Canada’s blood transfusion service and the patients who benefit from it owe a great deal to pioneering innovation in the field of blood typing. Work by immunohematologists Marie Crookston at the University of Toronto and Dr. Bruce Chown, Dr. Jack Bowman and team at the Winnipeg Rh Laboratory in the mid-twentieth century advanced clinical knowledge of transfusion reactions due to blood cell antibody responses. Their studies made the transfusion service aware of these potentially life-threatening reactions and gave clinicians new treatments. Furthermore, results like these from the broader field of blood typing also paved the way for current research looking at camouflaging blood cells and making artificial universal donor blood.
Dr. Bruce Chown and the Winnipeg Rh Laboratory
Dr. Bruce Chown graduated from the University of Manitoba medical school in 1922. He spent three years in pediatric research in the United States before returning to the Children’s Hospital in Winnipeg. In 1940, his research interests turned to human blood groups in general, and newborn and infant conditions in particular.
At the time, Rhesus (Rh) factor on the surface of red blood cells and the Rh factor system were not fully understood. Although Rh factor was discovered by Karl Landsteiner in 1937, its importance became apparent only through follow-up work in 1940. A paper on hemolytic disease of newborn babies showed that this newly discovered blood type caused neonatal deaths and severe transfusion reactions.
Rh factor is a blood group antigen, a protein that spans across the red cell membrane to the outside of the cell. Humans either do or do not possess these markers, hence the blood-typing classifications Rh+ or Rh−. There are several different Rh antigens, but the most common one referred to is termed D. Normally the Rh system does not cause a problem unless an Rh− individual is sensitized and carries anti-Rh antibodies. This is rare, but sensitization can happen during pregnancy and with blood transfusion. Sensitized individuals will therefore destroy any Rh+ red blood cells they encounter.
Dr. Mark Scott at the Centre for Blood Research
Dr. Mark Scott, a senior investigator with the Canadian Blood Services and the Centre for Blood Research at the University of British Columbia (UBC) is pinning camouflage to red blood cells to help them avoid a patient’s immune system. The camouflage molecule, known as PEG, sits on the cell surface and blocks antibody attack, thus protecting the donor cells from destruction. Another approach is to snip the red cell antigens from the cell membrane. UBC associate professor Dr. Jayachandran Kizhakkedathu and team have developed an enzyme that does just that, making artificial O− blood for transfusion.
Research like this may make it possible for blood banks and transfusion services to respond quickly to patient needs in the future, serving disaster medicine where large volumes are required almost instantly, and providing safe products for patients with rare blood groups. Without pioneering basic research into blood type characterization from immunohematologists like Crookston and Chown, the idea of an artificial universal donor blood would be impossible.
This post, along with others in our Innovation150 series, was prepared by Amanda Maxwell, for Canadian Blood Services, with grateful thanks to Dr. Jacalyn Duffin, Queen’s University, Kingston, Ontario, for additional insights and materials.