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Can We Create Universal Blood?

Can We Create Universal Blood?
This video is brought to you by CuriosityStream.  Sign up today at curiositystream.com/   realscience to get free access to Nebula and catch  up on Real Engineering's Logistics of D-Day series   in time for the final episode. In 1959 the  British Medical Journal reported on something   that had never been seen before - several patients  with a mysterious condition, something happening   inside their

blood

that doctors didn't think  was possible. Historically, we've understood   our

blood

types to be a constant immovable  fact of our genetics and of our existence.   But what these doctors found were several  definitive cases of people with an A

blood

   type showing signs of their

blood

type changing  suddenly having red

blood

cells temporarily   expressing the B

blood

type antigen. This  acquired B phenomenon, as it's called,   was never seen in healthy people, only ever in  people with cancer in their stomach or intestine   or with some other condition where the integrity  of the gastrointestinal wall was compromised.   Over time their

blood

type would return to  normal, but scientists were not entirely sure   what had caused it. In 1972 detectives found  a dismembered body in the River Thames. During   the forensic investigation one body part recovered  was shown to have O type

blood

. Later, however, a   different part that had remained in the water for  a longer period was identified as having B-type  

blood

. The...
can we create universal blood

blood

groups therefore implied the two  parts were not from the same individual. However   other evidence determined beyond a shadow of a  doubt that the two parts did belong to each other.   This therefore raised the suspicion that the  second part found had an acquired B-type

blood

.   What is the common link in these two strange  situations? It's not a change in genetics that's   causing the

blood

type to change, nor is it an  accidental introduction of a different

blood

type   from somewhere else. It's the work of bacteria  -specifically a certain type of bacterial enzyme   that cleaves or alters certain

blood

antigens  turning one

blood

type into another. For the   first time scientists realized that our

blood

  types are not so immovable after all. This   acquired B phenomenon can certainly raise problems  with typing

blood

for medicine or with forensic   science, but it could also hold the answer to  a very big problem. If

blood

can accidentally   be transformed from one type to another, can  it be done on purpose? Can we use this idea to   change

blood

types in order to

create

universal

  donor

blood

that is always so desperately needed? Every two seconds someone in the U.S. needs

blood

,  but only around 38 percent of the U.S. population   is eligible to give

blood

or platelets. And  less than ten percent actually do it. And only   seven percent of the population has the so-called 

universal

donor

blood

O negative. The...
can we create universal blood
red cross   reports that on average it only has about six  units of type O

blood

available for every one   hundred thousand people. But more than twice  that is needed every day. You can start to see   the problem here. There is an ever-present need  for

blood

, especially

universal

donor

blood

,   and only so much available. In a previous video  I discussed the importance of the different

blood

   groups and the ABO and Rh systems. The ABO system  is the most important and your group is determined   by the presence of the antigens A and B which are  carried on the surface of your red

blood

cells.   You can have type A, B, AB, or O - O meaning you  have neither of the A or B antigens. The ABO group   antigens are sugars that work to recognize foreign  cells in the

blood

stream. The O

blood

type lacks   the A or B antigen and only has what is known as  the H antigen. It's sort of like a blank or base   antigen. the A and B antigens are then attached to  this H antigen in the A and B

blood

types, and the   only difference between the A and B

blood

antigens  is a single sugar at the end of each structure.   People with the A antigen on the surface of  their red

blood

cells will have an antibody   against the B antigen found on the B type

blood

  cells. And conversely people with the B antigen   will have antibodies against the a antigens found  on A type

blood

. During transfusion if the wrong   type of

blood

is injected the red

blood

...
can we create universal blood
cells  in the injected

blood

will be attacked by the   antibodies and the recipient's

blood

causing them  to clump together or agglutinate this will result   in hemolysis or destruction of the red

blood

cells  which causes serious illness and can be fatal for   the recipient the rh or rhesus system works in a  similar way if you're missing the most important   rh antigens you're considered to have a negative 

blood

type rh negative recipients can only receive   rh negative

blood

but rh positive recipients  can receive either rh positive or negative

blood

   and this is how the eight most common

blood

types  are formed and because the o negative

blood

type   does not produce an incompatibility reaction  in any of the eight types it's considered to   be the

universal

donor it's extremely valuable in  medical situations because in a sudden accident   there may not be time to assess a patient's

blood

  for its type as they're bleeding out if in doubt   o negative

blood

will pretty much always be a safe  bet but o negative

blood

can be very hard to come   by some solutions to the

blood

shortage aim to  get more people to donate others aim to improve   the logistics of

blood

delivery helping to get it  to the people who need it most but even if more   people donated the treadmill of supply and demand  is still profoundly difficult to stay on top of   and this is why the idea of creating

universal

 

blood

has...
floated around the scientific community   for decades if we could turn any type of

blood

  into oh

blood

then many complications in the  

blood

donation network could be alleviated  but how far are we from it becoming a reality   in 1982 scientists first experimented with the  idea of turning any of the

blood

types   a b or a b into o

blood

because the a and b 

blood

types differ from the o type in a simple   sugar chain scientists believed that they could  convert a b and a b red

blood

cells to o type red  

blood

cells by removing these extra sugars with  an appropriate enzyme such converted o red

blood

   cells could then in theory be used as

universal

  donor

blood

this procedure wouldn't affect the   rh status of the

blood

however but conversion  of a positive and b positive red

blood

cells   would yield o positive

blood

whereas a negative  and b negative red

blood

cells would yield o   negative

blood

at the time of this experiment  there was only one commercially available enzyme   that might be able to cleave these sugars alpha  galactosidase derived from green coffee beans   this looked promising to researchers but  the enzyme came with several problems   it required a low ph of 5.7 to do the  conversion which is not ideal for red  

blood

cells that prefer a ph of around 7.4 and  to do it a huge amount of enzyme was required   making the process inefficient and not economical  and most significantly it could only cleave the...
b   type antigen not the a this is because this  enzyme can cleave the galactose of the b antigen   but does nothing to the n acetyl galactosamine  of the a antigen nonetheless scientists were   able to convert b-type

blood

to o

blood

which  was a huge milestone these converted

blood

   cells were shown to have a normal lifespan  and to be well tolerated in the human body   but because only 10 percent of the population  has b-type

blood

versus the 46 of the population   that has a type including the a antigen this idea  would not be viable until scientists could find an   a cleaving enzyme therefore little more  was heard of this technology for many years   that is until 2007 determined to find the missing  piece of the puzzle scientists began the hunt for   a brand new enzyme and they began to look in  the place where the reports about the acquired   b phenomenon had first alluded to the world  of microbes if gut or river bacteria could   accidentally transform

blood

types maybe the  right enzyme could be found among the millions   of microbes that live there thus researchers began  digging through 2 500 fungal and bacterial samples   looking for an enzyme that could efficiently  cleave both a and b sugar groups and within these   samples of bacteria an answer was indeed waiting  for them they discovered two new enzymes within   two different bacteria one often found in bodies  of water and one found in the human gut the enzyme  ...
found in the gut bacteria could cleave the b sugar  group at a ph of seven and the enzyme found in   the river bacteria could cleave the a sugar group  after a 60 minute incubation with the appropriate   enzyme red

blood

cells with a b and a b antigens  no longer expressed any of them they had all been   converted to the

universal

donor

blood

this looked  like the answer that researchers had been looking   for for years but today this technology is still  not in use something about this process was still   preventing it from moving into clinical practice  although the enzyme found in river bacteria could   indeed cleave the a antigen it was still wildly  inefficient the a cleaving enzyme was 30 times   less efficient than the bee cleaving enzyme 60  milligrams of enzyme per unit of red

blood

cells   was needed to convert a to o whereas only two  milligrams of enzyme was needed to convert b to   o and this is not a trivial difference isolation  and purification of enzymes is a costly process   enzymes need to be optimized for stability and  efficiency expressed in some unlucky organism in a   massive fermenter purified to an insane degree and  then packaged handled and shipped and if the idea   is to convert all

blood

types to oh

blood

even in  remote parts of the world the cost of needing huge   amounts of enzyme would make the whole thing  infeasible the dream of creating a

universal

  

blood

was once again tabled but 16 years later ...
scientists have become armed with new technology   metagenomic analysis historically to search for  new enzymes researchers would have to collect   samples of microbes from the environment and then  culture them a method of multiplying the organisms   by letting them reproduce in the lab this of  course takes a fair amount of time and effort but   with metagenomic analysis scientists can assess  the genetics of everything in a sample at once   and look for the desired genes because of this  researchers were able to screen 20 000 bacterial   samples from the human gut looking for an enzyme  that could efficiently cleave the a antigen   at first they didn't see anything promising but  when they tested two of the resulting enzymes at   once the a antigen came right off the two enzymes  are a type of deacetylase and galactoseminidase   and are from a bacteria called flavonofractor  plowtai when they work together they provide   the solution that has eluded scientists for years  and only tiny amounts are needed as little as one   milligram per unit of red

blood

cells versus  the 60 that was needed in previous studies   their high efficiency means they could be cost  effectively added to the already existing routines   of

blood

collection processing and storage with  major implications for the global

blood

supply   typing

blood

could become obsolete and everyone  who donates could become a

universal

donor   people with the more rare...

blood

types won't have  to wonder if the right

blood

will be available   to them and countless lives could be saved this  breakthrough paper was only published last year   so time will tell how soon we can see this in  the real world but there's a lot of reason to   be optimistic for now though more work is  needed to ensure that all of the a antigens   are thoroughly removed and that the process will  not cause any adverse effects in the recipient   and researchers also need to make sure the  microbial enzymes have not inadvertently altered   anything else on the red

blood

cell that could  cause problems but it looks like this decades-long   quest may be over and that the reality of oh 

blood

synthesis is right around the corner   the

blood

supply chain is a complicated  ever-moving machine it's a global treadmill   that thousands work tirelessly to stay on  top of and never is that supply chain more   important than in times of war and examples from  the 20th century show us exactly how true that is   during world war ii the american red cross flew  almost 200 000 pints of whole

blood

from the   us to the allied forces in europe more than 50  000 pints of

blood

were needed for the soldiers   fighting during the d-day invasion of normandy  alone and coordinating this was not a trivial task   as germany tried to conquer the continent of  europe the allied forces became locked in a war of   force and power yes but also...
one of supply chain  logistics and during the invasion of normandy   this contest came to its most important climax  years of planning hundreds of thousands of men   thousands of ships tanks and trucks hundreds of  gliders and airborne troops all working together   to pull off the largest amphibious invasion in  military history an invasion that would change   the course of history forever if you're interested  in how the allies were able to coordinate such a   massive military effort then you should catch  up on the logistics of d-day series made by   our other channel real engineering available  exclusively on nebula it's a multi-part series   with episodes about the logistics of close air  support fuel supply deception tactics and more   the final episode in the series will be released  soon detailing the famed truck convoy the red   ball express that supplied allied forces moving  quickly through europe after breaking out from the   d-day beaches in normandy this original series  is available on nebula which is the streaming   platform made by me and several other  educational youtube content creators   it's a place where we can upload our videos ad  free and a place where we can experiment with   new sometimes controversial content that wouldn't  work on youtube there are long form documentaries   by creators like wendover productions  original series by creators like tom scott and   collaborative series like...
working titles that are 

create

d by dozens of different creators together   so to watch the final episode of the logistics  of d-day series and to catch up on all the past   episodes the best way to sign up to nebula is with  the bundle deal we've made with curiosity stream   curiosity stream is a streaming platform with  thousands of high budget documentaries about   everything from aviation physics space and nature  it alone is a great way to learn about all of your   favorite subjects but now curiosity stream has  partnered with us to offer an incredible deal by   signing up to curiositystream you now also get  a subscription to nebula for just 14.79 for the   entire year by going to curiositystream.com real  science by signing up to this deal you are greatly   supporting this channel and all of your favorite  educational content creators thanks for watching   and if you'd like to see more from me the links  to my instagram twitter and patreon are below