Scientists at the University of British Columbia (UBC) have discovered a gut bacterium that may transform blood transfusions across the globe. The bacterium, Akkermansia muciniphila, found naturally in the human gut, secretes enzymes that can convert blood types A, B, and AB to type O—the universal donor type. The discovery, reported in Nature Microbiology, may substantially resolve global blood shortages and enhance transfusion success in critical care situations.Compatibility in blood groups is crucial in transfusions. Red blood cells of ours have antigens—specific sugar-protein molecules—on their surface. These antigens define our blood type (A, B, AB, or O). O blood cells don't have A and B antigens, and therefore, these are compatible for patients with A+, B+, AB+, or O+ blood. This is why type O, particularly O-negative, is the most sought-after blood group in emergency and trauma centers across the world.However, blood donations usually don't meet the required demand. This is a serious problem because, while more than 117 million pints of blood are donated every year globally, still, there are mismatched types in both planned and emergency operations. If there were a safe and scalable way of converting A, B, and AB blood into O, healthcare systems would be revolutionized and thousands of lives could be saved.The secret to this change is in the enzymes secreted by Akkermansia muciniphila. These enzymes hydrolyze mucin, a glycoprotein rich in sugar that lines and protects the gut. Interestingly, the structure of mucin is similar to the sugar chains present in blood group antigens.Working with donor samples, UBC scientists extracted a particular pair of enzymes from the gut flora of an AB+ donor. These enzymes effectively broke down A and B antigens on red blood cells, essentially turning them into type O universal donor cells. The researchers even went on to work with a complete unit of A-type blood using this technology—a milestone never reached before using this level of efficiency and safety.A key component of this finding was cracking the code for the structure of the new enzyme by using crystallography. The researchers collaborated with the Canadian Light Source (CLS) at the University of Saskatchewan to see the structure of the enzyme, which enabled them to know why it had such high affinity for A antigens and why it was more efficient and quicker than other enzymes utilized in similar endeavors before.The enzymes performed impressively well, even on the recently-discovered longer A and B blood group variants—a feat that earlier conversion methods faltered at. Interestingly, the conversion of blood type B was more straightforward than that of type A, though both could be successfully treated under room temperature conditions in only 30 minutes, and without chemicals—a quantum leap in rendering the process viable for the clinic.What is ECO Blood?The scientists refer to the transformed samples as "enzyme-converted to O" or ECO blood. It takes only around 8 grams of the enzyme to convert 200ml of blood, indicating the process can be scaled up for practical medical application. In contrast to previous techniques first tried in 2007, which were hampered by efficiency and safety issues, this new technique is faster, cleaner, and more compatible with hospital environments.ECHO blood is a term for echocardiography, a non-invasive medical imaging test that uses high-frequency sound waves to create detailed images of the heart in real-time. The imaging method enables physicians to evaluate the functioning of the heart by viewing its size, shape, pumping capability, and blood flow through the heart's chambers and valves. Echocardiography is important for diagnosing heart disease, heart health monitoring, and making decisions about treatment without surgery or the use of radiation.These results are timely, as over half the population in nations such as Canada will require blood or have someone who does during their lifetime. Furthermore, shortages of blood are a worldwide problem, frequently compounded by emergencies, natural disasters, and pandemics that disrupt donation cycles. If effective in human trials and cleared for clinical use, this enzyme technology may become a pillar of contemporary transfusion medicine.Although the discovery is a breakthrough, the scientists are being cautious. Although the type B blood conversion has been done effectively, further work is required to convert type A blood reliably and safely in all subtypes. Future research will aim to optimize these enzymatic reactions and scale up the process for clinical trials.Lead researcher Dr. Stephen Withers pointed out the clinical significance, "Our conversion of RBCs was particularly conducted at the maximum red blood cell concentration, minimum assay time, and minimum temperature compared to existing literature. The conditions are important in terms of keeping it mild enough for use clinically.This breakthrough illustrates the enormous potential of microbiome research to address some of medicine's most enduring challenges. By tapping into the untapped potential of gut bacteria, scientists could soon be eradicating blood type barriers—opening up a future in which safe, universal blood transfusions are no longer confined by compatibility.How It Works?Blood type is assigned by particular antigens—carbohydrate-based molecules—found on the surface of red blood cells. Type A people have A antigens, type B people have B antigens, and AB people have both. Type O people lack both A and B antigens, so their red blood cells are compatible for transfusion across the board, particularly in crisis situations when matching bloods might not be immediately on hand.The enzymes from A. muciniphila effectively "shave off" the A and B antigens from red blood cells, reducing them to a neutral, antigen-free state—Type O. In the laboratory, scientists successfully treated Type A red blood cells with this enzymatic cocktail, stripping away the antigens effectively and within a relatively short time period of 30 minutes at room temperature. They also achieved similar results with Type B blood, and even with extended variants of A and B groups recently discovered.Practically, around 8 grams of this enzyme blend can be used to convert 200 milliliters of A or B blood into "enzyme-converted to O" (ECO) blood. This conversion was achieved at high red blood cell concentration, under mild and additive-free conditions, which are best for clinical feasibility and safety of the patient.How Does This Breakthrough Affect Healthcare?The capacity to transform types A and B of blood into universal donor type O is a giant step in the history of transfusion medicine. Blood transfusions are salvage operations employed during surgery, traumatic injury, cancer therapy, and chronic disease, but they are reliant on blood group compatibility to prevent potentially lethal immune reactions. The major hindrance in emergency care and blood bankation is the scarcity of type O blood, which is the universal donor for Rhesus (Rh) factor positive individuals—representing close to 75% of the world's population.Through the use of gut-derived enzymes from Akkermansia muciniphila to remove antigens from A and B red blood cells, scientists have created a new avenue for increasing the availability of universal blood. This could mean hospitals need to use donors and recipients less often based on matching by blood type, a process that all too frequently causes delay in such procedures, particularly in emergencies. It also would mean that short supplies or unusual blood types might be reduced through converting more typically available types into type O.At a wider health care level, this innovation has the potential to ease the global shortage of blood donors, improve blood bank inventory management, and provide greater availability of blood in rural or under-resourced areas where certain types are difficult to obtain.