Wikipedia:Reference desk/Archives/Science/2017 May 30#Cancer spreading through the blood

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= May 30 =

The good, the bad, and the immunocompromised

Can the immune systems of immunocompromised individuals distinguish "good bacteria" from "bad bacteria"? Do they get sick because of the immune cells are overwhelmed by opportunistic pathogens, or do they get sick because of the failure of the "good bacteria" to protect by creating a barrier? In regards to the microbiota of the gut, do these individuals have trouble with absorption of nutrients too? 50.4.236.254 (talk) 04:06, 30 May 2017 (UTC)

: As far as absorbtion goes - yes. Very much so. See Crohn's_disease. My sister has it. 196.213.35.146 (talk) 12:06, 30 May 2017 (UTC)

:Immunocompromised conditions form a spectrum that can run from mild to severe, and whose impact can vary depending on what component(s) of the immune system have been affected. That being said, it is not really possible to give a complete answer that covers all possible immune conditions. However, I will give one example. For patients with severe neutropenia (a kind of failure of the innate immune system) the most common problem is often from ubiquitous bacteria already present on or in the body that start to grow out of control or migrate to tissues where they would not ordinarily reside. Obviously, such a patient is also at risk from new pathogens, but often the most immediate risk is from the body's inability to continue to control normal bacteria. Dragons flight (talk) 07:19, 31 May 2017 (UTC)

  • I recommend the book I Contain Multitudes by Ed Yong, which goes into a lot of detail about this. Long story short, there aren't really good and bad bacteria - the bacteria that are "good" for us only stay good as long as they stay exactly where they're meant to be. Even 'good' bacteria are opportunists, and if they get out of the gut, the 'good' bacteria will make you very sick indeed. Smurrayinchester 14:26, 1 June 2017 (UTC)

Cancer spreading through the blood

Our article Metastasis says

:Some cancer cells acquire the ability to penetrate the walls of lymphatic or blood vessels, after which they are able to circulate through the bloodstream (circulating tumor cells) to other sites and tissues in the body.

It seems to me that this implies that if a metastisized cancer patient donated blood, the recipient would acquire the cancer. But [https://www.cancer.gov/about-cancer/causes-prevention/risk/myths this site] says

:The only situation in which cancer can spread from one person to another is in the case of organ or tissue transplantation. A person who receives an organ or tissue from a donor who had cancer in the past may be at increased risk of developing a transplant-related cancer in the future. However, that risk is extremely low.

Why isn't metastisised cancer contagious through blood donation? Loraof (talk) 13:43, 30 May 2017 (UTC)

:Blood is often classified as a tissue. See for example [http://lifesci.dls.rutgers.edu/~babiarz/bloodtx.htm] and [https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0022037/]. So, the quote from cancer.gov does not exclude blood. --Jayron32 14:00, 30 May 2017 (UTC)

::The American Cancer Society writes that [https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/blood-transfusion-and-donation/blood-donation-by-cancer-survivors.html there have been no reports of cancer transmission by blood transfusion.] The American Red Cross allows most people who have had cancer to donate blood if the cancer was treated at least 1 year ago and the cancer has not come back. Blooteuth (talk) 14:34, 30 May 2017 (UTC)

:::The same site also notes "You cannot donate blood for other people if: You are being treated for cancer, Your cancer is spreading or has come back, You have had leukemia or lymphoma as an adult (including Hodgkin’s Disease), You have ever had Kaposi sarcoma" Which would indicate that they consider active or metastisized cancer to be a reasonable enough risk that they remove such people from the donation pool; they also exclude people with any history of blood cancers. "There have been no reports of cancer transmission by blood transfusion" could mean "our system does a good job of stopping it from happening" rather then "it cannot happen". --Jayron32 14:41, 30 May 2017 (UTC)

::::Kaposi sarcoma is likely a proxy for HIV, of which it was the first widely noted symptom (if symptom is the right word for an opportunist infection). —Tamfang (talk) 08:25, 1 June 2017 (UTC)

::Foreign cancer cells in the blood are very likely subject to immediate immune system attacks. Organ donors are well-matched, and patients still require massive immunosuppression. Red blood cells (the ones usually transfused) have a much simpler immune response (mostly due to the ABO blood group system and the Rh blood group system). --Stephan Schulz (talk) 14:46, 30 May 2017 (UTC)

:::Red blood cells also don't have nuclei and wouldn't be reproducing anyway. -Nunh-huh 15:05, 30 May 2017 (UTC)

:::The reason is probably because of the immune system of a recipient quickly destroys cancer cells. These is because (i) The recipient's immune system is less tolerant of cancer cells then the donor's immune system (ii) the immunological differences between different people are significant. This may lead to a transplant rejection but is protective against an infection with cancer cells. Ruslik_Zero 14:52, 30 May 2017 (UTC)

:::P.S. Stephan Schulz answered faster them me. Ruslik_Zero 14:53, 30 May 2017 (UTC)

::::Do you guys have any additional reading on that? --Jayron32 15:45, 30 May 2017 (UTC)

:::::Our core article is blood transfusions, which describes both some of the immunological aspects and the modern practice of using only selected blood components. --Stephan Schulz (talk) 17:05, 30 May 2017 (UTC)

:It has been well documented that melanoma can exhibit trans-placental malignancy, see e.g. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3074747/]. There seems to have been considerable research into whether a sub-clinical melanoma in blood donors can affect the blood transfusion recipients (see e.g. [https://www.ncbi.nlm.nih.gov/pubmed/17512857]) but I certainly wouldn't speculate as to what the consensus in the field currently is or how well the donors are screened for melanoma in various jurisdictions. Dr Dima (talk) 16:27, 30 May 2017 (UTC)

:A key factor here is tissue rejection. Basically, the body has a cell mediated immunity, immune cells that examine other cells in the body and reject them if the major histocompatibility complex isn't right. Cancer cells are foreign cells, and so they get rejected just like a foreign finger or liver would be rejected. Persons on immunosuppressant drugs to prevent tissue rejection therefore may be at higher risk not to reject a cancer from someone else. In general, clonally transmissible cancer is rare, with the notable exception of devil facial tumor disease. It is, however, not impossible - nothing is really impossible in biology. Wnt (talk) 16:33, 30 May 2017 (UTC)

:In a Swedish study, 3% of 354 094 blood donations were given by donors with an undiagnosed cancer. There was no excess risk of cancer among the 12,012 recipients of such units. See: Risk of cancer after blood transfusion from donors with subclinical cancer: a retrospective cohort study. Edgren, G. et al., Lancet 2007 {{PMID|17512857}}. --NorwegianBlue talk 21:58, 30 May 2017 (UTC)

Effect of purified vitamins orally and topically vs vitamins in foods orally or topically

Is there a difference in the effects? Is there a difference between putting on retinol skin creams and eating a carrot? 140.254.70.33 (talk) 16:14, 30 May 2017 (UTC)

:Retinol also known as Vitamin A1, is a vitamin found in all these foods and used as a dietary supplement. Vitamin A has multiple functions: it is important for growth and development, for the maintenance of the immune system and good vision. and it serves a role as retinoic acid (an irreversibly oxidized form of retinol), which is an important hormone-like growth factor for epithelial and other cells. Vitamin A skin creams [http://www.webmd.com/beauty/features/nutrients-for-healthy-skin-inside-out#3 reportedly show] a reduction in lines and wrinkles, control acne, and relieve psoriasis. However intake via the skin is too uncertain to count against the recommended dietary allowance. Blooteuth (talk) 11:33, 31 May 2017 (UTC)