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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 efficacy and safety of young blood transfusions for anti-aging purposes remain a subject of debate in the scientific community, with limited clinical evidence in humans. [1] [2] [3] There are also concerns of harm. [3] While some preclinical studies on animals suggest potential benefits, there is a lack of robust clinical evidence to support its use in humans. [4] [5] [6] [7] [8] [9] 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]
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. [10] 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. [10] [11] 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. [12] [13] Replacing plasma of old mice with saline and albumin from young mice was sufficient to rejuvenate brain, liver, and muscle. [13] A 2020 review of plasma components that change with age identified several candidate anti-aging and pro-aging factors. [14]
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; [10] [1] most such cases were the young parabiont. [10] 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. [15] However, other studies have found no effect of age. [16] [17] 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. [18]
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. [19]
In February 2019 the FDA issued a warning 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] [20]
A startup company, Ambrosia, has been selling "young blood transfusions" for $8,000 since 2016 framing it as a clinical trial, to see if such transfusions lead to changes in the blood of recipients. [1] [21] As of August 2017, 600 people had participated in the trial. [22] 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. [22] The company was started by Jesse Karmazin, a medical school graduate without a license to practice medicine. [23] 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. [23]
On February 19, 2019, Ambrosia announced it stopped testing the treatment, responding to concerns from the FDA. [20]
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. [21] [24]
The Maharaj Institute led by Dr. Dipnarine Maharaj MD, a Florida licensed physician, is currently running a clinical trial to test whether using G-CSF (Granulocyte Colony Stimulating Factor) stem cell mobilized young blood plasma can treat symptoms of frailty in patients aged 55 to 95. [25] [26] Participation in the trial is free of charge to the patients. [25] This trial has been promoted by Bill Faloon, who founded the Life Extension Foundation. [2] [27] The trial has received FDA Investigational New Drug (IND) and IRB approval for a Phase I/Phase II clinical trial as a single-arm study without a control group, which is not uncommon for Phase I/Phase II studies. [25] Dr. Maharaj also has a program for hematopoietic progenitor stem cell and immune cell banking so that patients can preserve their cells for future use. [26]
An organization called the Young Blood Institute has also run trials; these, however, involved exchange only of blood plasma. [28]
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, plasma, platelets, and other clotting factors. White blood cells are transfused only in very rare circumstances, since granulocyte transfusion has limited applications. Whole blood has come back into use in the setting of trauma.
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.
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.
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, renal insuficiency, 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.
Everolimus, sold under the brand name Afinitor among others, is a medication used as an immunosuppressant to prevent rejection of organ transplants and as a targeted therapy in the treatment of renal cell cancer and other tumours.
Graft-versus-host disease (GvHD) is a syndrome, characterized by inflammation in different organs. GvHD is commonly associated with bone marrow transplants and stem cell transplants.
Plasmapheresis is the removal, treatment, and return or exchange of blood plasma or components thereof from and to the blood circulation. It is thus an extracorporeal therapy, a medical procedure performed outside the body.
Anakinra, sold under the brand name Kineret, is a biopharmaceutical medication used to treat rheumatoid arthritis, cryopyrin-associated periodic syndromes, familial Mediterranean fever, and Still's disease. It is a slightly modified recombinant version of the human interleukin 1 receptor antagonist protein. It is marketed by Swedish Orphan Biovitrum. Anakinra is administered by subcutaneous injection.
Rejuvenation is a medical discipline focused on the practical reversal of the aging process.
Stem-cell therapy uses stem cells to treat or prevent a disease or condition. As of 2016, the only established therapy using stem cells is hematopoietic stem cell transplantation. This usually takes the form of a bone marrow transplantation, but the cells can also be derived from umbilical cord blood. Research is underway to develop various sources for stem cells as well as to apply stem-cell treatments for neurodegenerative diseases and conditions such as diabetes and heart disease.
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.
Growth differentiation factor 11 (GDF11), also known as bone morphogenetic protein 11 (BMP-11), is a protein that in humans is encoded by the growth differentiation factor 11 gene. GDF11 is a member of the Transforming growth factor beta family.
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.
Platelet-rich plasma (PRP), also known as autologous conditioned plasma, is a concentrate of plasma protein derived from whole blood, centrifuged to remove red blood cells but retaining platelets. Though promoted for treating various medical conditions, evidence of its benefits was mixed as of 2020, showing effectiveness in certain conditions and ineffectiveness in others.
Ruxolitinib, sold under the brand name Jakafi among others, is a medication used for the treatment of intermediate or high-risk myelofibrosis, a type of myeloproliferative neoplasm that affects the bone marrow; polycythemia vera, when there has been an inadequate response to or intolerance of hydroxyurea; and steroid-refractory acute graft-versus-host disease. Ruxolitinib is a Janus kinase inhibitor. It was developed and marketed by Incyte Corp in the US under the brand name Jakafi, and by Novartis elsewhere in the world, under the brand name Jakavi.
Betibeglogene autotemcel, sold under the brand name Zynteglo, is a gene therapy for the treatment for beta thalassemia. It was developed by Bluebird Bio and was given breakthrough therapy designation by the US Food and Drug Administration in February 2015.
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.
Lenzilumab is a humanized monoclonal antibody that targets colony stimulating factor 2 (CSF2)/granulocyte-macrophage colony stimulating factor (GM-CSF).
Convalescent plasma is the blood plasma collected from a survivor of an infectious disease. This plasma contains antibodies specific to a pathogen and can be used therapeutically by providing passive immunity when transfusing it to a newly infected patient with the same condition. Convalescent plasma can be transfused as it has been collected or become the source material for hyperimmune serum or anti-pathogen monoclonal antibodies; the latter consists exclusively of IgG, while convalescent plasma also includes IgA and IgM. Collection is typically achieved by apheresis, but in low-to-middle income countries, the treatment can be administered as convalescent whole blood.