Blood, meat, and upscaling tissue engineering: Promises, anticipated markets, and performativity in the biomedical and agri-food sectors

Abstract

Tissue engineering is a set of biomedical technologies, including stem cell science, which seek to grow biological tissue for a diversity of applications. In this paper, we explore two emergent tissue engineering technologies that seek to cause a step change in the upscaling capacity of cell growth: cultured blood and cultured meat. Cultured blood technology seeks to replace blood transfusion with a safe and affordable bioengineered replacement. Cultured meat technology seeks to replace livestock-based food production with meat produced in a bioreactor. Importantly, cultured meat technology straddles the industrial contexts of biomedicine and agri-food. In this paper, we articulate (i) the shared and divergent promissory trajectories of the two technologies and (ii) the anticipated market, consumer, and regulatory contexts of each. Our analysis concludes by discussing how the sectoral ontologies of biomedicine and agri-food impact the performative capacity of each technology’s promissory trajectory.

Full text

Original Article
Blood, meat, and upscaling tissue
engineering: Promises, anticipated
markets, and performativity
in the biomedical and agri-food
sectors
Neil Stephens
a,
*, Emma King
b
and Catherine Lyall
c
a
Social Sciences and Communications, Brunel University London, Kingston Lane, Uxbridge,
Middlesex 01895268460, UK.
E-mail: neil.stephens@brunel.ac.uk
b
University of Stirling, Stirling, UK.
E-mail: emma.king@stir.ac.uk
c
University of Edinburgh, Edinburgh, UK.
E-mail: c.lyall@ed.ac.uk
*Corresponding author.
Abstract Tissue engineering is a set of biomedical technologies, including stem cell science,
which seek to grow biological tissue for a diversity of applications. In this paper, we explore two
emergent tissue engineering technologies that seek to cause a step change in the upscaling
capacity of cell growth: cultured blood and cultured meat. Cultured blood technology seeks to
replace blood transfusion with a safe and affordable bioengineered replacement. Cultured meat
technology seeks to replace livestock-based food production with meat produced in a bioreactor.
Importantly, cultured meat technology straddles the industrial contexts of biomedicine and agri-
food. In this paper, we articulate (i) the shared and divergent promissory trajectories of the two
technologies and (ii) the anticipated market, consumer, and regulatory contexts of each. Our
analysis concludes by discussing how the sectoral ontologies of biomedicine and agri-food impact
the performative capacity of each technology’s promissory trajectory.
BioSocieties (2018) 13, 368–388. https://doi.org/10.1057/s41292-017-0072-1;
Published online 15 January 2018
Keywords: cultured blood; cultured meat; in vitro meat; promise; anticipated markets; tissue
engineering
The online version of this article is available Open Access
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Introduction
Tissue engineering, and the related scientific fields of stem cell science and regenerative
medicine, involves working to control the growth capacity of cells to produce useful tissue,
typically for medical contexts. The aim is to replace damaged tissue (e.g., retinas or insulin-
producing cells) or to stimulate healthy cell growth with the recipient’s own cells (e.g.,
kidney tissue). Alternatively, engineered tissue could be produced for testing and developing
the effectiveness or the side effects of drugs within the laboratory. Typically, tissue
engineering research is small scale and conducted in petri dishes. A small number of tissue
engineering technologies are, however, targeting a step change in the upscale of stem cell-
based work that would see a significant increase in productive capacity.
In this paper, we compare the promissory narratives and imagined market contexts of two
of these innovative technologies: cultured blood and cultured meat. Both are among a group
of technologies exploring the upscale of tissue engineering through mass culturing in
bioreactors: sterile ‘vats’ that control for temperature and gaseous content that encourage cell
growth in liquid media. Cultured blood and cultured meat are not the only tissue engineering
technologies entering this space, but they are by far the two technologies with the most
ambitious targets for the quantities of tissue produced with, ultimately, cultured blood
seeking to replace all blood donation and cultured meat seeking to replace all meat
consumption. The quantities involved here would truly constitute a step change in the upscale
capacity if delivered, with, for the UK alone, total annual blood use being around 176 metric
tonnes, and total annual meat consumption over five millions tonnes.
1
However, considerable
technical challenges remain. Cultured blood and cultured meat are different to existing cell
bioreactor work, for example vaccines, that expand cells to collect what they secrete because,
for cultured blood and cultured meat, the final products are the cells themselves (Hodson,
2015). Other uncertainties exist, for example for cultured meat whether the cells really will
change from being endothermic (requiring additional heat) to exothermic (creating their own
heat) as theoretically predicted, and to what degree. Subsequently, both technologies are early
stage, fitting Hedgecoe’s (2004) notion of ‘‘promissory science’’ with more by way of future
orientated projections than tangible product.
Cultured blood and cultured meat are good case studies to compare because of the
distinctiveness of some of their shared characteristics (most notably in terms of upscale) and
their key differences (especially their contrasting market contexts). Both cultured blood and
cultured meat involve producing tissue intended to enter the human body, although their
method of entry is quite distinct. For cultured blood, entry would be intravenous with
subsequent flow through the cardiovascular system. For cultured meat, in contrast, the tissue
would enter the body orally and pass through the digestive system. Beyond this, the social
context of entry also differs, with cultured blood entering the body in contexts of licensed
biomedical intervention and cultured meat via home cooking, restaurants, and canteens. Our
account is divided into six sections: the first articulates the wider context of cultured blood
and cultured meat; the second describes our methods; the third introduces our theoretical
approach; the fourth compares the promissory narratives of cultured blood and cultured
1 Blood figure provided by the UK cultured blood Novosang project (http://novosang.co.uk), meat fig-
ure calculated by authors based upon Food and Agricultural Organization of the United Nations Statistics
Division data for 2011 (FAOSTAT, 2016).
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meat; the fifth articulates the anticipated market conditions of proponents in each field; and
the sixth concludes by discussing the impact of sectoral ontologies on the performative
capacity of promise. In doing so, this paper makes a significant contribution as the first social
science analysis to critically engage with the emergent topic of substantial upscaling of tissue
engineering across these domains.
Technology Contexts: Cultured Blood
Red blood cell transfusions are widely used in modern medical care to overcome blood loss
through trauma or surgery, or disorders that impair effective blood production, and
currently rely on a supply of blood from human donors. Many richer nations have an
established blood transfusion system but there remains many areas of the world without
access to safe blood. However, donor numbers are decreasing and tighter controls to prevent
Transfusion-Transmitted Infections (TTIs) are increasing the cost of transfusions. Many
argue that within 20 years a crisis point will be reached in the ability of the transfusion
services to supply the global blood demands of modern healthcare so an alternative method
of blood transfusion is being sought.
Two existing technologies seek to provide an alternative to donated blood. ‘Synthetic’ blood
equivalents are designed to replace the oxygen-carrying capacity of red blood cells but have
generally proved unsuccessful with limited clinical use (Henkel-Honke and Oleck, 2007;
Grethlein and Rajan, 2012). In contrast, reducing blood use through cell salvage and changing
medical practices is proving more successful (Rees et al,1996; Martyn et al,2002).
Cultured blood technology follows a different path by working to manufacture various
blood cell types – primarily red blood cells (for delivering oxygen) and plasma (for aiding
clotting) – through tissue engineering. Red blood cells make up around 40–45% of the volume
of human blood and are the main focus of the cultured blood research discussed here. The aim
of research in this area is to produce an unlimited supply of laboratory-grown red blood cells,
removing the need for blood donors, and creating an infection-free source. If O Rhesus negative
blood is produced (the universal donor), then this could supply the majority of the population.
Research on cultured blood in its various forms has been overwhelmingly University based
and dates back as far as 1993 (Rousseau et al,2014; Sardonini and Wu, 1993; Koller et al,
1993; Palsson et al,1993) with groups active internationally including in Spain (Ramos-
Mejı
´a et al,2014), South Korea (Park et al,2015), and the USA (Giani et al,2016).
A Japanese group working on clotting has used human pluripotent cells in steps to produce
an ‘‘inexhaustible source of hPSC-derived platelets for clinical application’’ (Nakamura et al,
2014, p. 535). In France, a key group around Luc Donay produced red blood cells that
matured inside mice (Neildez-Nguyen et al,2002) and later developed a proof-of-principle
protocol for using cultured blood in humans through which they injected 2 mL of cultured
blood into a patient using the patient’s own cells as source material (Giarratana et al,2011).
The group we have observed most closely is the UK-based Novosang project (previously
BloodPharma project). This group originated in response to a call from the US Defense
Advanced Research Projects Agency (DARPA), who wished to develop a method of
producing blood on the battlefield. The team behind Novosang was unsuccessful in
obtaining DARPA funding but continued to work on culturing red blood cells supported by
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UK funders. Although originally using human embryonic stem cells (hESCs) (Mountford,
2008; Mountford and Turner, 2011), they now use iPS cells from adult donors and
anticipate that the final clinical product will be made entirely using adult cells. Using this,
they have now developed ‘‘a clinical grade Good Manufacturing Practice protocol for using
stem cell lines to manufacture red blood cells’’ (Wellcome Trust, 2017).
More recently, in May 2017, two papers from US laboratories published simultaneously
in Nature reported the successful creation of hematopoietic stem cells that have the potential
to produce all of the cell types found in blood, with one using induced pluripotency stem
cells that developed human blood cells once injected into mice (Sugimura et al,2017) and the
other modifying existing mouse blood cells to produce hematopoietic stem cells (Lis et al,
2017) in work seen as early steps toward producing limitless supplies of blood (Johnston,
2017). The field has shown that laboratory-grown red blood cells are now possible but huge
scale-up challenges exist to produce a standardized product sufficient to supply transfusion
services internationally.
Technology Contexts: Cultured Meat
Cultured meat technology seeks to produce muscle tissue that can be eaten as meat. The first
attempts were around the time of the millennium through two similarly timed projects. The
first, funded by NASA, sought to expand the muscle tissue of a goldfish to provide an
increased mass of potentially edible muscle tissue as a way of exploring solutions to meat
production during space travel (Benjaminson et al,2002). Around the same time, the arts
group SymbioticA, through their tissue culture and arts project, used biological tissue in their
arts practice to grow small quantities of, firstly, fetal sheep tissue and, subsequently, frog
tissue to produce muscle that could be consumed as meat (Zurr and Catts, 2003).
In 2005, a university-based research program began in the Netherlands, funded by the
Dutch government department responsible for policy on agriculture and climate change.
Spanning three universities, this group worked on basic cell culturing technique in Utrecht to
derive a stable embryonic stem cell line from pig and in Eindhoven to explore how muscle
tissue could be stimulated into increasing its growth levels through chemical and electrical
stimulation. Other small laboratories emerged following this period in Sweden, the US, and
Canada, all working on relatively small projects with relatively small numbers of people
looking at the very early stages of developing small prototype tissue engineering muscle
growth technologies and bioreactors. It was also during this period that the US-based third
sector group New Harvest became visible in their work to support cultured meat through
promotion, supporting networking, and raising philanthropic donations to fund early-stage
research. In 2008, People for the Ethical Treatment of Animals (PETA) offered $1 m for the
first group to produce a substantial quantity of chicken meat and by 2011 would fund Dr.
Nick Genovese’s three year research project in the area. During this first decade of research,
the preferred term for cultured meat of most scientists involved in the field was ‘in vitro meat.’
As the Dutch group’s project came to an end in 2010, one of the team, Professor Mark Post
of Maastricht University, commented in a newspaper report (Specter, 2011) that, if he had
sufficient funds, he could develop the world’s first laboratory-grown hamburger. He
subsequently secured funding for this enterprise, leading to the most high-profile moment in
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cultured meat technology in 2013, when he and his team, funded by Google cofounder Sergey
Brin, staged a press conference in which the world’s first cultured burger was cooked and
eaten in front of the world’s media (O’Riordan et al,2017). With the cultured burger came a
shift from ‘in vitro meat’ to ‘cultured’ as the preferred term (Datar, 2016; Stephens and Lewis,
2017). Following the press conference, other groups in America, Israel, Russia, and the UK
entered the field, and Post’s Maastricht laboratory remains active. By 2016, several start-up
companies became active, most notably Mark Post’s ‘‘Mosa Meats,’’ Nick Genovese’s
‘‘Memphis Meats’’ (who showcased a proof-of-concept cultured meatball in 2016 and
cultured chicken and duck meats in 2017), and New York-based ‘‘Modern Meadow,’’ who
produced some ‘‘steak chips,’’ but now focus upon cultured leather. The move to leather saw
the emergence of the new umbrella terms ‘cellular agriculture’ and the ‘post-animal
bioeconomy’ to bracket together cultured animal products also including milk and egg white.
Also at this time a second third sector group, the Good Food Institute, entered the space to
promote and fund research, and introduced the new phrase ‘‘clean meat’’ to describe the
technology. Most recently, in mid-2017, plant-based food start-up company Hampton Creek
made the announcement that surprised some in the field that it aimed to sell a commercial
cultured meat product by 2018. However, while there are an increasing number of groups
involved, the field remains small with some arguing that the technology remains early stage.
Promise, the Sociology of Expectations, and the Performative Turn
in Economics
All technological innovations are embedded within sets of promissory narratives and future
imaginaries (Bidault and Cummings, 1994;Lo
¨sch, 2006; Borup et al,2006). These are used
to set a framework of meaning for interpreting the work conducted so far and the work
proposed for the future. These accounts are also important to enrolling financial, scientific,
institutional, and public support for continued development. Such narratives are, inevitably,
contested by detractors of the technology, or proponents of other technologies, who provide
counter-narratives that articulate different frameworks of meaning and seek to align
financial, scientific, and institutional resources in a different configuration. There is a
growing literature documenting how scientists construct the promissory narratives and
expectations around their own particular technologies (Hedgecoe, 2004) that has retained a
sustained interest in biomedicine (Kitzinger and Williams, 2005; Pickersgill, 2011; Stephens
and Dimond, 2015) including blood (Brown et al,2006; Martin et al,2008).
Promissory narratives are essential in mobilizing funding (Borup et al,2006), bringing
together interdisciplinary or multidisciplinary teams in the pursuit of a common goal (Lyall
et al,2011), and in justifying the funding of research that represents the best value for
money. Through these mechanisms, and others, expectations offer the possibility of bringing
into being the world they conjure through performative acts (Brown and Michael,
2003,2014). The downside of promissory narratives is the susceptibility to path dependency
and lock-in (Liebowitz and Margolis, 1995), where a change away from a nonoptimal
technology may prove too costly.
Allied to the sociology of expectations literature are a set of authors working on what has
been termed the ‘performative turn’ in economics (Muniesa, 2014), mostly focusing upon
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the capacity of models and broader imaginaries of market situations to offer the potential of
bringing the markets they describe into reality. Callon (1998) argues that successful
economic theories engage in world-making by pointing to a world and then bringing it into
being. MacKenzie (2006) articulates a typology of performative mechanisms in financial
markets to articulate how some equations – such as the Black–Scholes – lead people and
markets to act in accordance with its predictions. Muniesa (2014) writes of the ‘‘provoked
economy’’ through which economic ideas can realize (as in ‘make real’) the activities they
describe. Importantly, the claim is that only a select few economic actions have the
performative capacity to bring themselves into being. As MacKenzie (2006) notes, some
have no impact on practice and, of those that do shape practice, some make markets less like
those anticipated with only a subset molding markets into something like what they predict.
Callon (2007) argues that economic activities with the potential for performativity extend
beyond formal economic modeling to include other technologies and forms of knowledge.
As MacKenzie et al (2007) argue, performative acts can be as mundane as ‘‘suggestive
vocabularies’’ (p. 6) for understanding future market contexts. Our work follows the move
within this literature that steps away from financial markets to include diverse settings
including fishery quotas (Holm and Nolde Nielsen, 2007), consumer preference testing
(Muniesa, 2014), and computer system procurement (Pollock and Williams, 2010). In what
follows, we explore the tentative performativities of cultured blood and cultured meat as
novel and early-stage innovations to inspect the market situations both as they exist today
and as they are imagined in the future.
Methods
This paper draws upon two projects that were conducted independently. Emma King studied
the UK cultured blood project from 2009 to 2013 conducting laboratory observation,
documentary analysis, and outreach work alongside the cultured blood team (King, 2015).
Emma and Catherine Lyall then conducted a study of public reactions to cultured blood,
using focus groups and interviews (Lyall and King, 2016; King, 2017; King and Lyall, 2018).
This focus group and interview research was led from Anonymous University and funded by
the same Scottish Funding Council grant funding the scientific research. It explored the
attitudes of publics and ‘experts’ in different fields (for example, ethicists, representatives of
different religious groups, medical staff) toward the development and use of cultured red
blood cells for transfusion. During this process, Emma and Catherine were embedded within
the cultured blood team, attending regular meetings and conference calls in which the
scientists spoke of their visions for cultured blood. This work found that there was overall
positivity about the use of cultured red blood cells, with concerns focused on the potential
problems of commercialization and future restriction on access to blood, rather than on
concerns with the technology itself.
The second project, conducted by Neil Stephens, reports documentary analysis and an
interview and observational study conducted with the scientists, funders, and proponents of
cultured meat technology. This project commenced in 2009 with the bulk of the 42
interviews conducted between 2010 and 2013, and ongoing observational and documentary
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analysis continuing ever since. Neil has attended all international meetings of the field since
2010, including the press conference in which the cultured burger was tasted.
In 2013, the authors commenced discussions on developing comparative work across the
independent projects leading to an extended period of dialogue. This included a joint
meeting with the scientific team conducting the cultured blood research in 2014 during
which the comparative work conducted to date was presented and discussed to generate
further topics for consideration. Following this, the authors used their existing data sets to
conduct a formal thematic comparison on eight themes: promissory narratives, future
economic imaginaries, anticipated regulations, institutional forms, laboratory work,
ontological status, socio-ethical debate, and the cultural and media landscape. The
comparison of the first six of these themes constitutes the substantive focus of this paper,
while the comparison of the remaining two informs our analysis but features less
prominently. The dialogic comparative work necessitated a further period of data collection
during 2015–2017 through ongoing contact with the practitioner community and an
updated literature review on recent developments in cultured meat and extending the
international focus of our work on cultured blood. The projects have been considered and
approved independently by the Research and Ethics Committees at the University of
Edinburgh and Cardiff University. Collectively, the two studies on cultured blood, the
extended study of cultured meat, and the sustained subsequent cross-analysis of both
constitute a robust and significant dataset from which our argument is drawn.
The Promissory Narratives of Culturing Blood and Meat
We now identify eight promissory narratives evident in the scientists’ accounts for both
cultured blood and cultured meat. These classifications allow us to highlight shared
narratives, while also making explicit how they are differently constructed in the biomedical
and agri-food sectors.
The achievability narrative: Both cultured meat and cultured blood suggest that significant
upscale of stem cell tissue engineering is possible. Currently, blood use in the UK alone
stands at around 2.2 million units a year, with each bag of blood containing 2.5 trillion cells
(Mountford and Turner, 2011). Estimating global blood markets is difficult because many
countries with developing healthcare systems currently lack a blood transfusion service that
can provide comparative figures. Nevertheless, replacing just UK blood donation with a
tissue engineering-based system represents significant upscale compared with any existing
stem cell technology today. Yet, blood consumption is minute compared to global meat
consumption, estimated to be 278,863 thousand tonnes of tissue in 2009 alone (Henchion
et al,2014), and rising. The boldness of the promissory narrative that suggests the possibility
of these quantities is captured in a comment by a plenary speaker and bioengineer at the
2015 Cultured Meat Symposium, who claimed that currently there is not enough stainless
steel in the world to build the bioreactors required. For both cultured blood and cultured
meat, the narrative of achievability is bold and far beyond that of any other current stem cell
technology. Bioengineers Chris Hewitt and Qasin Rafiq calculate that, if the entire world’s
bioreactor capacity of around one million liters were turned over to culturing meat, then it
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would only be capable of feeding 400,000 people, suggesting that significant investment in
building bioreactors would be needed (Hodson, 2015).
The crisis narrative: Both technologies are linked to a crisis narrative about pessimistic
futures that should be guarded against. For cultured blood, the crisis point focuses upon the
pressure on the blood transfusion services over the coming decades. Falling donor numbers,
growing and aging populations, and the increasing costs of testing and processing are core
justifications for pursuing alternatives to the current system. In addition, there is a global
narrative around supplying blood to a wider population, as we pick up in the ‘global poverty
narrative’ below.
In cultured meat, the crisis is quite different; it is a crisis of the environment, land use, and
population. Proponents of cultured meat cite the UN Agricultural Group’s report
Livestock’s Long Shadow (Steinfeld, 2006) about the impact of meat production on
deforestation, greenhouse gas emissions, and environmental degradation. This has been
supported by a widely cited life-cycle analysis of a hypothetical system compared with
existing livestock practices that suggested greenhouse gas emissions could be 78–96% lower
and water use could be 82–96% lower than meat (Tuomisto and Teixeira de Mattos, 2011).
This is distinctive among tissue engineering technologies as it invokes an environmental
promissory narrative not found anywhere else within the field.
The minimized infection narrative: Both cultured blood and cultured meat proponents
suggest that their cultured tissue will be less infected than the tissue they seek to replace. The
main concerns are both diseases found in tissue and the antibiotics used to control these
diseases. In the cultured meat case, the focus is animal-borne disease based on precedents
such as CJD and bird flu found in farming environments. Since a cultured meat system uses
significantly fewer animals and the tissue eaten is cultured without a living body, the
incidence of disease and antibiotic use is thought to be significantly reduced.
In cultured blood, the focus is Transfusion-Transmitted Infections (TTIs), including
Hepatitis C and HIV, transmitted through blood transfusion. Stricter controls are leading to
lower eligible donor numbers and increased processing costs for donated blood, in addition
to preparing for future unknown TTIs. The issue of antibiotics is less pronounced in cultured
blood than it is in cultured meat, as many countries place restrictions on donors who have
recently used antibiotics.
The global poverty narrative: Both cultured blood and cultured meat are associated with
global poverty. For cultured meat, this relates to global food poverty and justice issues
around hunger and malnutrition. With cultured blood, this is primarily articulated as being
about access to safe blood in developing nations, especially areas with fast developing
healthcare systems but high levels of endemic infections. However, it is noticeable that in
both cultured meat and cultured blood there is uncertainty within the respective research
communities about the deliverability on these issues. In the cultured meat case, the narrative
is frequently softened with accounts about the impact of geopolitical issues in global food
distribution as key issues beyond the sheer quantity of food available. In the cultured blood
case, questions are raised over the capacity to produce and store cultured blood effectively in
less wealthy nations given the likely requirement for significant refrigeration facilities. In
areas with poor healthcare provision, access to medical care is the limiting factor for patient
survival, rather than the amount of blood available.
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The enhancement narrative: Both technologies are associated with narratives around
improving upon current blood and meat. In the context of cultured blood, the main
anticipated added value over donated blood is (i) the potential to produce generic O negative
blood type that can be used by almost anyone; (ii) the potential to create an improved
therapy for multiply transfused patients (due to only transfusing ‘young’ red blood cells);
and (iii) producing rare blood groups for patients who cannot currently be transfused. For
cultured meat, the enhancements are seen in (i) healthier meats, with either additional
nutrition engineered in, or fats and disease-provoking amino acids engineered out; and (ii)
innovative meats that taste better, or look better, and take on new forms, and to a lesser
extent meats from animals such as lions that are insufficiently docile to farm easily in
industrial contexts.
The ‘biological source’ narrative: Embedded within the narratives of both technologies is a
focus upon the living beings that provide standard blood and meat; human for blood and
industrialized animals for meat. However, the issues are configured very differently. Human
blood donors are seen as insufficient in numbers to provide the quantity of blood needed.
Livestock animals are seen as having insufficient space and resources on the planet’s surface
for them to supply the meat we need. Livestock animals are also configured as ethically
sensitive beings that need protection from slaughter, to produce a ‘meat without murder.’
Both cultured blood and cultured meat are said to address this by requiring significantly
fewer living beings to deliver the required tissue. This noted, both cultured blood and
cultured meat still require some biological source from tissue donors, raising issues about the
provenance of this initial tissue.
The military/astronaut narrative: Early interest in both technologies came from the large
American governmental agencies. For cultured blood, this was DARPA’s interest in the
military applications of a blood that could be used easily and safely on a battlefield. For
cultured meat, it was NASA’s interest in providing meat during long-term space travel
(Benjaminson et al,2002). In both cases, the users are professionals working under the
extreme conditions of war or space travel in the national scientific and political interest. The
astronaut narrative subsequently became played down by the field for over a decade as the
other narratives became established and dominant, until a group at North Carolina State
University started referencing space travel in the mid-2010s for their work on culturing
turkey muscle, and New Harvest attended a NASA workshop on innovative food for space
travel in 2017.
The financial narrative: Both cultured blood and cultured meat have been associated with
the capacity to make money and develop a high-skill knowledge economy, particularly in the
case of cultured meat, where tissue engineering expertise is positioned as a higher quality
skill set than many other roles in current livestock agriculture. The form that this economic
component is anticipated to take is the focus of our next analytical section.
Markets and Anticipated Futures
Like any technology, the scientists active in both cultured blood and cultured meat operate
with a set of anticipated futures. While the futures of each technology remain contested
within their scientific communities, there are clear themes developing that speak to the
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anticipated consumer, the anticipated market, and the anticipated regulatory pathway.
These anticipated futures shape current practices through an anticipation of potential
opportunities and challenges. The literature on the performative turn in economics is
therefore relevant even for these early-stage biological projects. In this section, we explore
three issues – consumer publics, market contexts, and regulatory pathways – but first we
reflect upon the current market situations of each technology.
Current market situation: cultured blood and cultured meat are both early-stage
technologies, and their current market situations reflect that. That said, important differences
remain between the two in terms of the institutional forms that their funding streams take. As
noted above, the UK cultured blood team began in response to a call from DARPA but they
subsequently attracted substantial mainstream funding through a biomedical – as opposed to
defence – route, from the Wellcome Trust, the world’s largest medical research funding
charity. The Scottish Funding Council has also been a major funder of the cultured blood
project along with blood transfusion services across the UK. Funders of the Japanese cultured
blood work included the government via the Ministry of Education, Culture, Sports, Science
and Technology (MEXT) and the Ministry of Health Labor and Welfare, and funders of the
French team include the Association pour la Recherche en Transfusion (Research and
Transfusion Association – a charity funding projects around blood transfusion technologies
since 1968), a national public institution the Etablissement Franc¸ais des Greffes (the French
Graft Establishment), and the Assistance Publique-Ho
ˆpitaux de Paris (the Paris public hospital
system). The theme of governmental and established charity funders continues in the 2017 US
papers with Sugimura et al (2017) drawing support from National Institutes of Health, the
Crohn’s and Colitis Foundation of America, and the Doris Duke Medical Foundation, while
Lis et al (2017) counts the National Institutes of Health, the Leukemia & Lymphoma Society,
and the Qatar National Priorities Research Program, among its funders. Funding from these
respected institutions lends credibility to the work.
The cultured meat funding context contrasts starkly to that of cultured blood. The
cultured meat field is characterized by an unusual constellation of funding bodies and small
supporting groups. We have already noted the early work of NASA and bio-arts group
SymbioticA. Other early work was funded by the pro-cultured meat third sector group New
Harvest, who continue to provide funds and promotional support through PhD stu-
dentships. The 2005 Dutch project was funded by a governmental body interested in the
environment. People for the Ethical treatment of Animals (PETA) also funded a 3-year
postdoctoral project in America. University-based laboratories in Canada and Sweden have
been largely self-funding, sometimes relying upon Masters students’ projects to keep the
research area operative. As noted above, Mark Post’s laboratory was funded by Google’s
Sergey Brin after a media campaign.
There is also a set of small start-up companies active in the area. Further extending the
role of IT entrepreneurs in cultured meat, the start-up company Modern Meadow in
America has attracted venture capital and funding streams such as the Breakout Labs
scheme, supported by PayPal founder Peter Theil. Most recently, start-up Memphis Meats
announced in August 2017 that they had received funding of $17 million from investors
including Bill Gates, Richard Branson, and global food corporation Cargill. Mark Post has
himself started a company called Mosa Meat. Third sector group the Good Food Institute
also funnel philanthropic derived funds to start-ups via an allied private venture capital fund
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New Crop Capital, which has supported Memphis Meats among others. The Israel-based
start-up SuperMeat raised $215,380 through crowdfunding website Indiegogo. The US-
based companies often have links to the Singularity University or Indiebio, both California-
based tech incubators focused on disruptive technologies.
In recent years, cultured meat has attracted the support of some within the Effective
Altruism movement. The central tenets of this utilitarian ethics and impact assessment-based
approach to philanthropy is articulated in Macaskill’s (2015)Doing Good Better and
Singer’s (2015)The Most Good You Can Do. The Effective Altruism (2017) website
advocates cultured meat through reference to an Open Philanthropy Project (2016)
investigation and in 2017 gave a direct donation to New Harvest of $10,000. Another group
focused upon animal issues, Animal Charity Evaluators (2016), rates New Harvest as a
‘‘Standout Charity’’ and Good Food Institute as a ‘‘Top Charity’’ suitable for philanthropic
donations. In contrast, there is no equivalent Effective Altruism support for cultured blood,
with the only activity in the area working to promote standard blood donation (Aceso Under
Glass, 2015).
These funding differences speak to the distinctive space occupied by cultured meat. None
of the above-listed funders – arts groups, newly established third sector organizations, IT
entrepreneurs, vegan venture capitalist companies, crowdfunding websites, or disruptive
philanthropic platforms – are typical funders of tissue engineering research or are known to
have any role in supporting cultured blood. As we argue, these current market situations
both inform and are informed by anticipated future economic contexts. We now articulate
the anticipated publics, markets, and regulatory regimes for both technologies.
Anticipated consumer publics: Proponents of cultured blood imagine it operating in the
space currently occupied by blood donation systems, namely medical settings within public
and private healthcare. Proponents of cultured blood imagine different contexts of use
within advanced economies with sophisticated and well-funded healthcare systems through
to poorer nations in the world, where the support infrastructures, economic realities, and the
health status of the patient could be configured differently. Early adopters are anticipated to
be patients with disorders preventing effective blood production such as thalassemia, sickle
cell, or some types of cancer. As noted, there is also the potential for military uses of cultured
blood technology.
In cultured blood, the amount of choice that the consumer will have is unclear and could
depend upon the national regulation within each jurisdiction. In the UK with its National
Health Service for example, a wider decision to switch to cultured blood may leave
individual patients with very little choice over the blood that they receive. Given the use of
blood in emergency medicine, it is also likely that many people may be transfused
in situations in which they were unable to give consent. Public concerns about commer-
cialization and the potential role of private companies in the future replacing the current
blood donation system were one of the overarching findings from the study of public
attitudes to cultured blood (Lyall and King, 2016; King and Lyall, 2018).
N. Stephens et al
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There has been little work to date concerned with producing empirically based projections
on consumer publics’ attitudes to alternative blood products. The project reported here
by Emma and Catherine (Lyall and King, 2016; King and Lyall, 2018) was the first project
to look specifically at public attitudes to cultured blood, although work is now being done
by a team based at the University of Bristol.
2
The only other study in the area is the
EuroBloodSubstitutes project from the mid-2000s with participants from the UK and
Holland that included donor blood, GM blood, chemical blood, and bovine blood but not
cultured blood (Ferguson et al,2008).
Cultured meat anticipates a more novel type of consumer public, embedded clearly within
food consumption in sites of the home and restaurant. The anticipated cultured meat
consumer publics are ethically informed, politically active citizens, who seek to remove
ethically and environmentally problematic elements of their consumption without becoming
vegetarian or vegan (Stephens, 2013; O’Riordan et al,2017). The consumer’s capacity for
choice is central to how they are anticipated: they choose cultured meat to contribute to a
better world without experiencing a change in their experience of eating.
In contrast to cultured blood, there are an increasing number of projections for public’s
perceptions of cultured meat. These range from academic studies using diverse methodolo-
gies to journalistic online surveys that in turn are quoted in other media contexts. Academic
cultural studies’ analyses of social media responses include Laestadius (2015), Laestadius
and Caldwell (2015), and O’Riordan et al (2017). Published focus group research has been
conducted in the Netherlands (van der Weele and Driessen, 2013), Ireland (Department of
Agriculture, Food and the Marine, 2013), the USA (Hart Research Associates, 2017),
Finland (Vinnari and Tapio, 2009), the UK (Bows et al,2012; O’Keefe et al,2016), and a
comparative study of Belgium, the UK, and Portugal (Marcu et al,2015; Verbeke et al,
2015), and we know of other as-yet unpublished academic focus group work conducted in
Spain and the UK. There has also been a survey of 1,800 people (Hocquette et al,2015),
another of 673 people in the USA (Wilks and Phillips, 2017), and an experimental
psychology project also conducted in The Netherlands (Bekker et al,2017). In addition to
this, the Good Food Institute have produced work criticizing existing projections on
consumer responses claiming that flawed methodology (for example, using negative
terminology or underspecifying potential benefits) led them to exaggerate negative responses
(Friedrich, 2016), and Effective Altruism group Animal Charity Evaluators (2017)
conducted a randomized trial of whether the term ‘cultured’ or ‘clean’ meat most appeals
to consumers. Collectively, these studies report diverse opinions from the strongly
supportive to the strongly resistant, while also documenting sets of ambiguities and
uncertainties about the personal, societal, and political context of the technology.
Anticipated market context: Both technologies are anticipated to initially enter a mixed
economy, where traditional blood and traditional meat are still available as competitor
products. The significant quantities of tissue anticipated in replacing all the donated blood in
the world, or all the meat consumed in the world, mean that swift and absolute replacement
of competitor technologies anticipates a level of upscale far beyond what is initially likely.
2http://www.hra.nhs.uk/news/research-summaries/public-and-patient-views-of-laboratory-grown-red-
blood-cells/.
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In terms of cultured blood, in advanced economies, the scientists want hospital
administrations to pay for the blood. However, in the initial instance, due to the expense
of clinical trials, it is more likely that the involvement of pharmaceutical companies or
venture capital may be required in order to produce a marketable tissue-engineered product.
In the UK, blood is seen as a ‘free commodity.’ However, the current ‘cost’ of blood in
the UK is around £120 per unit
3
(approximately $150); however, this could rise to
£600–800 ($775–1000) if the full cost of infrastructure is taken into account (Varney and
Guest, 2003). Rousseau et al (2014) reference Timmins and Nielsen et al (2009) and
Zeuner et al (2012) to suggest that, at current technology, one unit of blood could cost
$8,000–15,000 to produce, which they compare to the typical $225 current hospital cost
for a unit of leukocyte-reduced red blood cells. However, there may be instances where a
higher price could be justified; for example, cultured blood use by thalassemic patients
could result in fewer transfusions, reduced side effects, and a longer life span and may,
therefore, justify a higher cost. Taking a similar line, Rousseau et al (2014) suggest that
the current cost per unit for allo-immunized patients is $700–1200, and predict that this
cost would also be met by health insurance companies in critical situations. This given,
these prices are clearly below the current likely costs with Rousseau et al (2014)
identifying a cultured blood cost of $3,000 per unit as the appropriate target which
remains higher than even rare blood types at current prices.
The anticipated economics of cultured meat are quite distinct, once again in the world of
agri-food as opposed to healthcare. The economic context of meat production differs
significantly from traditional healthcare and therapeutic product markets and meat prices
remain significantly lower than those for biomedical technologies. As opposed to $225-per-
unit blood supplies, cultured meat proponents compare their tissue engineering technology
to burgers, sausages, and beef steaks found in supermarkets.
The vastly different pricing strategies found in the healthcare and food sectors raise
significant challenges for the cultured meat community. Cultured meat proponents remain
open to a diversity of commercialization routes for their technology, including like-for-like
replacements of existing processed meat products, or locally produced artisan cultured meat
facilities in each town and city able to support one (van der Weele and Tramper, 2014).
Cultured meat products are anticipated to initially be high-end, ethically desirable products,
with a slightly higher price point than standard meat products, comparable with organic or
free range meat although, over time, scientists hope that the price could fall in line with all
meat products. This given, an alternative route remains of cultured meat not only entering a
mixed economy but also entering mixed products of, for example, sausages combining both
whole animal and cultured meat product. This mixing approach reconfigures the promissory
narratives, with those around environmental crisis, infection, and animal welfare weakened
when mixed with livestock meat, although resultant financial opportunities may be
increased.
3 In England, the standard tariff for blood supplied by NHSBT is set yearly, with hospitals paying for each
unit of blood used (NHS England and Monitor, 2016). In 2014/15, the cost was £121.85 per unit; in
2015/16, it was £120 per unit. http://www.nhsbt.nhs.uk/news-and-media/news-articles/news_2015_07_
10.asp. In Scotland, the SNBTS and the blood it produces are centrally funded from the core NHS budget,
but the cost would be similar.
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Anticipated regulations: Both technologies remain at an early stage of development.
However, future regulatory pathways are still anticipated by the scientists involved and form
an important component of their market context. In both cultured blood and cultured meat,
there remain uncertainty about exactly what form this regulatory pathway would take,
although the clear distinction between biomedical and agri-food sectors is recognized.
During the UK Novosang project, the human embryonic stem cells used in the early
development of cultured blood required licensing from the Human Fertilisation and
Embryology Authority (HFEA). Whether embryonic or adult cells are used, it is expected
that EU clinical cultured blood products would be regulated by the national competent
authority of the European Medicines Agency as an Advanced Therapy Medicinal Product,
with equivalent pathways followed in other jurisdictions (Mittra et al,2015).
Anticipating the regulatory pathway in cultured meat involves additional uncertainties
and creativity in practice for the scientists involved. As in the cultured blood case, cultured
meat scientists are primarily biomedical. They are primarily individuals with expertise built
in the healthcare industry around cell culturing, tissue engineering, and bioreactor design.
For these individuals, the move into food regulation presents a new and unfamiliar terrain
that they seek to learn about through strategic alliances with consultancy professionals and
food manufacturing organizations. Attempting to address this, third sector organization the
Good Food Institute have staff working on articulating and assessing policy pathways in
different countries. Two existing analyses produced by lawyers of potential regulatory
pathways in the EU (Petetin, 2014) and the USA (Schneider, 2013) concluded that current
regulation was not suitable to cope with the definitional challenges of cultured meat, and
that technical uncertainties in what form the technology may take mean the regulatory
trajectory is inherently ambiguous.
Discussion: Promissory Narratives, Anticipated Markets,
and Sectoral Ontologies
This paper argues that cultured blood and cultured meat share eight promissory themes,
although the form these take varies with the specifics of a biomedical/blood and an agri-
food/meat context. While both promise the achievability of upscale, cultured meat implies a
higher tissue yield to replace existing systems (in the UK over 5,000,000 tonnes of meat per
year compared to around 176 tonnes of blood), and deliver it at a much lower price point
(around £2 per burger compared with £100 per bag of blood). Both technologies are
embedded within a crisis narrative based upon shortcomings in current provision, be that
around pressures on blood transfusion or pressures on the environment. This has some
overlap with the shared minimized infection narrative in which the control of sterile
production facilities promises to minimize the disease and antibiotic risk in the tissue we eat
or have transfused into our bodies. Further health benefits are claimed with an enhancement
narrative through engineering only generic O negative blood type, or engineering in
additional nutritional benefits. The biological source narrative relates to the beings from
which tissue is traditionally taken, be that insufficiently numbered blood donors or
industrialized and poorly treated livestock. The military/astronaut narrative captures the
role of large governmental agencies keen to use cultured technologies to benefit their
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employees in extreme conditions. Finally, both promise financial reward, and we have
detailed the current and anticipated market contexts through which this might occur.
Promissory narratives are important constitutive components of both cultured blood and
cultured meat, giving direction, structure, and enrolling support. However, promissory
narratives are also malleable and can be reconfigured over time. This is evident in both of
our case studies. The UK cultured blood group formalized their actions around a defence-
orientated funding call before consolidating their research around the biomedical narrative
of the Wellcome Trust and blood services. In cultured meat, we saw initial work entirely
focused around delivering food for space travel, followed by a complete reconfiguration
around a new set of terrestrial promises, before space once again entered the scene as a new
group voiced their anticipated goals in 2016 and New Harvest attended the NASA event in
2017.
The key commonality between cultured blood and cultured meat is the shared focus on a
step change increase in the upscale of stem cell-based tissue engineering, while the key
difference is the context of marketization in biomedical or agri-food sectors. We must note
that, in these differing contexts of marketization, cultured meat has had to make a switch
that cultured blood has not. Cultured meat technology draws upon biomedical innovation
that is being applied in the agri-food sector. This switch from biomedicine to food has raised
challenges for the scientists involved in terms of the status and institutional support afforded
their technology. The issue of status operates at a profound level, beyond the credibility of
whether cultured meat can deliver its promises, into questions of what cultured meat
actually is. Capturing this, Stephens (2010, p. 400) described cultured meat as an ‘‘as-yet
undefined ontological object’’ to articulate potential ambiguities about whether tissue-
engineered muscle really can be understood as meat, or as a meat alternative, or simply not
as food at all.
4
The shift in sector is key to amplifying this ambiguity: while tissue
engineering in biomedical contexts is an accepted category of practice – it has generally
become ‘normal’ – and makes little challenge to existing expectations around how biology is
done. That is not to say there is no ontological ambiguity around cultured blood. The use of
red blood cells themselves does raise questions about how this particular product is
perceived and categorized, sitting between ‘real’ donated red blood cells and a synthetic
pharmaceutical (King, 2017; King and Lyall, 2018), but this ambiguity is less dramatic than
meat because tissue engineering has become established within biomedicine. Shifting tissue
engineering into the agri-food sector engenders ambiguity, as it clashes with well-established
understandings of what meat is and how it should be produced. In other work, Stephens
(2013) argues that promissory narratives are used in an attempt to resolve the ontological
ambiguity of cultured meat, and that the cultured burger press conference was a key moment
in stabilizing both its meanings and the potential consumer publics that will buy it
(O’Riordan et al,2017; Stephens and Ruivenkamp, 2016). Here we close by exploring the
sectoral ontologies of cultured blood and cultured meat and the impact this has on the
performative potential of promissory narratives to bring their promises into being.
By sectoral ontologies, we mean the categorizations and methods of organization and
sense-making typical of the economic and scientific sectors of biomedicine and agri-food.
4 See also Chiles (2013), Kramer (2015), Jo
¨nsson (2016) and Stephens and Ruivenkamp (2016) on the
relation between promise and ambiguity for cultured meat.
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The origin and application narratives of cultured blood exist within a single sectoral
ontology, while the origin and application narratives of cultured meat shift between the
sectoral ontologies of biomedicine and agri-food. This, we argue, informs the current market
situation of both technologies. The cultured meat field is characterized by an unusual
constellation of funding bodies and small groups that exemplify the ontological ambiguity
over what cultured meat is. In the absence of a clear definition of what cultured meat is,
there is also an absence of established institutions to support it. Ontological and institutional
alignment supports the performativity of promises and economic activities.
Cultured blood – being unambiguously biomedical – benefits from aligned sectoral
ontology in origin and application, as evidenced in funding from prestigious organizations
such as the National Institutes of Health, the Wellcome Trust, and Etablissement Franc¸ais
des Greffes. The economic activities of cultured blood groups exist within a university-
based, publicly and established charity-funded biomedical context, and the individuals
involved are overwhelmingly experts in various forms of biomedical engineering. The
institutional and the ontological are aligned, facilitating economic performativities.
Cultured meat, conversely, exists in a less mainstream funding context. Developers of
cultured meat must work to assert these alignments in order to benefit from them. Groups
such as New Harvest and the Good Food Institute actively seek opportunities to connect
finance flows with the distinct and novel promissory and market context of cultured meat.
Their suggestive vocabularies therefore need to work harder than those of cultured blood to
provoke the world they suggest into being. Furthermore, the majority of scientists in cultured
meat are trained in biomedicine, and those based in universities often run biomedical
research in parallel to their agri-food work. These biomedical researchers work in
conjunction with a smaller number of food and meat professionals and scientists, and
through graduate programs such as that supported by New Harvest we are only now seeing
an early wave of researchers trained specifically in this field. This hybridity is illustrative of
the ways in which cultured meat does not easily fit the typical structures of neither the agri-
food nor the biomedical sector, as additional sense-making work is required to form
meaningful alignments. The ontological ambiguity of cultured meat frames these institu-
tional and sectorial hybridities and thus inhibits the performative character of their
promises.
This carries forth into anticipated consumer publics, marketization, and regulatory
pathways. For cultured blood, consumer publics, pathways through regulation, and the
mode of marketization are relatively clear and resilient: in pre-Brexit UK, this is European
Medicines Agency approval and NHS service provision. For cultured meat, a regulatory
pathway and the attendant methods of scrutiny require development, a marketing model
needs advancing, and consumer publics are still to be enrolled. The clash of sectoral
ontologies brings with it clear practical challenges.
While promissory pathways can be essential in mobilizing funding and establishing
development trajectories, imaginaries can also fail to perform markets into being. Questions
still remain over the technical feasibility of both cultured blood and cultured meat as an
upscaled industrial reality. These early-stage technologies retain early-stage imaginaries of
their future pathway to commercialization, and potential barriers to entry may remain
underestimated (cf. Gunnarsdottir et al,2015 for a cultured meat example). What is clear is
that cultured blood has several advantages over cultured meat: the long-term tissue yield
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goal is lower, the likely competitive price point is higher, and the stability of its sectoral
ontology furnishes it with an institutional context that better affords the performative
capacity of promise. In contrast, cultured meat proponents could equally point to
production advantages in that the tissue need not still be living at the point of use, and
that food regulatory hurdles are likely to be lower than their biomedical equivalents.
However these futures are played out, blood and meat are currently the most ambitious sites
of promised tissue engineering upscale. Their long-term commercial viability remains
indeterminate but their current contexts reveal pertinent insight into the role of promise,
performance, and sectoral ontology. In documenting these, we have begun the important
work of analyzing significant upscale as a distinct set of practices requiring social science
assessment and have pointed to the need for subsequent studies exploring upscale in other
contexts.
Acknowledgements
The studies on which the research is based have been subject to appropriate ethical review.
There are no competing interests – intellectual or financial – in the research detailed in the
manuscript. Neil Stephens’ research leading to this publication has received funding from
the European Community’s Seventh Framework Programme (FP7/2007–2013) under grant
agreement number 288971 (EPINET). Stephens’ involvement has also received the support
of the Economic and Social Research Council (ESRC). His work is part of the Research
Programme of the ESRC Genomics Network at Cesagen (ESRC Centre for Economic and
Social Aspects of Genomics). Neil Stephens’ work was also supported by the Wellcome Trust
(WT096541MA) and a visiting scholarship to CGS Centre for Society and Genomics in The
Netherlands, May to July 2011. Emma King and Catherine Lyall’s research leading to this
publication has received funding from the Scottish Funding Council (SFC Grant Number
227208694) and an ESRC Case Studentship Award. This support is gratefully acknowl-
edged. We also thank our participants and collaborators in the cultured blood and meat
fields.
About the Authors
Neil Stephens is a Research Fellow at Brunel University London. His research interests
include robotic surgery, mitochondrial donation, tissue engineering, and cultured meat. In
2018 he starts a new Wellcome Trust funded project - Big Tissue and Society - that will
expand his focus on upscaling tissue engineering.
Emma King is a Research Fellow at the University of Stirling. Her research has included
analyzing developments in cultured blood and interventions to prevent swallowing among
patients undergoing radiotherapy treatment for head and neck cancer.
Catherine Lyall is Professor of Science and Public Policy at University of Edinburgh Science,
Technology & Innovation Studies. Her research seeks to advance an understanding of
N. Stephens et al
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problems of science and technology policy formation and strategic decision making by
adopting interdisciplinary and practitioner-based perspectives.
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