Transcriptional alterations during blood storage to monitor stored red cells and reduce storage-lesions

Unmet Need

Currently, red blood cell (RBC) testing focuses on factors such as hemoglobin content, RBC count, blood typing, and antibody content. These tests, though comprehensive, do not measure the health and quality of RBCs. This is especially relevant in the context of blood transfusions. RBCs taken from patients are stored in blood bags, where they can develop lesions after extended periods of storage. Current tests are unable to determine time of storage, meaning that patients could receive subpar transfusions that could have many lesioned or non-viable RBCs. This affects the efficacy of the transfusion, and the transfusion of lesioned cells could also contribute to patient complications. Despite the fact that there are 16 million blood transfusions that occur annually in the USA, there are no tests to assess RBC quality accurately and quickly. There is a need for measuring the health and quality of RBCs.

Technology

Duke inventors have developed a method to asses health of RBCs through genetic signatures. This is intended to be used to identify unique RBC gene signatures. Specifically, this technology measures the expression of specific MicroRNAs and TransferRNAs (miRNAs and tRNAs) over time. Though RBCs do not have nuclei, they still contain short RNAs that can be sequenced to identify unique RBC gene signatures. Because expression of these RNA sequences increases with time, heightened RNA levels can be used to determine how long blood has been stored as well as the likelihood of development of lesions during storage. This can ensure that patients receiving blood transfusions are given high quality RBCs. This test also enables detection of genetic factors, like malaria resistance, and diseases, like sickle cell anemia, which can inform the transfusion processes. This patented technology has been demonstrated to detect MiRNAs and tRNAs in Western blots, multiplexed RNA samples, and in conjunction with high-throughput methods such as RNASeq.

Other Applications

This technology could also be used to detect blood doping, which is when athletes receive transfusions of their own blood to artificially increase blood oxygen and hemoglobin levels to boost performance. Blood doping is illegal and is currently detected by approximations informed through hemoglobin testing, which is not always the most accurate or reliable method.

Advantages

• Improved accuracy over hemoglobin testing: testing genetic material allows for more sensitive detection of blood cell age
• Allows for high-throughput testing: can be paired with RNASeq to scale testing
• Can improve transfusion efficacy: measurement of blood cell quality can maximize benefits of transfusions for patients and prevent unhealthy blood from being transfused