Today, transfusion-related acute lung injury (TRALI) is the leading cause of death following a blood transfusion. So far, it has not been treatable, but a researcher at Lund University in Sweden, Rick Kapur, has now discovered that an anti-inflammatory drug cures the disease in mice. For his achievement, he is awarded the International Society of Blood Transfusion’s prestigious award.
TRALI is a rare transfusion reaction that occurs within a few hours after a blood transfusion. Despite its rarity, TRALI is the leading cause of transfusion-related deaths. Through a largely unknown biological reaction, the lungs get filled with liquid causing the patient to suffocate. The disease mechanism is still only partly known and there is no specific treatment available. Moreover, the disease is difficult to diagnose and therefore probably under-reported.
Rick Kapur is trying to understand the mechanisms behind TRALI in order to identify potential therapies:
“We know that certain risk factors in the patient, along with elements in the blood transfusion itself such as antibodies, play a role in the development of the disease”, explains Rick Kapur.
Rick Kapur was born and raised in the Netherlands, where he also received his medical training and doctoral education. After graduating, he moved to Canada where he began his research on TRALI. Since last year, he has been working as a postdoc at the Department of Laboratory Medicine at Lund University and will this year be awarded the prestigious Jean Julliard Prize for his contributions to transfusion medicine.
“I’m pleased to receive such recognition and the international attention that comes with the prize, as it is very difficult to get an international research award so early in one’s career”, says Kapur.
He has developed new mouse models to gain more knowledge of TRALI, and begun validating the knowledge from the animal experiments in human clinical samples. The insights from the animal models enabled him to find a successful therapy that he believes could also work on humans.
“It’s an anti-inflammatory drug which is a real breakthrough in the field. It is the first time someone finds a treatment for animals that works after the outbreak of the disease. Because the disease progression is so fast, it has been difficult to study what actually happens, but we were now able to study the disease in genetically modified mice for the first time. Now we want to increase international cooperation to be able to start clinical trials.”
The aim has previously been to avoid the suspected triggers of the transfusion disease. One way is to refrain from using pregnant women’s blood in transfusions, as the blood has been shown to contain antibodies that can trigger the disease. This strategy is used in Sweden and has reduced the number of incidents, but not the number of deaths.
“Now we can move from preventing the disease towards treating it, which is a huge step forward.”
However, a lot of work remains. The researchers still do not know completely how the disease occurs.
“To me, constantly testing the knowledge we gain from animals in relation to humans is essential. Although each step is important, humans are, after all, the ones we want to cure in the end”, concludes Rick Kapur.