Please respond to Nkechi post in one of the following ways :Share insights on how the factor you selected impacts the pathophysiology of the immune disorder your colleague selected.
Expand on your colleague’s posting by providing additional insights or contrasting perspectives based on readings and evidence.
I did Psoriasis and HIV
6501 Week 2 Discussion 1 Initial Post
Maladaptive Responses to Immune Disorders
Immune system disorders cause abnormally low activity or over activity of the immune system. In cases of immune system over activity, the body attacks and damages its own tissues (autoimmune diseases). Immune deficiency diseases decrease the body’s ability to fight invaders, causing vulnerability to infections. According to Huether and McCance (2017), autoimmune diseases occur when the immune system reacts against self-antigens to such a degree that autoantibodies or autoreactive T cells damage the individual’s tissues. In response to an unknown trigger, the immune system may begin producing antibodies that instead of fighting infections, attack the body’s own tissues. The two Immune disorders I selected are Human Immunodeficiency Virus (HIV) and Systemic Lupus E (SLE).
Pathophysiology of HIV
HIV is a devastating blood-borne pathogenic disease that infects and destroys CD4- positive (CD4+) Th cell that are essential for the development of plasma and cytotoxic T cells (Huether & McCance, 2017). HIV is commonly transmitted via unprotected sexual activity, blood transfusions, hypodermic needles, and from mother to child. Upon acquisition of the virus, the virus replicates inside and kills T helper cells, which are required for almost all adaptive immune responses. There is an initial period of influenza-like illness, and then a latent, asymptomatic phase. When the CD4 lymphocyte count falls below 200 cells/ml of blood, the HIV host has progressed to AIDS, a condition characterized by deficiency in cell-mediated immunity and the resulting increased susceptibility to opportunistic infections and certain forms of cancer. Per Huether & McCance (2017), HIV is a member of family of virus called retroviruses, which carry genetic information in form of RNA instead of DNA and these retroviruses use viral enzyme, reverse transcriptase to convert RNA into double-stranded DNA. This disease represses the immune reaction against itself and additionally creates a generalized immune deficiency by suppressing the development of immune responses against other pathogens and opportunistic microorganisms (Huether & McCance, 2017).
Pathophysiology of Systemic Lupus Erythematosus (SLE)
Systemic lupus erythematosus (SLE) is an autoimmune rheumatic disease in which the body’s immune system attacks its own healthy tissue and is characterized by chronic inflammatory injury and damage of multiple organ systems (Hammer & McPhee, 2014). The pathophysiology of disease involves three phases: initiation phase (which occurs when autoantibody response in lupus targets group of self-antigens and this initiating event in lupus is a unique form of apoptotic cell death), propagation phase (where autoantibodies bind to extracellular molecules in target organs, activate inflammatory functions with tissue damage, also autoantibodies directly induce cell death), and final Flares phase (this phase reflects immunologic memory, occurring in response to rechallenge of the primed immune system with antigen) (Hammer & McPhee, 2014). SLE can have phases of worsening symptoms that alternate with periods of mild symptoms. Most people with SLE can live a normal life with treatment. According to the Lupus Foundation of America, (2012), at least 1.5 million Americans are living with diagnosed lupus. The foundation believes that the number of people who have the condition is much higher and that many cases go undiagnosed. Symptoms can vary and can change over time. Common symptoms include: severe fatigue, joint pain, joint swelling, headaches, a rash on the cheeks and nose, which is called a “butterfly rash”, hair loss, anemia, blood-clotting problems, fingers turning white or blue and tingling when cold, which is known as Raynaud’s phenomenon.
Maladaptive and Physiological Responses
Maladaptive responses to disorders are compensatory mechanisms that ultimately have adverse health effects for patients. While a physiological response is an automatic reaction that triggers a physical response to a stimulus. The physiological response of person with HIV is that the body will suppress immune responses against pathogens thereby creating an immune deficiency or development of AIDs and Maladaptive response is characterized by a significant decline in the amount of CD4-positive Th cells. Decrease in the CD4 count leads to a negative consequence on the immune system and thereby causing severely diminished response to range of infectious pathogens and cancers (Huether & McCance, 2017). The physiological response of SLE is the unique adaptive immune response driven by antigens contained in self-tissues which is responsible for pathologic consequences of the disease. Maladaptive response of SLE is characterized by chronic inflammatory injury and damage to multiple organ systems (Hammer & McPhee, 2014). Both SLE and HIV are devastating autoimmune diseases linked to some degree of mental health problems such as depression and anxiety or even aggressiveness. SLE is associated to significant complications such as thrombocytopenia, pleural effusions, myocarditis, pericarditis, endocarditis, deep vein thrombosis, pulmonary embolism, hemolytic anemia, stroke, inflammation of blood vessels, complications in pregnancy and possible miscarriages.
Factors affecting the immune disorders
The factor affecting HIV is genetics. HIV belongs to the retroviruses family and this branch of the family transmits genetic information in the form of RNA instead of DNA. Retroviruses alter RNA into double-stranded DNA using an enzyme called reverse transcriptase. The newly formed DNA is then introduced into the genetic material of the infected cell using another viral enzyme called integrase. HIV virus can also cross the placenta during birth or the virus can be transmitted to a child through milk during breastfeeding (Huether & McCance, 2017).
The factor affecting SLE is gender. SLE affects women more than men. Women also may experience more severe symptoms during pregnancy, with their menstrual periods or during child bearing years (Hammer & McPhee, 2014). These observations have led some medical professionals to believe that the female hormone estrogen may play a role in causing SLE. Systemic lupus erythematosus (SLE) is a chronic inflammatory disease that has protean manifestations and follows a relapsing and remitting course. According to Lupus Foundation of America, more than 90% of cases of SLE occur in women, frequently starting at childbearing age.
Hammer, G. G., & McPhee, S. (2014). Pathophysiology of disease: An introduction to clinical medicine. (7th ed.) New York, NY: McGraw-Hill Education.
Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.
Lupus Foundation of America. (2012). Retrieved from http://www.lupus.org/newsite/index.htm