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Golden blood: The rarest blood in the world
We explore the history of blood types and how they are classified to find out what makes the Rh-null type important to science and dangerous for those who live with it.
- Fewer than 50 people worldwide have 'golden blood' — or Rh-null.
- Blood is considered Rh-null if it lacks all of the 61 possible antigens in the Rh system.
- It's also very dangerous to live with this blood type, as so few people have it.
Golden blood sounds like the latest in medical quackery. As in, get a golden blood transfusion to balance your tantric midichlorians and receive a free charcoal ice cream cleanse. Don't let the New-Agey moniker throw you. Golden blood is actually the nickname for Rh-null, the world's rarest blood type.
As Mosaic reports, the type is so rare that only about 43 people have been reported to have it worldwide, and until 1961, when it was first identified in an Aboriginal Australian woman, doctors assumed embryos with Rh-null blood would simply die in utero.
But what makes Rh-null so rare, and why is it so dangerous to live with? To answer that, we'll first have to explore why hematologists classify blood types the way they do.
A (brief) bloody history
Our ancestors understood little about blood. Even the most basic of blood knowledge — blood inside the body is good, blood outside is not ideal, too much blood outside is cause for concern — escaped humanity's grasp for an embarrassing number of centuries.
Absence this knowledge, our ancestors devised less-than-scientific theories as to what blood was, theories that varied wildly across time and culture. To pick just one, the physicians of Shakespeare's day believed blood to be one of four bodily fluids or "humors" (the others being black bile, yellow bile, and phlegm).
Handed down from ancient Greek physicians, humorism stated that these bodily fluids determined someone's personality. Blood was considered hot and moist, resulting in a sanguine temperament. The more blood people had in their systems, the more passionate, charismatic, and impulsive they would be. Teenagers were considered to have a natural abundance of blood, and men had more than women.
Humorism lead to all sorts of poor medical advice. Most famously, Galen of Pergamum used it as the basis for his prescription of bloodletting. Sporting a "when in doubt, let it out" mentality, Galen declared blood the dominant humor, and bloodletting an excellent way to balance the body. Blood's relation to heat also made it a go-to for fever reduction.
While bloodletting remained common until well into the 19th century, William Harvey's discovery of the circulation of blood in 1628 would put medicine on its path to modern hematology.
Soon after Harvey's discovery, the earliest blood transfusions were attempted, but it wasn't until 1665 that first successful transfusion was performed by British physician Richard Lower. Lower's operation was between dogs, and his success prompted physicians like Jean-Baptiste Denis to try to transfuse blood from animals to humans, a process called xenotransfusion. The death of human patients ultimately led to the practice being outlawed.4
The first successful human-to-human transfusion wouldn't be performed until 1818, when British obstetrician James Blundell managed it to treat postpartum hemorrhage. But even with a proven technique in place, in the following decades many blood-transfusion patients continued to die mysteriously.
Enter Austrian physician Karl Landsteiner. In 1901 he began his work to classify blood groups. Exploring the work of Leonard Landois — the physiologist who showed that when the red blood cells of one animal are introduced to a different animal's, they clump together — Landsteiner thought a similar reaction may occur in intra-human transfusions, which would explain why transfusion success was so spotty. In 1909, he classified the A, B, AB, and O blood groups, and for his work he received the 1930 Nobel Prize for Physiology or Medicine.
What causes blood types?
It took us a while to grasp the intricacies of blood, but today, we know that this life-sustaining substance consists of:
- Red blood cells — cells that carry oxygen and remove carbon dioxide throughout the body;
- White blood cells — immune cells that protect the body against infection and foreign agents;
- Platelets — cells that help blood clot; and
- Plasma — a liquid that carries salts and enzymes.6,7
Each component has a part to play in blood's function, but the red blood cells are responsible for our differing blood types. These cells have proteins* covering their surface called antigens, and the presence or absence of particular antigens determines blood type — type A blood has only A antigens, type B only B, type AB both, and type O neither. Red blood cells sport another antigen called the RhD protein. When it is present, a blood type is said to be positive; when it is absent, it is said to be negative. The typical combinations of A, B, and RhD antigens give us the eight common blood types (A+, A-, B+, B-, AB+, AB-, O+, and O-).
Blood antigen proteins play a variety of cellular roles, but recognizing foreign cells in the blood is the most important for this discussion.
Think of antigens as backstage passes to the bloodstream, while our immune system is the doorman. If the immune system recognizes an antigen, it lets the cell pass. If it does not recognize an antigen, it initiates the body's defense systems and destroys the invader. So, a very aggressive doorman.
While our immune systems are thorough, they are not too bright. If a person with type A blood receives a transfusion of type B blood, the immune system won't recognize the new substance as a life-saving necessity. Instead, it will consider the red blood cells invaders and attack. This is why so many people either grew ill or died during transfusions before Landsteiner's brilliant discovery.
This is also why people with O negative blood are considered "universal donors." Since their red blood cells lack A, B, and RhD antigens, immune systems don't have a way to recognize these cells as foreign and so leaves them well enough alone.
How is Rh-null the rarest blood type?
Let's return to golden blood. In truth, the eight common blood types are an oversimplification of how blood types actually work. As Smithsonian.com points out, "[e]ach of these eight types can be subdivided into many distinct varieties," resulting in millions of different blood types, each classified on a multitude of antigens combinations.
Here is where things get tricky. The RhD protein previously mentioned only refers to one of 61 potential proteins in the Rh system. Blood is considered Rh-null if it lacks all of the 61 possible antigens in the Rh system. This not only makes it rare, but this also means it can be accepted by anyone with a rare blood type within the Rh system.
This is why it is considered "golden blood." It is worth its weight in gold.
As Mosaic reports, golden blood is incredibly important to medicine, but also very dangerous to live with. If a Rh-null carrier needs a blood transfusion, they can find it difficult to locate a donor, and blood is notoriously difficult to transport internationally. Rh-null carriers are encouraged to donate blood as insurance for themselves, but with so few donors spread out over the world and limits on how often they can donate, this can also put an altruistic burden on those select few who agree to donate for others.
Some bloody good questions about blood types
A nurse takes blood samples from a pregnant woman at the North Hospital (Hopital Nord) in Marseille, southern France.
Photo by BERTRAND LANGLOIS / AFP
There remain many mysteries regarding blood types. For example, we still don't know why humans evolved the A and B antigens. Some theories point to these antigens as a byproduct of the diseases various populations contacted throughout history. But we can't say for sure.
In this absence of knowledge, various myths and questions have grown around the concept of blood types in the popular consciousness. Here are some of the most common and their answers.
Do blood types affect personality?
Japan's blood type personality theory is a contemporary resurrection of humorism. The idea states that your blood type directly affects your personality, so type A blood carriers are kind and fastidious, while type B carriers are optimistic and do their own thing. However, a 2003 study sampling 180 men and 180 women found no relationship between blood type and personality.
The theory makes for a fun question on a Cosmopolitan quiz, but that's as accurate as it gets.
Should you alter your diet based on your blood type?
Remember Galen of Pergamon? In addition to bloodletting, he also prescribed his patients to eat certain foods depending on which humors needed to be balanced. Wine, for example, was considered a hot and dry drink, so it would be prescribed to treat a cold. In other words, belief that your diet should complement your blood type is yet another holdover of humorism theory.
Created by Peter J. D'Adamo, the Blood Type Diet argues that one's diet should match one's blood type. Type A carriers should eat a meat-free diet of whole grains, legumes, fruits, and vegetables; type B carriers should eat green vegetables, certain meats, and low-fat dairy; and so on.
However, a study from the University of Toronto analyzed the data from 1,455 participants and found no evidence to support the theory. While people can lose weight and become healthier on the diet, it probably has more to do with eating all those leafy greens than blood type.
Are there links between blood types and certain diseases?
There is evidence to suggest that different blood types may increase the risk of certain diseases. One analysis suggested that type O blood decreases the risk of having a stroke or heart attack, while AB blood appears to increase it. With that said, type O carriers have a greater chance of developing peptic ulcers and skin cancer.
None of this is to say that your blood type will foredoom your medical future. Many factors, such as diet and exercise, hold influence over your health and likely to a greater extent than blood type.
What is the most common blood type?
In the United States, the most common blood type is O+. Roughly one in three people sports this type of blood. Of the eight well-known blood types, the least common is AB-. Only one in 167 people in the U.S. have it.
Do animals have blood types?
They most certainly do, but they are not the same as ours. This difference is why those 17th-century patients who thought, "Animal blood, now that's the ticket!" ultimately had their tickets punched. In fact, blood types are distinct between species. Unhelpfully, scientists sometimes use the same nomenclature to describe these different types. Cats, for example, have A and B antigens, but these are not the same A and B antigens found in humans.
Interestingly, xenotransfusion is making a comeback. Scientists are working to genetically engineer the blood of pigs to potentially produce human compatible blood.
Scientists are also looking into creating synthetic blood. If they succeed, they may be able to ease the current blood shortage, while also devising a way to create blood for rare blood type carriers. While this may make golden blood less golden, it would certainly make it easier to live with.* While antigens are typically proteins, they can be other molecules as well, such as polysaccharides.
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Higher education faces challenges that are unlike any other industry. What path will ASU, and universities like ASU, take in a post-COVID world?
- Everywhere you turn, the idea that coronavirus has brought on a "new normal" is present and true. But for higher education, COVID-19 exposes a long list of pernicious old problems more than it presents new problems.
- It was widely known, yet ignored, that digital instruction must be embraced. When combined with traditional, in-person teaching, it can enhance student learning outcomes at scale.
- COVID-19 has forced institutions to understand that far too many higher education outcomes are determined by a student's family income, and in the context of COVID-19 this means that lower-income students, first-generation students and students of color will be disproportionately afflicted.
What conditions of the new normal were already appreciated widely?<p>First, we understand that higher education is unique among industries. Some industries are governed by markets. Others are run by governments. Most operate under the influence of both markets and governments. And then there's higher education. Higher education as an "industry" involves public, private, and for-profit universities operating at small, medium, large, and now massive scales. Some higher education industry actors are intense specialists; others are adept generalists. Some are fantastically wealthy; others are tragically poor. Some are embedded in large cities; others are carefully situated near farms and frontiers.</p> <p>These differences demonstrate just some of the complexities that shape higher education. Still, we understand that change in the industry is underway, and we must be active in directing it. Yet because of higher education's unique (and sometimes vexing) operational and structural conditions, many of the lessons from change management and the science of industrial transformation are only applicable in limited or highly modified ways. For evidence of this, one can look at various perspectives, including those that we have offered, on such topics as <a href="https://www.insidehighered.com/digital-learning/blogs/rethinking-higher-education/lessons-disruption" target="_blank">disruption</a>, <a href="https://www.nytimes.com/2020/02/20/education/learning/education-technology.html" target="_blank">technology management</a>, and so-called "<a href="https://www.insidehighered.com/sites/default/server_files/media/Excerpt_IHESpecialReport_Growing-Role-of-Mergers-in-Higher-Ed.pdf" target="_blank">mergers and acquisitions</a>" in higher education. In each of these spaces, the "market forces" and "market rules" for higher education are different than they are in business, or even in government. This has always been the case and it is made more obvious by COVID-19.</p> <p>Second, with so much excitement about innovation in higher education, we sometimes lose sight of the fact that students are—and should remain—the core cause for innovation. Higher education's capacity to absorb new ideas is strong. But the ideas that endure are those designed to benefit students, and therefore society. This is important to remember because not all innovations are designed with students in mind. The recent history of innovation in higher education includes several cautionary tales of what can happen when institutional interests—or worse, <a href="https://www.insidehighered.com/news/2016/02/09/apollos-new-owners-seek-fresh-start-beleaguered-company" target="_blank">shareholder</a> interests—are placed above student well-being.</p>
Photo: Getty Images<p>Third, it is abundantly apparent that universities must leverage technology to increase educational quality and access. The rapid shift to delivering an education that complies with social distancing guidelines speaks volumes about the adaptability of higher education institutions, but this transition has also posed unique difficulties for colleges and universities that had been slow to adopt digital education. The last decade has shown that online education, implemented effectively, can meet or even surpass the quality of in-person <a href="https://link-springer-com.ezproxy1.lib.asu.edu/article/10.1007/s10639-019-10027-z" target="_blank">instruction</a>.</p><p>Digital instruction, broadly defined, leverages online capabilities and integrates adaptive learning methodologies, predictive analytics, and innovations in instructional design to enable increased student engagement, personalized learning experiences, and improved learning outcomes. The ability of these technologies to transcend geographic barriers and to shrink the marginal cost of educating additional students makes them essential for delivering education at scale.</p><p>As a bonus, and it is no small thing given that they are the core cause for innovation, students embrace and enjoy digital instruction. It is their preference to learn in a format that leverages technology. This should not be a surprise; it is now how we live in all facets of life.</p><p>Still, we have only barely begun to conceive of the impact digital education will have. For example, emerging virtual and augmented reality technologies that facilitate interactive, hands-on learning will transform the way that learners acquire and apply new knowledge. Technology-enabled learning cannot replace the traditional college experience or ensure the survival of any specific college, but it can enhance student learning outcomes at scale. This has always been the case, and it is made more obvious by COVID-19.</p>
What conditions of the new normal were emerging suspicions?<p>Our collective thinking about the role of institutional or university-to-university collaboration and networking has benefitted from a new clarity in light of COVID-19. We now recognize more than ever that colleges and universities must work together to ensure that the American higher education system is resilient and sufficiently robust to meet the needs of students and their families.</p> <p>In recent weeks, various commentators have suggested that higher education will face a wave of institutional <a href="https://www.businessinsider.com/scott-galloway-predicts-colleges-will-close-due-to-pandemic-2020-5" target="_blank">closures</a> and consolidations and that large institutions with significant online instruction capacity will become dominant.</p> <p>While ASU is the largest public university in the United States by enrollment and among the most well-equipped in online education, we strongly oppose "let them fail" mindsets. The strength of American higher education relies on its institutional diversity, and on the ability of colleges and universities to meet the needs of their local communities and educate local students. The needs of learners are highly individualized, demanding a wide range of options to accommodate the aspirations and learning styles of every kind of student. Education will become less relevant and meaningful to students, and less responsive to local needs, if institutions of higher learning are allowed to fail. </p> <p>Preventing this outcome demands that colleges and universities work together to establish greater capacity for remote, distributed education. This will help institutions with fewer resources adapt to our new normal and continue to fulfill their mission of serving students, their families, and their communities. Many had suspected that collaboration and networking were preferable over letting vulnerable colleges fail. COVID-19's new normal seems to be confirming this.</p>
President Barack Obama delivers the commencement address during the Arizona State University graduation ceremony at Sun Devil Stadium May 13, 2009 in Tempe, Arizona. Over 65,000 people attended the graduation.
Photo by Joshua Lott/Getty Images<p>A second condition of the new normal that many had suspected to be true in recent years is the limited role that any one university or type of university can play as an exemplar to universities more broadly. For decades, the evolution of higher education has been shaped by the widespread imitation of a small number of elite universities. Most public research universities could benefit from replicating Berkeley or Michigan. Most small private colleges did well by replicating Williams or Swarthmore. And all universities paid close attention to Harvard, Princeton, MIT, Stanford, and Yale. It is not an exaggeration to say that the logic of replication has guided the evolution of higher education for centuries, both in the US and abroad.</p><p>Only recently have we been able to move beyond replication to new strategies of change, and COVID-19 has confirmed the legitimacy of doing so. For example, cases such as <a href="https://www.washingtonpost.com/education/2020/03/10/harvard-moves-classes-online-advises-students-stay-home-after-spring-break-response-covid-19/" target="_blank">Harvard's</a> eviction of students over the course of less than one week or <a href="https://www.nhregister.com/news/coronavirus/article/Mayor-New-Haven-asks-for-coronavirus-help-Yale-15162606.php" target="_blank">Yale's apparent reluctance</a> to work with the city of New Haven, highlight that even higher education's legacy gold standards have limits and weaknesses. We are hopeful that the new normal will include a more active and earnest recognition that we need many types of universities. We think the new normal invites us to rethink the very nature of "gold standards" for higher education.</p>
A graduate student protests MIT's rejection of some evacuation exemption requests.
Photo: Maddie Meyer/Getty Images<p>Finally, and perhaps most importantly, we had started to suspect and now understand that America's colleges and universities are among the many institutions of democracy and civil society that are, by their very design, incapable of being sufficiently responsive to the full spectrum of modern challenges and opportunities they face. Far too many higher education outcomes are determined by a student's family income, and in the context of COVID-19 this means that lower-income students, first-generation students and students of color will be disproportionately afflicted. And without new designs, we can expect postsecondary success for these same students to be as elusive in the new normal, as it was in the <a href="http://pellinstitute.org/indicators/reports_2019.shtml" target="_blank">old normal</a>. This is not just because some universities fail to sufficiently recognize and engage the promise of diversity, this is because few universities have been designed from the outset to effectively serve the unique needs of lower-income students, first-generation students and students of color.</p>
Where can the new normal take us?<p>As colleges and universities face the difficult realities of adapting to COVID-19, they also face an opportunity to rethink their operations and designs in order to respond to social needs with greater agility, adopt technology that enables education to be delivered at scale, and collaborate with each other in order to maintain the dynamism and resilience of the American higher education system.</p> <p>COVID-19 raises questions about the relevance, the quality, and the accessibility of higher education—and these are the same challenges higher education has been grappling with for years. </p> <p>ASU has been able to rapidly adapt to the present circumstances because we have spent nearly two decades not just anticipating but <em>driving</em> innovation in higher education. We have adopted a <a href="https://www.asu.edu/about/charter-mission-and-values" target="_blank">charter</a> that formalizes our definition of success in terms of "who we include and how they succeed" rather than "<a href="https://www.washingtonpost.com/opinions/2019/10/17/forget-varsity-blues-madness-lets-talk-about-students-who-cant-afford-college/" target="_blank">who we exclude</a>." We adopted an entrepreneurial <a href="https://president.asu.edu/read/higher-logic" target="_blank">operating model</a> that moves at the speed of technological and social change. We have launched initiatives such as <a href="https://www.instride.com/how-it-works/" target="_blank">InStride</a>, a platform for delivering continuing education to learners already in the workforce. We developed our own robust technological capabilities in ASU <a href="https://edplus.asu.edu/" target="_blank">EdPlus</a>, a hub for research and development in digital learning that, even before the current crisis, allowed us to serve more than 45,000 fully online students. We have also created partnerships with other forward-thinking institutions in order to mutually strengthen our capabilities for educational accessibility and quality; this includes our role in co-founding the <a href="https://theuia.org/" target="_blank">University Innovation Alliance</a>, a consortium of 11 public research universities that share data and resources to serve students at scale. </p> <p>For ASU, and universities like ASU, the "new normal" of a post-COVID world looks surprisingly like the world we already knew was necessary. Our record breaking summer 2020 <a href="https://asunow.asu.edu/20200519-sun-devil-life-summer-enrollment-sets-asu-record" target="_blank">enrollment</a> speaks to this. What COVID demonstrates is that we were already headed in the right direction and necessitates that we continue forward with new intensity and, we hope, with more partners. In fact, rather than "new normal" we might just say, it's "go time." </p>
Check out these mysterious optical illusions that affect our visual perception.
- Troxler's effect or "fading" causes images to disappear from your field of vision.
- Scientists don't have a full understanding yet of how this works.
- The effect is linked to the way neurons are adapted by the visual system.
THE LILAC CHASER<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yMDU1OTgyOC9vcmlnaW4uZ2lmIiwiZXhwaXJlc19hdCI6MTYyMjg0OTI5Mn0.Bha6hEz63mh7MzwjAz9uL0Sgk3xD9N7ALTk9acWjW5M/img.gif?width=980" id="94559" class="rm-shortcode" data-rm-shortcode-id="a6fa6ecc96de1cc55da7f3191c8fa086" data-rm-shortcode-name="rebelmouse-image" />
Look at the black cross at the center of the image and the spots in this "lilac chaser" illusion will fade away in a few seconds. A grey background and the cross will remain unless you are among those who will also see a moving blue-green spot. You might even notie a bunch of green spots when you move your eyes away after a while.
HOW DOES IT WORK?<p>Research indicates the effect is related to how neurons important for perceiving stimuli are adapted by the visual system. Unchanging stimuli will eventually disappear from our awareness while our mind will fill the areas where they used to be with the background information (or color). A <strong>"sensory fading" </strong>or<strong> "filling-in"</strong> is linked to <em><strong>saccades</strong></em> – involuntary eye movements that happen even when the gaze appears settled. If we fixate on a point, an unmoving image or scene would fade from view in a few seconds thanks to the "<em>local neural adaptation </em>of the <em>rods, cones</em> and <em>ganglion cells</em> in the retina," <a href="https://www.illusionsindex.org/i/troxler-effect" target="_blank">explains the Illusions Index.</a> </p><p>The effect is made stronger if the stimulus image is low contrast or blurred. </p><p>While <a href="https://linkinghub.elsevier.com/retrieve/pii/S0042698905006693" target="_blank">studies</a> showed the effect doesn't only occur in the eyes but partially in the brain, there's not yet a definitive explanation for everything involved in this unusual visual phenomenon. </p>
Another example image of the Troxler effect. Look at the center of the image for about 10 seconds.
And another fun example:<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="1c95efc4dbb1d807658af68ed6261020"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/c6j4ftoJzj8?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span>
Sallie Krawcheck and Bob Kulhan will be talking money, jobs, and how the pandemic will disproportionally affect women's finances.
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