The immunological safety of transfusions is based, among other things, on the compatibility of erythrocyte blood groups. Today there are about 380 different antigens in 44 systems. More than half of them are considered rare, i.e. their frequency in the general population is less than 4/1000. Among them, some are rare in all populations ("Rhesus" null), others, although rare, are exclusive to certain populations (RH:-46), others finally, are rare or even non-existent in certain populations and frequent and exclusive in others (Duffy null in Africa). These last two elements recall the notion of geography of blood groups whose preferential distribution is the result of evolutionary forces already discussed in a previous project.
Given these elements, it is therefore conceivable that a population with erythrocyte specificities that migrates to a host population where these specificities are non-existent and that this moving population does not donate blood for cultural reasons, for example, may be exposed to a risk of transfusion blockage due to lack of compatible blood products. If all populations are exposed to this problem in the context of globalization, African populations, because of their level of genetic diversity and the high frequency of pathologies requiring transfusion such as sickle cell anemia, are more at risk than others.
Therefore, the availability of these products is a real public health, demographic and ethical issue. For transfusion, but also for immunogenic biotherapies, it is necessary to find the same for everyone, whatever their origin and migratory route.
In response to this medical problem, which is to transfuse everyone while respecting the rules of compatibility, the EFS has implemented a channel dedicated to rare bloods and in particular those of African ancestry, which relies in particular on the use of SHS, within a structure called
"EFS Social Lab" in order to develop the strategy of integration of this bio-cultural diversity in its blood collection and blood product delivery system.
It is in connection with this "EFS Social Lab" which relies on academic research units, including ADES, that our project, led by Stéphane Mazières (PhD, HDR, CR CNRS), Laurine Laget (PharmD, PhD, EFS), Caroline Izard (PharmD, PhD, EFS) and Jacques Chiaroni (PUPH, MD, PhD, HDR), which includes several components:
- Description of erythrocyte polymorphisms according to a population approach in order to identify populations exposed to transfusion blockage and which must be the subject of adapted communicationIdentify
- for these populations the cultural determinants of blood donation (or even therapeutic products from the human body to treat the "Other" (stem cells, organ donation, cornea etc...) in order to develop an adapted strategy of awareness and loyalty building Within the unit, this component relies on a strong inter-team collaboration with the "body, norms and health" team, whose socio-anthropological approach to the "body as medicine" will shed light on this biomedical issue