B Acad Nat Med Paris
-
B Acad Nat Med Paris · Dec 2020
Review[From the bench to the clinic: The challenge of translating platelet production in vitro].
Platelet transfusions, which are currently totally dependent on altruistic donations, are absolutely necessary to the treatment of patients with thrombocytopenia following trauma, surgery or other pathologies (especially malignancies). Producing platelets in vitro represent a major technological and scientific breathrough that would address logistical issues (supply chain, stock holding…) and medical concerns (compatibility and biosafety). The translation of this innovation will need to be accompanied by rigorous quality control, harmonised between laboratory when it comes to functionality and biosafety for use in the clinic.
-
Rabies still causes about 60,000 human deaths per year, mainly in poor populations in Africa and Asia. However, since Louis Pasteur developed the first vaccine 130 years ago, prophylactic measures have been considerably improved and simplified. They now consist of the vaccine combined with purified rabies immunoglobulins of equine or human origin. ⋯ Approaches have been developed to deal with these two issues that offer hope for a paradigm shift for the benefit of exposed populations. Finally, mass rabies vaccination in dogs, which are the most cost-effective measure for preventing rabies in humans, are difficult to implement and sometimes have moderate effectiveness. The identification and analysis of the epidemiological drivers conditioning the circulation of the virus in dog populations allow a better understanding of the key control points that need to be associated with these campaigns for a better efficacy.
-
Blood platelets are anucleated elements of the blood. With a diameter of 2 to 3 μm, they are the smallest elements of blood. While their main role is to stop or prevent bleeding, they are also involved in other functions, such as immunity, inflammation or tumour progression. ⋯ Consequently, this type of product could have its place in meeting a number of transfusion challenges such as alloimmunization or refractory states. However, culture yields remain low and many hurdles still need to be overcome before considering an application in transfusion. This article reviews the rationale for the production of cultured platelets for transfusion and summarizes the main advances in the field while highlighting its limitations.