House S07EP05 “Unplanned Parenthood”
Sorry folks; it looks like Fox is making us wait until the week of Spring Break for another new episode. Monday’s episode is a repeat, but I don’t think that I’ve reviewed here at YCP-Micro yet. I have seen it before, but I do not recall the particulars just yet. UPDATED Post Episode Recap, with Bonus!
The Wikipedia summary starts off pretty spoiler-free for now, so let’s put that up there to tide us over until 9 PM Monday!
After a newborn experiences inexplicable breathing problems and liver failure, House and the team look at the baby’s mother, Abbey’s (Jennifer Grey) own medical history for possible clues. When the team makes a discovery about her newborn’s health, Abbey is presented with a difficult decision that could potentially affect both her baby’s health and her own. Meanwhile, following Cuddy’s directive, House challenges Foreman and Taub to hire a female doctor to join the team. When Cuddy asks House to babysit her daughter, Rachel, both House and Wilson learn a few hard lessons in parenting.
So last week we had a character named “Ferris Bueller,” and this week we have Ferris’ sister as a guest star! Pretty awesome if you ask me.
Well, Jennifer Grey dies at the end, but the baby lives. The episode really shined though, as House and Wilson were back together for the week, watching after Dr. Cuddy’s daughter while she was otherwise occupied.
Backing up an hour, Abbey (Jennifer Grey) delivered a baby girl, who went into respiratory distress upon delivery. The lung problems were immediately followed by liver problems of unknown etiology. No treatments worked to improve the baby’s condition, with the exception of a blood transfusion from mother to daughter. This one appears miraculous, and reverses the onslaught of signs and symptoms that had been appearing since the start of the show. A needle biopsy indicates the cause of the symptoms: melanoma, which because the baby has not ever been in the sun, must have come from the mother. A mole under her fingernail confirms the presence of Abbey’s cancer. Melanoma is an aggressive cancer, with a high tendency for metastasis, and has done so from mother to child in utero. The blood transfusion began to reverse the baby’s cancer, and turns out to be because of the presence of “cancer-fighting antibodies,” which have originated from Abbey. Abbey appears healthy though, and so the immune stimulus promoting these antibodies is unknown. The team suspects a fortuitous autoimmune disease is in effect, but it turns out to be far more serious: a lung cancer, which stimulates the immune system to produce the antibodies that are combating the melanoma in the mother, and in the baby via transfusion.
Abbey is told she needs surgery and chemotherapy to eliminate the cancers, and her baby will need chemo as well. Her procedures have a high probability of effecting remission, but the baby’s carries a not insignificant risk, due to side effects. Abbey decides to postpone her treatment, so that her baby can continue to receive blood donations with the cancer-fighting antibodies, and likely cure her with no side effects. Her decision results in her suffering a pulmonary embolism, which she dies of.
A timely episode, with our discussion of antibodies and antigens. Autoantigens are those antigens found on our own cells, and normally we do not have an active immune response against these antigens unless an autoimmune disease is present. The team thought that Abbey had an underlying autoimmune disease, and the antibodies present from this condition were having a fortuitous cross-reactivity with the cancer cells. Cancer cells, due to their significantly different growth patterns from normal cells, may frequently express antigens not found on normal cells. These can be targets for immune eradication, via the mechanisms of the adaptive immune response, but the aggressive nature of tumors and their origins from our normal cells means this is a pretty far fetched occurrence. Our story this week was likely only possible due to the complex interactions of antigens originating from two separate tumors.
BONUS: By using Google, identify an antigen that is used in the diagnosis of a cancer!