Flahou C, Sugimoto N, Eto K
Department of Clinical Application, Center for iPS Cell Research and Application, Kyoto University, 53, Kawahara-cho, 606-8507 Shogoin, Sakyo-ku, Kyoto, Japon.
Department of Regenerative Medicine, Chiba University Graduate School of Medicine, Chiba, Japon.
Bull Acad Natl Med. 2020 Dec;204(9):961-970. doi: 10.1016/j.banm.2020.09.040. Epub 2020 Sep 28.
Ex vivo production of human platelets have been pursued as an alternative measure to resolve limitations in the supply and safety of current platelet transfusion products. To this end, induced pluripotent stem cells (iPSCs) are considered an ideal global source, since they are not only pluripotent and self-renewing, but also are available from basically any person, have relatively few ethical issues, and are easy to manipulate. From human iPSCs, megakaryocyte (MK) lines with robust proliferation capacity have been established by the introduction of specified sets of genes. These expandable MKs are also cryopreservable and thus would be suitable as master cells for good manufacturing practice (GMP) grade production of platelets, assuring availability on demand and safety against blood-borne infections. Meanwhile, developments in bioreactors that physically mimic the in vivo environment and discovery of substances that promote thrombopoiesis have yielded competent platelets with improved efficiency. The derivation of platelets from iPSCs could further resolve transfusion-related alloimmune complications through the manufacturing of autologous products and human leukocyte antigen (HLA)-compatible platelets by manipulation of HLAs and human platelet antigens (HPAs). Considering these key advances in the field, HLA-deleted platelets could become a universal product that is manufactured at industrial level to safely fulfill almost all demands. In this review, we overview the ex vivo production of iPSC-derived platelets towards clinical applications, a production that would revolutionize the blood transfusion system.
体外生产人血小板已被视为一种替代措施,以解决当前血小板输血产品在供应和安全性方面的局限性。为此,诱导多能干细胞(iPSC)被认为是一种理想的通用来源,因为它们不仅具有多能性和自我更新能力,而且基本上可从任何人获取,伦理问题相对较少,且易于操作。通过导入特定的基因组合,已从人iPSC建立了具有强大增殖能力的巨核细胞(MK)系。这些可扩增的MK也可冷冻保存,因此适合作为用于按照药品生产质量管理规范(GMP)级生产血小板的主细胞,确保按需供应并防止血源感染。同时,在物理模拟体内环境的生物反应器方面的进展以及促进血小板生成的物质的发现,已产生了效率更高的合格血小板。通过对人类白细胞抗原(HLA)和人类血小板抗原(HPA)进行操作,从iPSC衍生血小板可通过生产自体产品和HLA相容的血小板进一步解决输血相关的同种免疫并发症。考虑到该领域的这些关键进展,缺失HLA的血小板可能成为一种通用产品,可在工业规模生产,以安全地满足几乎所有需求。在本综述中,我们概述了用于临床应用的iPSC衍生血小板的体外生产,这种生产将彻底改变输血系统。