythroid precursors.
输血是现代医学中常见的一种程序，在全世界范围内都有实施；然而，许多国家报告称血液供应不足。即使在目前供应充足的发达国家，预计到 2050 年，血液供应也将不足。在偶尔发生的广泛灾害和危机期间，血液供应也会紧张。从同一血单位中输注血液成分，如红细胞 (RBC)、血小板或中性粒细胞，用于多种目的，并减少同种免疫反应，这种做法越来越常见。即使对于缺乏细胞核和许多抗原细胞表面分子的 RBC 和血小板，也可能发生同种免疫，尤其是在有慢性输血需求的患者中。一旦发生同种免疫，这些患者就需要来自具有不同血型抗原组合的供体的 RBC，这使得在每次发生同种免疫后寻找供体成为一项挑战。替代血液替代品，如合成氧载体，迄今为止尚未成功。在这篇综述中，我们重点介绍了目前允许从造血干细胞、多能干细胞和永生化红系前体细胞体外产生 RBC 的研究和技术。
