Young blood transfusion

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Young blood transfusion refers to transfusing blood specifically from a young person into an older one with the intention of creating a health benefit. [1] The scientific community currently views the practice as essentially pseudoscientific, with comparisons to snake oil. [1] [2] [3] There are also concerns of harm. [3] The U.S. Food and Drug Administration, in 2019, cautioned "consumers against receiving young donor plasma infusions" stating that they are an "unproven treatment". [3]

Contents

Research

Experiments beginning in the 1950s in the Cornell University lab of Clive McCay on pairs of old and young rodents placed into parabiosis provided some evidence, albeit limited and "largely anecdotal", that the circulation of blood from young mice increased both the longevity and the tissue function of old mice. [4] After decades in which relatively little work on parabiosis in aging was done, the work was revived by researchers at Stanford University and the University of California at Berkeley. [4] [5] Parabiosis experiments are difficult to generalize, as the circulatory systems of the mice are fully joined and it is unclear whether the benefits come from the sharing of blood or the older mouse's access to the younger mouse's organs. [1]

A study conducted at UC Berkeley found that when delivered alone, blood from older mice was more inhibitory to the regenerative capacities of younger mice than blood from younger mice was beneficial to older ones, and that the benefit of young blood in older mice was less than had been observed when older mice were subjected to parabiosis. [6] [7] Replacing plasma of old mice with saline and albumin from young mice was sufficient to rejuvenate brain, liver, and muscle. [7] A 2020 review of plasma components that change with age identified several candidate anti-aging and pro-aging factors. [8]

In experiments like this, researchers found that some of the parabiosed died quickly (11 out of 69 in one experiment) for reasons the scientists could not explain, but described as possibly some form of immune rejection; [4] [1] most such cases were the young parabiont. [4] Amy Wagers, a researcher who coauthored several mouse studies on young blood transfusion, has said that her papers do not provide a scientific basis for some of the existing human trials. [2]

A review of studies on donor age for whole blood transfusions reported that blood from donors under the age of 20 years, when compared to donors aged 20–60 years, resulted in a modestly higher risk of death in the recipients. [9] However, other studies have found no effect of age. [10] [11] Research on blood transfusion outcomes has been complicated by the lack of careful characterization of the transfusion products that have been used in clinical trials; studies had focused on how storage methods and duration might affect blood, but not on the differences among lots of blood themselves. [12]

Another approach to achieving "younger" blood is to rejuvenate blood-producing stem cells in the bone marrow. A 2023 study reported that the existing rheumatoid arthritis drug anakinra blocked IL-1B in elderly mice and returned those cells to a more youthful state. [13]

Commercial development

In February 2019 the FDA warned about companies offering young blood transfusions stating:

"simply put, we’re concerned that some patients are being preyed upon by unscrupulous actors touting treatments of plasma from young donors as cures and remedies. Such treatments have no proven clinical benefits for the uses for which these clinics are advertising them and are potentially harmful. There are reports of bad actors charging thousands of dollars for infusions that are unproven and not guided by evidence from adequate and well-controlled trials. The promotion of plasma for these unproven purposes could also discourage patients suffering from serious or intractable illnesses from receiving safe and effective treatments that may be available to them." [3] [14]

Ambrosia

A startup company, Ambrosia, has been selling "young blood transfusions" for $8,000 since 2016 under the guise of running a clinical trial, to see if such transfusions lead to changes in the blood of recipients. [1] [15] As of August 2017, they had 600 people join. [16] The clinical trial has no control arm and so is neither randomized nor blind. As described, whole blood collected by blood banks that had passed its 42-day storage limit was centrifuged to remove cells, the resulting cell-free plasma pooled from several donations and intravenously transfused into recipients. [16] The company was started by Jesse Karmazin, a medical school graduate without a license to practice medicine. [17] David Wright is the licensed doctor overseeing the clinical trial; in his practice he administers intravenous treatments of vitamins and antibiotics for nontraditional purposes and was disciplined by the California Medical Board for the latter in 2015. Jonathan Kimmelman, a bioethicist from McGill University, suggests that Ambrosia is running this as a trial as they would be unable to get FDA approval to sell this treatment otherwise. [17]

On February 19, 2019, Ambrosia announced it stopped testing the treatment, responding to concerns from the FDA. [14]

Alkahest

Another company, Alkahest, was founded based on the Stanford rodent studies. As of 2017 it is collaborating with European pharmaceutical company Grifols to create a blood plasma-based experimental biologic drug which they propose to test on people with Alzheimer's. [15] [18]

Maharaj/Faloon trial

Scientific American reported in 2018 that young blood transfusion was being offered as a paid "trial", [2] which, like Ambrosia's trial, [2] [19] had no distinct control group from the treatment; it also charged participants $285,000 per person. [2] Dipnarine Maharaj, a Florida physician running the trial, has previously offered both traditional and nontraditional anti-aging treatments such as stem cell banking. [2] He also has ties to the Hippocrates Health Institute, an organization promoting unproven alternative medicine. [20] This trial was promoted by Bill Faloon, [2] who founded the Life Extension Foundation, [21] which was raided by the FDA In 1987 for illegally importing medicine, though the case was dropped in 1996. [22]

Young Blood Institute

An organization called the Young Blood Institute has also run trials; these, however, involved exchange only of blood plasma. [23]

See also

Related Research Articles

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Gene therapy is a medical technology that aims to produce a therapeutic effect through the manipulation of gene expression or through altering the biological properties of living cells.

<span class="mw-page-title-main">Blood transfusion</span> Intravenous transference of blood products

Blood transfusion is the process of transferring blood products into a person's circulation intravenously. Transfusions are used for various medical conditions to replace lost components of the blood. Early transfusions used whole blood, but modern medical practice commonly uses only components of the blood, such as red blood cells, white blood cells, plasma, platelets, and other clotting factors.

Life extension is the concept of extending the human lifespan, either modestly through improvements in medicine or dramatically by increasing the maximum lifespan beyond its generally-settled biological limit of around 125 years. Several researchers in the area, along with "life extensionists", "immortalists", or "longevists", postulate that future breakthroughs in tissue rejuvenation, stem cells, regenerative medicine, molecular repair, gene therapy, pharmaceuticals, and organ replacement will eventually enable humans to have indefinite lifespans through complete rejuvenation to a healthy youthful condition (agerasia). The ethical ramifications, if life extension becomes a possibility, are debated by bioethicists.

<span class="mw-page-title-main">Whole blood</span> Unseparated donated human blood

Whole blood (WB) is human blood from a standard blood donation. It is used in the treatment of massive bleeding, in exchange transfusion, and when people donate blood to themselves. One unit of whole blood brings up hemoglobin levels by about 10 g/L. Cross matching is typically done before the blood is given. It is given by injection into a vein.

<span class="mw-page-title-main">Blood plasma</span> Liquid component of blood

Blood plasma is a light amber-colored liquid component of blood in which blood cells are absent, but which contains proteins and other constituents of whole blood in suspension. It makes up about 55% of the body's total blood volume. It is the intravascular part of extracellular fluid. It is mostly water, and contains important dissolved proteins, glucose, clotting factors, electrolytes, hormones, carbon dioxide, and oxygen. It plays a vital role in an intravascular osmotic effect that keeps electrolyte concentration balanced and protects the body from infection and other blood-related disorders.

<span class="mw-page-title-main">Multiple myeloma</span> Cancer of plasma cells

Multiple myeloma (MM), also known as plasma cell myeloma and simply myeloma, is a cancer of plasma cells, a type of white blood cell that normally produces antibodies. Often, no symptoms are noticed initially. As it progresses, bone pain, anemia, kidney dysfunction, and infections may occur. Complications may include hypercalcemia and amyloidosis.

A blood bank is a center where blood gathered as a result of blood donation is stored and preserved for later use in blood transfusion. The term "blood bank" typically refers to a department of a hospital usually within a clinical pathology laboratory where the storage of blood product occurs and where pre-transfusion and blood compatibility testing is performed. However, it sometimes refers to a collection center, and some hospitals also perform collection. Blood banking includes tasks related to blood collection, processing, testing, separation, and storage.

<span class="mw-page-title-main">Blood donation</span> Blood withdrawal for use by another person via transfusion

A blood donation occurs when a person voluntarily has blood drawn and used for transfusions and/or made into biopharmaceutical medications by a process called fractionation. Donation may be of whole blood, or of specific components directly (apheresis). Blood banks often participate in the collection process as well as the procedures that follow it.

<span class="mw-page-title-main">Apheresis</span> Medical techniques to separate one or more components of blood

Apheresis is a medical technology in which the blood of a person is passed through an apparatus that separates out one particular constituent and returns the remainder to the circulation. It is thus an extracorporeal therapy.

<span class="mw-page-title-main">Plasmapheresis</span> Removal, treatment and return of blood plasma

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Rho(D) immune globulin (RhIG) is a medication used to prevent RhD isoimmunization in mothers who are RhD negative and to treat idiopathic thrombocytopenic purpura (ITP) in people who are Rh positive. It is often given both during and following pregnancy. It may also be used when RhD-negative people are given RhD-positive blood. It is given by injection into muscle or a vein. A single dose lasts 12 weeks. It is made from human blood plasma.

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<span class="mw-page-title-main">Transfusion-related acute lung injury</span> Medical condition

Transfusion-related acute lung injury (TRALI) is the serious complication of transfusion of blood products that is characterized by the rapid onset of excess fluid in the lungs. It can cause dangerous drops in the supply of oxygen to body tissues. Although changes in transfusion practices have reduced the incidence of TRALI, it was the leading cause of transfusion-related deaths in the United States from fiscal year 2008 through fiscal year 2012.

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<span class="mw-page-title-main">Packed red blood cells</span> Red blood cells separated for blood transfusion

Packed red blood cells, also known as packed cells, are red blood cells that have been separated for blood transfusion. The packed cells are typically used in anemia that is either causing symptoms or when the hemoglobin is less than usually 70–80 g/L. In adults, one unit brings up hemoglobin levels by about 10 g/L. Repeated transfusions may be required in people receiving cancer chemotherapy or who have hemoglobin disorders. Cross-matching is typically required before the blood is given. It is given by injection into a vein.

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Immunoglobulin therapy is the use of a mixture of antibodies to treat several health conditions. These conditions include primary immunodeficiency, immune thrombocytopenic purpura, chronic inflammatory demyelinating polyneuropathy, Kawasaki disease, certain cases of HIV/AIDS and measles, Guillain–Barré syndrome, and certain other infections when a more specific immunoglobulin is not available. Depending on the formulation it can be given by injection into muscle, a vein, or under the skin. The effects last a few weeks.

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Washed red blood cells are red blood cells which have had most of the plasma, platelets and white blood cells removed and replaced with saline or another type of preservation solution. The most common reason for using washed red blood cells in transfusion medicine is to prevent the recurrence of severe allergic transfusion reactions that do not respond to medical treatment. The usual cause of these allergic reactions is proteins in the donor plasma. These proteins are removed by the process of washing the red blood cells.

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References

  1. 1 2 3 4 5 Novella, Steven (3 August 2016). "Parabiosis – The Next Snakeoil". Science-Based Medicine.
  2. 1 2 3 4 5 6 7 Robbins, Rebecca (March 2, 2018). "Young-Blood Transfusions Are on the Menu at Society Gala". Scientific American. Retrieved 26 May 2018.
  3. 1 2 3 4 "Statement from FDA Commissioner Scott Gottlieb, M.D., and Director of FDA's Center for Biologics Evaluation and Research Peter Marks, M.D., Ph.D., cautioning consumers against receiving young donor plasma infusions that are promoted as unproven treatment for varying conditions". FDA. 19 February 2019. Retrieved 20 February 2019.
  4. 1 2 3 4 Conboy MJ, Conboy IM, Rando TA (June 2013). "Heterochronic parabiosis: historical perspective and methodological considerations for studies of aging and longevity". Aging Cell. 12 (3): 525–530. doi:10.1111/acel.12065. PMC   4072458 . PMID   23489470.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  5. ↑ Scudellari, Megan (January 21, 2015). "Ageing research: Blood to blood". Nature. 517 (7535): 426–29. Bibcode:2015Natur.517..426S. doi: 10.1038/517426a . PMID   25612035.
  6. ↑ Rebo J, Mehdipour M, Gathwala R, Causey K, Liu Y, Conboy MJ, Conboy IM (2016). "A single heterochronic blood exchange reveals rapid inhibition of multiple tissues by old blood". Nat Commun. 7: 13363. Bibcode:2016NatCo...713363R. doi: 10.1038/ncomms13363 . PMC   5121415 . PMID   27874859.
  7. 1 2 Mehdipour M, Skinner C, Conboy MJ, Conboy IM (2020). "Rejuvenation of three germ layers tissues by exchanging old blood plasma with saline-albumin". Aging . 12 (10): 8790–8819. doi:10.18632/aging.103418. PMC   7288913 . PMID   32474458.
  8. ↑ Kang JS, Yang YR (2020). "Circulating plasma factors involved in rejuvenation". Aging . 12 (22): 23394–23408. doi:10.18632/aging.103933. PMC   7746393 . PMID   33197235.
  9. ↑ Edgren G, Ullum H, Rostgaard K, Erikstrup C, Sartipy U, Holzmann MJ, Nyrén O, Hjalgrim H (June 2017). "Association of Donor Age and Sex With Survival of Patients Receiving Transfusions". JAMA Intern Med. 177 (6): 854–60. doi:10.1001/jamainternmed.2017.0890. PMC   5540056 . PMID   28437543.
  10. ↑ Vasan SK, Chiesa F, Rostgaard K, Magnusson PK, Halmin M, Nielsen KR, Titlestad KE, Hjalgrim H, Edgren G (February 4, 2016). "Vasan SK, Chiesa F, Rostgaard K, Magnusson PK, Halmin M, Nielsen KR, Titlestad KE, Hjalgrim H, Edgren". Blood. 127 (5): 658–61. doi: 10.1182/blood-2015-11-683862 . PMID   26702060 . Retrieved 30 July 2020.
  11. ↑ Guinn NR, Waldron NH, Cooter ML, Goldberg CL, Kertai MD, Raghunathan K, Bandarenko N, Hoffman M, Bennett-Guerrero E (July 2016). "No association between donor age and recipient outcomes: transfusion of plasma in patients undergoing coronary artery bypass grafting surgery". Transfusion. 56 (7): 1723–9. doi:10.1111/trf.13616. PMID   27105928. S2CID   3604995 . Retrieved 30 July 2020.
  12. ↑ Ning, S; Heddle, NM; Acker, JP (January 2018). "Exploring donor and product factors and their impact on red cell post-transfusion outcomes". Transfusion Medicine Reviews. 32 (1): 28–35. doi:10.1016/j.tmrv.2017.07.006. PMID   28988603.
  13. ↑ Irving, Michael (2023-02-06). "Arthritis drug mimics "young blood" transfusions to reverse aging in mice". New Atlas. Retrieved 2023-02-06.
  14. 1 2 Mole, Beth (February 19, 2019). "Blood of the young won't spare rich old people from sadness and death, FDA says". Ars Technica. Archived from the original on February 20, 2019. Retrieved February 20, 2019.
  15. 1 2 de Magalhães, JP; Stevens, M; Thornton, D (November 2017). "The Business of Anti-Aging Science". Trends in Biotechnology. 35 (11): 1062–73. doi: 10.1016/j.tibtech.2017.07.004 . PMID   28778607.
  16. 1 2 Haynes, Gavin (21 August 2017). "Ambrosia: the startup harvesting the blood of the young". The Guardian. Retrieved 23 May 2018.
  17. 1 2 Maxmen, Amy (January 13, 2017). "This startup takes cash from aging adults in exchange for young people's blood". MIT Technology Review. Retrieved May 26, 2018.
  18. ↑ Drew, Liam (27 September 2017). "Neuroscience: The power of plasma". Nature. 549 (7673): S26–S27. Bibcode:2017Natur.549S..26D. doi: 10.1038/549S26a . PMID   28953857.
  19. ↑ "Young Donor Plasma Transfusion and Age-Related Biomarkers". ClinicalTrials.gov . 17 June 2016. Retrieved 2 March 2020.
  20. ↑ "The Hippocrates Health Institute: Cancer quackery finally under the spotlight, but will it matter?". Science-Based Medicine. 2015-02-23. Retrieved 2018-06-09.
  21. ↑ Funcheon, Deirdra (2015-05-12). "South Florida Church Pursues Eternal Life Through Cryonics, Inflaming Critics and the IRS". Miami New Times. Retrieved 2018-06-10.
  22. ↑ Almond, Steven (1994-06-08). "They're Gonna Live Forever". Miami New Times. Retrieved 2018-06-09.
  23. ↑ Basu, Tanya; Weill, Kelly (22 February 2019). "FDA Warns: Don't Give These Companies Your 'Young Blood'". The Daily Beast. Retrieved 15 December 2019.

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