What should be accepted in biomedical practice and research? New and old ethical dilemmas

Should young blood transfusions be allowed in rejuvenation processes? Is it ethical to pay for these transfusions? Should donors be remunerated? Is it ethical to increase the human life span by getting blood from younger donors transfused to older people? These questions stir up strong emotions in most of us. They represent not only ethical dilemmas but are within the boundaries of our scientific and philosophic understanding.

The history of human blood transfusions is odd. From early attempts with animals and bleeding to cure a series of ailments to our understanding of blood types, blood has stirred a lot of controversy. Bill Schutt brilliantly discusses some of these interesting stories in the lecture: What goes in: The strange story of blood transfusions available on Youtube.

With the new research on young blood transfusions to young patients (parabiosis), several effects were observed such as the reversion of aging-related degenerative diseases (1) and the increase of mice life span (2). This motivated the development of startups that quickly received huge sums of private funding (1). Since then, regulatory agencies such as the FDA have issued notes about the topic (3). In their note from 2019, FDA discusses: “Today, we’re alerting consumers and health care providers that treatments using plasma from young donors have not gone through the rigorous testing that the FDA normally requires in order to confirm the therapeutic benefit of a product and to ensure its safety. As a result, the reported uses of these products should not be assumed to be safe or effective.“ However, researchers are careful about these findings and recommend caution. The factors that play in these transfusions in animal studies are not clearly understood by the scientific community (3). Therefore, they cannot be translated into the complexity of humans. Given our little understanding, the regulation of research and the market of parabiosis is paramount. We should think together as a society on answers to the questions asked opening this short communication.

Read more:

(1)CORBYN, Zoe. Could young blood stop us from getting old? The Guardian: 2 Feb. 2020. Available at: https://www.theguardian.com/society/2020/feb/02/could-young-blood-stop-us-getting-old-transfusions-experiments-mice-plasma

(2)ZIMMER, Carl. Blood of young mice extends the life in the old? The New York Times, Jul. 2023. Available at: https://www.nytimes.com/2023/07/27/health/mice-blood-aging.html#:~:text=In%20the%20early%202000s%2C%20parabiosis,showed%20signs%20of%20accelerated%20aging

(3) GOTTLIEB, Scott. 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. Available at: https://www.fda.gov/news-events/press-announcements/statement-fda-commissioner-scott-gottlieb-md-and-director-fdas-center-biologics-evaluation-and-0

SCHUTT, Bill. What goes in the strange story of blood transfusions? Available at: https://www.youtube.com/watch?v=DKs7iIwsU1c&t=1807s

 

This article was written by André Plath  as part of a series articles curated by BioTrib’s Early Stage Researchers.

André is one of BioTrib’s Early Stage Researcher‘s who is investigating Boundary Lubrication of Fibrous Scaffolds at ETH Zürich, Switzerland.