Blood transfusion is an established medical procedure in which a recipient typically
receives blood or its components from another person. Most commonly, erythrocytes
are transfused, which can trigger severe immune reactions in the recipient due to their
surface antigens. The method of erythroid differentiation in vitro from induced
pluripotent stem cells has proven to be a promising approach that could potentially
reduce the dependence on immunogenic donor blood in the future. By reprogramming
somatic cells into iPSCs, followed by genetic modification and subsequent
differentiation into mature erythrocytes, it is possible to control the properties of the red
blood cells produced. A precise understanding of the processes of dedifferentiation,
subsequent erythroid differentiation and the replication of in vivo erythropoiesis greatly
facilitates the generation of erythrocytes in vitro. In vitro cultured cells could be the
answer to challenges related to blood supply and storage, transmission of infections and
immunogenicity of the recipient. With the advent of CRISPR/Cas technology, it is now
possible to knock out genes encoding highly immunogenic antigens, such as those of
the rhesus (Rh) blood group system, which are known to trigger strong immune
responses. Although the method of erythroid differentiation from iPSCs is still at an
early stage of development with challenges in terms of differentiation, efficiency and
economic viability. However, the results of previous studies show the great potential for
further progress in the production of safe and functional erythrocytes.
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