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The unborn baby was in trouble. Her mother’s doctors at a British hospital knew something was wrong with the fetal blood, so they performed an emergency caesarean section several weeks before the baby was born. But despite this and the blood transfusions that followed, the baby suffered a devastating brain hemorrhage. Sadly, he passed away.
It was not known why the bleeding occurred. But there was a clue in the mother’s blood, where doctors had detected antibodies. Some time later, as doctors tried to find out more about them, a pattern of the mother’s blood arrived at a Bristol lab. run through researchers who examine blood types.
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They made an unexpected discovery: The woman’s blood was an ultra-rare type, which may also have made her baby’s blood incompatible with hers. It’s conceivable that this caused her immune formula to produce antibodies opposite to her baby’s blood, antibodies that then crossed the placenta and damaged her child, ultimately leading to her loss. It may seem unlikely that such a thing could also happen, however, decades ago, before doctors had a greater understanding of blood types, it was much more common.
By reading the mother’s blood sample, as well as several others, the scientists were able to determine precisely what made her blood different and, in doing so, showed a new set of blood equipment: the “Er” system, the 44th to be described. .
You probably know the 4 main blood types: A, B, O, and AB. But this is not the only blood classification system. There are many tactics for organizing red blood cells based on differences in the sugars or proteins that cover their surface, called antigens. Grouping systems work simultaneously, so your blood can be classified into: it can, for example, be type O in the ABO system, positive (instead of negative) in the Rhesus system, etc.
Through antigen differences, if someone receives incompatible blood from a donor, for example, the recipient’s immune formula can stumble upon those antigens as foreign and react against them. This can be very dangerous, and that is why donated blood will have to be compatible if someone is receiving a transfusion.
Esther Nakkazi
Lauren Goode
Lily Hay Newman
Boone Ashworth
On average, researchers have described a new blood classification formula every year for the past decade. These new formulas tend to involve blood types that are incredibly rare, but for those affected by them, just knowing they have such blood can save lives. Here’s the story of how scientists unraveled the mystery of the latest blood formula and why it’s important.
It was in 1982 that researchers first described an antibody in a blood pattern that suggested the mysterious blood type existed. Scientists couldn’t say much more than that at the time, but they knew the antibody was a clue pointing to an unknown molecule or design. that caused the person’s immune formula to generate it.
In the years since, more people with these rare antibodies have appeared, but only occasionally. Usually, those other people have emerged through blood tests containing the mysterious and rare antibodies. Eventually, Thornton and his colleagues at NHS Blood and Transplant in the UK made a decision to take a look at what antibodies might be. “We’re working on rare cases,” she says. It starts with a patient with a challenge we’re looking to solve. “
But so few were the mysterious antibodies in the most recent paintings that when the team began their research, they only had ancient blood samples from just thirteen other people, accumulated over 40 years, to analyze. Other systems put in place have recently been discoveredthanks to an equally small number of other people. In 2020, Thornton and colleagues described a new blood type called MAM-negative that, at the time, had only shown up in 11 other people worldwide. And some of the recently discovered highs of blood types have been discovered in exclusive families, he adds. “MAM” and “Er” are difficult-to-understand references to the names of patients whose blood samples first triggered the option to discover a new blood type.
It turns out that the new clustering system, 44, detailed in the journal Blood, is linked to a protein found on the surface of red blood cells.
Thornton originally had the idea that this protein, called Piezo1, was related after comparing the genomes of patients in the study. She and her colleagues discovered how the gene responsible for this protein varies among other people of other Er blood types. According to different differences, a small number of other people have amino acids of choice, or building blocks, in their Piezo1 protein. As a result, blood cells containing the non-unusual Piezo1 maximal protein appear to be foreign to your body’s immune system.
The team then tested whether or not the antibodies reacted with lab cultures containing mutant versions of the Piezo1 protein, which they created using gene editing. This allowed them to verify that variation in Piezo1 was the driving force behind blood incompatibility in the other people whose samples they examined. “It was something you wouldn’t have been able to do a few years ago,” says co-author Ash Toye, professor of mobile biology at the University of Bristol.
Esther Nakkazi
Lauren Goode
Lily Hay Newman
Boone Ashworth
There are five Er antigens in total, with five imaginable diversifications of Piezo1 on the surface of red blood cells that can lead to incompatibility. Two of the antigens were recently described through Thornton and other researchers, and one of them was discovered in the blood of a pregnant woman in the United Kingdom who lost her bath.
Most likely, the results of the study will be officially ratified as the definition of a new blood organization formula later this year at an assembly of the International Society of Blood Transfusion. The effort required to make the discovery was “enormous,” says Neil Avent, an honorary professor. of the University of Plymouth blood diagnostic organisation, which was not involved in the work. It also revealed complexities about this rare blood, for example, that there are genetic mutations linked to it.
On the other side of the Atlantic, a separate team of researchers had also tried to get to the bottom of the secrets of the new Er blood type, but the British team had overcome it. “This is happening in this area,” says Connie Westhoff of the New York Blood Center, who was part of the U. S. research. “U. S. ” From time to time we know that we rush to find the solution in several other labs. “
She says she and her colleagues have more blood samples that appear to be from other people with rare Er blood type. uncovered.
“Discovering a new blood type formula is like finding a new planet. It magnifies the landscape of our reality,” says Daniela Hermelin of Saint Louis University School of Medicine, who was not involved in the study. This adds to our wisdom of how blood incompatibility can affect pregnant women and their babies, she explains. And now that cases of blood incompatibility can potentially be attributed to blood type Er, the chances increase that doctors will be able to properly diagnose such a challenge and treat it, by transfusion blood to the baby. in the womb, for example.
It will also be possible to search for and identify patients who have this problematic blood. For example, someone might go to the hospital for a transfusion and have an initial blood test that shows the presence of certain rare antibodies. Doctors may also simply send the blood for analysis, and it may also turn out that they have the rare blood that Er described in the article. “We set up our controls so we can do that too,” Thornton says. that person’s transfusion, he adds. In the future, scientists in a lab could possibly grow red blood cells that can also be presented to those patients for transfusion.
It’s very, very unlikely you’ll have an incompatibility with someone else’s blood because of Er antigens, Advent says. But “if you do, it’s something you need to know. “
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