Production of Transfusable Red Blood Cells from Stem Cells / 대한수혈학회지

ABSTRACT

Blood transfusion is a well-established cell therapy. However, blood available for transfusion is a limited resource and is available only through donations by healthy volunteers. Moreover, the perpetual and widespread shortage of blood products, problems related to transfusion transmitted infections, and new emerging pathogens have elicited an increase in demand for artificial blood. Therefore, research for alternative RBC substitutes has begun in the 1960s. Hemoglobin-based oxygen carriers (HBOC) and perfluorocarbon-based oxygen carrier (PBOC) were two popular study subjects; however, research on these substitute candidates was halted due to unsatisfactory results and safety issues, including death, in the 1990s. Since then, worldwide efforts to produce RBC have shifted over to stem cell-derived RBC production using cord blood and G-CSF-mobilized peripheral blood stem cells, and some progress has been made. In terms of practical usefulness, however, large-scale production and cost effectiveness are still problematic. Recently, human embryonic stem cells (hESC) and human-induced pluripotent stem cells (hiPSC) have shown the potential to produce RBCs as unlimited cell sources. These two methods using hESCs and hiPSCs are also cost-effective since autologous and O, D negative blood RBCs will be used for alloimmunized patients with multiple alloantibodies or rare blood types (high incidence antigens) as well as universal blood production. We will review the current research on in vitro RBC production from hematopoietic stem cells and pluripotent stem cells and assess future directions in this field.