[HN Gopher] Enzymes open new path to universal donor blood
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       Enzymes open new path to universal donor blood
        
       Author : gnabgib
       Score  : 136 points
       Date   : 2024-04-30 16:41 UTC (1 days ago)
        
 (HTM) web link (www.dtu.dk)
 (TXT) w3m dump (www.dtu.dk)
        
       | ashvardanian wrote:
       | Made my day! Progress worth living for!
        
       | downrightmike wrote:
       | Very cool stuff!
       | 
       | "For the first time, the new enzyme cocktails not only remove the
       | well-described A and B antigens, but also extended variants
       | previously not recognized as problematic for transfusion safety.
       | We are close to being able to produce universal blood from group
       | B donors, while there is still work to be done to convert the
       | more complex group A blood. Our focus is now to investigate in
       | detail if there are additional obstacles and how we can improve
       | our enzymes to reach the ultimate goal of universal blood
       | production," says Professor Maher Abou Hachem, who is the study
       | leader at DTU and one of the senior scientists behind the
       | discovery.
        
         | bayouborne wrote:
         | Cinemax's excellent 'The Knick' (about a chief surgeon at the
         | Knickerbocker Hospital in 1900's New York) had a gut-wrenching
         | one or two episode arc about efforts to refine transfusion
         | techniques and why the team kept seemingly randomly ending up
         | w/dead patients because no one had yet understood Rhesus factor
         | proteins.
        
       | TSP00N3 wrote:
       | Long time listener, first time caller (finally made a HN
       | account)..
       | 
       | Anyways, can someone please explain how positive/negative plays a
       | factor here? Rh +/- is mentioned once in the article but not
       | discussed as far as being a donor. I was always told O- is the
       | universal red cell donor [1]. Can anyone help explain is this
       | enzyme fixes the +/- component in addition to the ABO component?
       | Thanks!
       | 
       | [1] https://www.redcrossblood.org/donate-blood/blood-types.html
        
         | Terr_ wrote:
         | That's probably a separate and harder problem from this: The A
         | and B antigens refer to the presence of carbohydrates extending
         | from the cell membrane, whereas Rh factor + refers to the
         | presence of a protein.
         | 
         | Since there are different classes of bio-molecules, proteins
         | may need different techniques to remove, alter, or cover them
         | up.
         | 
         | If we do find such techniques, they may have _much_ broader
         | applications in immunology.
        
           | XorNot wrote:
           | Rhesus factor is a lot more forgiving though: i.e. in a
           | crisis you can transfuse rhesus positive blood to a rhesus
           | negative person successfully since the sensitization doesn't
           | emerge immediately.
        
         | HPsquared wrote:
         | There are three components that can cause problems with
         | transfusions: "A", "B" and "Rhesus". A person can have any
         | combination of those three (8 combinations).
         | 
         | The A/B/AB/O is basically having only A, only B, both, or
         | neither. And the +/- is whether you have the "Rhesus"
         | component.
         | 
         | The basic rule is that you can't introduce new components to a
         | person who doesn't have them in their system, and will be
         | treated as foreign contaminants.
         | 
         | So someone with all three components already (AB+) can take any
         | blood because their system already is used to all three
         | components.
         | 
         | A person with none of the components in their system (O-) would
         | have an allergic reaction to any of the three components being
         | introduced. On the other hand their blood is safe to donate to
         | anyone else as it won't introduce any "unexpected components"
         | to a recipient.
         | 
         | EDIT: ah, I see - article doesn't mention Rhesus. I guess it
         | can convert AB- to O-, or AB+ to O+.
        
           | Buttons840 wrote:
           | I _think_ O is recessive (if I remember from high school
           | correctly).
           | 
           | A is really AO (if we're being verbose). B is BO, AB is AB, O
           | is OO. Each parent passes one of them on. So, a A dad and O
           | mom would mix (being verbose again) AO and OO, and thus the
           | child might be AO or OO, A or O.
           | 
           | The + or - is for an independent "Rhesus" component, as you
           | say. Not sure how this passes through the genes. This is all
           | like high school level knowledge, so maybe someone can share
           | more if they want.
           | 
           | My dad had surgery and some paperwork we received said that
           | he had AB blood. It became a family joke because me and my
           | siblings are all O blood type. If my dad really did have AB
           | blood then we are not his children. The hospital later
           | confirmed it was a mistake.
        
             | blendergeek wrote:
             | You mostly remember correctly. One small nitpicko on the
             | genetics (based on my high school biology)
             | 
             | A can be either AA or AO and B can be either BB or BO.
             | 
             | AB is always AB like you said and O is always OO.
        
             | linooma_ wrote:
             | > I think O is recessive
             | 
             | Strangely, O is very common.
        
               | riffraff wrote:
               | I seem to remember the explanation is that A and B are
               | somewhat recent mutations in evolutionary terms, they
               | simply have not had time to cancel out 0 yet.
               | 
               | Of course there's crackpot theories (aliens!) too.
        
               | thaumasiotes wrote:
               | What's the strange part? "Recessive" and "common" are
               | different concerns.
               | 
               | Having five fingers per hand is recessive too.
        
               | quesera wrote:
               | > _Having five fingers per hand is recessive too._
               | 
               | Fascinating, and true.
               | 
               | Which engenders speculation about how the world would be
               | different if we counted in base-12. Obvious advantages to
               | convenient divisibility aside.
        
           | smegger001 wrote:
           | there is also the HH blood group that will react negatively
           | to O type blood as well as A and B.
        
             | Terr_ wrote:
             | That naming is a little confusing, because if you say
             | "blood group "A" or "B", that indicates the _presence_ of A
             | and B antigen structures, however  "blood group H" means a
             | _lack_ of H. (Since almost everybody has H, it was
             | discovered much later.)
             | 
             | Since H is also a building-block needed for A and B to show
             | up, it makes for fun medical-mystery plots, where a child's
             | blood-type _seems_ to be O and doesn 't match their
             | parents, but in reality they did get parental A/B/AB genes
             | that just aren't able to express because each parent
             | contributed a nonfunctional H-allele.
             | 
             | https://www.ncbi.nlm.nih.gov/books/NBK2268/
        
               | Terr_ wrote:
               | P.S. IANAPhlebotomist, but if I could wave a wand to
               | change the nomenclature, I'd make it stop relying on an
               | implicit "nothing" state that keeps changing under us as
               | we discover new features that are either usually-present
               | or usually-absent.
               | 
               | Instead patients would have a "blood code" that indicates
               | the tested presence or absence of _phenotype_ cellular
               | features, and any feature not listed would be considered
               | "not yet known, do a test if it might be important."
               | 
               | For example, today's AB- would become +HAB-R for "has
               | H,A,B lacks Rhesus factor." Similarly, O+ would become
               | +HR-AB, and the super rare mutation we were just talking
               | about would be either +R-HAB or -HABR.
               | 
               | Then when we eventually discover a yet-another factor
               | X... Well, yes, your code wouldn't be constant throughout
               | your life, because after an X-test it would gain either a
               | +X or -X... However the upshot is that it eliminates
               | weird implicit guessing games, and medical professionals
               | will "know what they don't know".
        
               | thaumasiotes wrote:
               | > For example, today's AB- would become +HAB-R for "has
               | H,A,B lacks Rhesus factor."
               | 
               | That's already the way A, B, and Rhesus factor work. The
               | abbreviation for Rhesus factor is "+", but the formal
               | terminology is "Rh+". I would have expected "H-" by
               | analogy.
        
               | Terr_ wrote:
               | > That's already the way A, B, and Rhesus factor work.
               | 
               | No, it isn't: The current ABO system is incapable of
               | expressing "null" data (e.g. "we don't know if B antigens
               | are present or not") and relies on implicit "no marking
               | means false" assumption, which becomes a problem if a
               | new/newly-important antigen feature is discovered, or if
               | a new variation of an existing antigen is found.
               | 
               | For example, suppose we discover a new type Z, which is a
               | membrane-sugar _just like A and B_ , and logically ought
               | to be encoded the same way. It exists in a 50/50 ratio in
               | every existing blood-group, and it finally explains some
               | rare but fatal transfusion problems.
               | 
               | Now some unconscious patient arrives at the emergency
               | room with a wristband saying "AB+". Does that string mean
               | they _were_ tested for Z already, and it was absent, or
               | does it mean there _no data_ about whether Z is present
               | or not? Nobody knows! Worse, if you do a test and
               | discover no Z, then you write the same thing and have the
               | same problem later, all because of the mistake of
               | encoding  "false" as an empty string.
               | 
               | Now you might say "Forget the ABO crap, require Z+ or Z-
               | to appear as a separate item", I'll say: "I totally
               | agree, but let's _remove_ the ABO crap and encode _all_
               | the antigens the same way to make it logically consistent
               | and clear. "
               | 
               | > I would have expected "H-" by analogy.
               | 
               | If you're thinking of another section like "A Rh+ H-",
               | then that's close to what I'm proposing, except that it
               | hasn't fixed the historical ambiguities of O/A/AB.
               | 
               | If you fix it to make things explicit and consistent, it
               | becomes "A+ B- Rh+ H- ", and if you shorten Rh to R and
               | group similar things together... that leads to codes like
               | +R-HAB or -ABH+R, which are (ordering aside) what I just
               | proposed.
        
               | Sn0wCoder wrote:
               | I have never heard of the H-allele. Not sure if
               | @Buttons840 has seen this but "It became a family joke
               | because me and my siblings are all O blood type. If my
               | dad really did have AB blood then we are not his
               | children. The hospital later confirmed it was a mistake."
               | 
               | Thank you for the information as I always love learning
               | more from the comments than the articles.
        
           | jorvi wrote:
           | Also important to note that blood plasma is the reverse. So
           | AB+ is universal plasma donor, and O- universal plasma
           | receiver!
        
       | noah_buddy wrote:
       | Similar news recently about opening up the doors to less
       | compatible donors for PBSC or bone marrow.
        
         | Purplehermann wrote:
         | Link?
        
       | gorkish wrote:
       | Enzymes catalysts and molecular scale physical chemistry is
       | really kicking ass recently. Seems that we are tipping over the
       | knife edge of well and truly cracking the code!
        
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