General Physiological and Pathophysiological Concepts: Peer Responses Essay

General Physiological and Pathophysiological Concepts: Peer Responses Essay

General Physiological and Pathophysiological Concepts: Peer Responses Essay

Discussion 1:

Hello, ______. I liked how you started your post by simply describing the various forms of immunity. Indeed, adaptive immunity may be classified as active or passive depending on the fact that antibodies or T cells are produced by the individual in reaction to the antigen or are provided directly. I thus agree with you that passively acquired immunity sometimes doesn’t incorporate the host’s immune response in any way, whereas active acquired immunity is gained by an individual either after natural contact with an antigen or just after vaccination (Elahi, 2020). According to the last line, I too believe that passive immunity happens when T cells or premade antibodies are passed from a donor to the receiver.

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In response to your question, breast milk contains several healthy compounds that help boost your baby’s immune system. These include probiotics, antibodies, lipids, and carbs in addition to proteins and lipids (Carsetti et al., 2020). A woman’s body creates antibodies in response to pathogen exposure to help fight disease. They are given to the baby through breast milk. Since that mothers and newborns frequently come into contact with the same germs, the mother’s breast milk can protect the baby. Compared to infants who are fed formula, breastfed newborns get fewer infections and recover more quickly. Yet, for mothers who are unable or unwilling to breastfeed, infant formula is a nutritious substitute. Breastfeeding won’t save your child from potentially lethal diseases like polio, diphtheria, or measles. Some infections are fairly serious and might make your child very unwell. Fortunately, there are now vaccines that safeguard your child by supporting the immune system.

References

Carsetti, R., Quintarelli, C., Quinti, I., Mortari, E. P., Zumla, A., Ippolito, G., & Locatelli, F. (2020). The immune system of children: the key to understanding SARS-CoV-2 susceptibility? The Lancet Child & Adolescent Health, 4(6), 414–416. https://doi.org/10.1016/S2352-4642(20)30135-8

Elahi, S. (2020). Neonatal and Children’s Immune System and COVID-19: Biased Immune Tolerance versus Resistance Strategy. The Journal of Immunology, ji2000710. https://doi.org/10.4049/jimmunol.2000710

Discussion 2:

Hello,____. I appreciate your effort in expanding on the chronic respiratory disorder known as asthma from the outset, and I can confirm that it is an airway inflammatory disorder that causes recurring attacks of coughing, chest tightness, wheezing, and shortness of breath. Asthma does not have a single cause, it is true (Coverstone et al., 2020). I believe that the etiology of asthma is intricate and involves bronchial hyperresponsiveness, intermittent airflow restriction, and airway inflammation. Environmental and genetic variables can influence the development of asthma, as you described. Family history of asthma, childhood bronchiolitis, cigarette smoke exposure, preterm birth and low birth weight, chemical exposure, and obesity are other risk factors. when exposed to an allergen, immunoglobulin E (IgE) often mediates the reaction.

Regarding asthma management, I admire how you approached it from the perspective of patient education. Clinicians should educate patients on asthma self-management approaches based on fundamental asthma knowledge, self-monitoring skills, the role of drugs, inhaler usage, and environmental control measures in addition to medications and triggers. As a result, I can see that you overlooked the necessary, healthy lifestyle modifications. For instance, being obese and being overweight might make managing asthma more difficult (Papi et al., 2020). Patients should be counseled to consume more fruits and vegetables as a result. Patients should be urged not to shun exercise even if for some, it might exacerbate asthma. An essential component of a healthy lifestyle is physical exercise. Generally speaking, I learned a lot from your work.

References

Coverstone, A. M., Seibold, M. A., & Peters, M. C. (2020). Diagnosis and Management of T2-High Asthma. The Journal of Allergy and Clinical Immunology: In Practice, 8(2), 442–450. https://doi.org/10.1016/j.jaip.2019.11.020

Papi, A., Blasi, F., Canonica, G. W., Morandi, L., Richeldi, L., & Rossi, A. (2020). Treatment strategies for asthma: reshaping the concept of asthma management. Allergy, Asthma & Clinical Immunology, 16(1). https://doi.org/10.1186/s13223-020-00472-8

Discussion 3:

Hello,______. It was intelligent of you to organize your work into two descriptive paragraphs. As a reader, I was able to understand the main premise of the entire piece from the first paragraph. Certainly, the most popular treatment for RA is methotrexate, a multi-route medicine categorized as a disease-modifying anti-rheumatic drug (DMARDS). Given its great potency and effectiveness in treating rheumatoid arthritis in these individuals, I thought it was crucial to mention that methotrexate is an FDA-approved folic acid antagonist that is also sometimes effective in treating juvenile idiopathic arthritis (Juge et al., 2021). Your description of its anti-inflammatory impact in the treatment of RA is adequate. Clinicians will be guided in their therapeutic strategy and toxicity monitoring by a better knowledge of the biological mechanisms and toxicities of methotrexate.

According to your second paragraph, patient education is essential for RA patients to gain as much as possible from methotrexate therapy. In addition to monitoring side effects and drug-drug interactions, as you have noted, it is crucial to urge patients to abstain from alcohol due to the increased risk of liver damage. This includes beer, wine, and hard liquor (Hannoodee & Mittal, 2020). Thus, it’s crucial to talk to the patient about the significance of the right dosage and administration, the fact that the prescribed dose is only to be taken once a week, and the fact that improper daily usage of the acceptable dose has resulted in lethal toxicity. Ensure that patients are aware of the importance of careful follow-up and toxicity monitoring. Lastly, there is an antidote accessible in case of an unintentional overdose (leucovorin rescue). Thank you for such an insightful piece of work.

References

Hannoodee, M., & Mittal, M. (2020). Methotrexate. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK556114/

Juge, P.-A., Lee, J. S., Lau, J., Kawano-Dourado, L., Serrano, J. R., Sebastiani, M., Koduri, G., Matteson, E., Bonfiglioli, K., Sawamura, M., Kairalla, R., Cavagna, L., Cassione, E. B., Manfredi, A., Mejia, M., Rodríguez-Henriquez, P., González-Pérez, M. I., Falfán-Valencia, R., Buendia-Roldán, I., & Pérez-Rubio, G. (2021). Methotrexate and rheumatoid arthritis-associated interstitial lung disease. The European Respiratory Journal, 57(2), 2000337. https://doi.org/10.1183/13993003.00337-2020

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Discussion 1: (CAT) Adaptive immunity can be either active or passive, depending on whether the antibodies or T cells are produced by the individual in response to antigen or are administered directly. Active acquired immunity (active immunity) is produced by an individual either after natural exposure to an antigen or after immunization, whereas passive acquired immunity (passive immunity) does not involve the host’s immune response at all. Rather, passive immunity occurs when preformed antibodies or T lymphocytes are transferred from a donor to the recipient (breast milk). This can occur naturally, as in the passage of maternal antibodies across the placenta to the fetus, or artificially, as in a clinic using immunotherapy for a specific disease. Organisms are passed from mother to baby by vertical transmission across the placenta.

If so , what type of immunity does the child get after breastfeeding ? 🙂

Discussion 2: (DH) Asthma  Asthma is a chronic inflammatory disease of the airways that results in recurrent episodes of wheezing, shortness of breath, chest tightness and coughing. The chronic inflammation can increase hyperresponsiveness in the airways. There is no single cause for asthma. Environmental and genetic factors can contribute to the development of asthma. Some risk factors are family history of asthma, bronchiolitis in childhood, tobacco smoke exposure, premature and low birth weight, exposure to chemicals, and obesity. Typically mediated by immunoglobulin E (IgE) when exposed to an allergen. At the first exposure, allergen-specific Ige antibodies attach to mast cells. Following exposures result in the release of leukotrienes, histamine, and prostaglandins which cause an inflammatory response which triggers an asthma attack (Khachi, et al., 2014). Education for patients with asthma should include medication management, such as how and when to use maintenance medications and rescue inhalers. The patient should be educated on how to avoid triggers, such as pet dander, dust, molds or other triggering substances. Patients will benefit from resources that can assist them with adjusting modifiable risks, such as smoking cessation programs and weight management. The goal is to maintain control and to reduce acute asthma exacerbations (Murray & O’Neill, 2018).

Kachi, H., Meynell, H., Murphy, A. (2014). Asthma: pathophysiologu, causes and diagnosis. The Pharamceutical Journal. Retrieved from https://pharmaceutical-journal.com/article/ld/asthma-pathophysiology-causes-and-diagnosis

Murray, B., & O’Neill, M. (2018). Supporting self-management of asthma through patient education. British journal of nursing (Mark Allen Publishing), 27(7), 396–401. https://doi.org/10.12968/bjon.2018.27.7.396

Discussion 3: (SO) Rheumatoid Arthritis – Methotrexate

Methotrexate is a multi-route medication classified as Disease Modifying Anti-rheumatic Drug (DMARDS) and is the most common drug for RA (Johns Hopkins Medicine, 2019). The anti-inflammatory effects of methotrexate work well on their own or can be paired with a TNF inhibitor or non-TNF biologic agent. The understanding of RA has increased significantly in recent years, but not everything is known about what causes the onset of RA. Methotrexate is a folic acid antagonist that partially interrupts adenosine and other immune pathways (Johns Hopkins Medicine, 2019). Methotrexate suppresses the immune system and has anti-inflammatory effects by inhibiting cytokine production and purine nucleotide biosynthesis (Whalen, 2018).

Patients taking methotrexate should have follow-up tests monitoring CBC, renal function test, and liver function tests weekly for four weeks and then at least bi-monthly (Hannoodee & Mittal, 2023). Also, since this is an immune suppressant, patients should be educated about infection risk. Side effects of methotrexate include GI upset issues and a significant risk for hepatotoxicity. Folic acid supplementation may improve methotrexate tolerability and reduce GI and hepatic side effects (Whalen, 2018). Methotrexate is contraindicated for use while pregnant. Drug interactions include NSAIDs, salicylates, TMP, penicillin, warfarin, valproate, proton pump inhibitors, cyclosporin, cisplatin have an increased risk of toxicity in the blood; aminoglycosides, neomycin, probenecid reduces the absorption so they should be used with care. The most significant and severe interactions are with NSAIDs and PPIs since they are commonly used in RA patients (Hannoodee & Mittal, 2023).

References

Hannoodee, M., & Mittal, M. (2023). Statpearls. StatPearls Publishing LLC. Retrieved March 24, 2023, from https://www.ncbi.nlm.nih.gov/books/NBK556114/.

Johns Hopkins Medicine. (2019). Rheumatoid Arthritis Treatment. Johns Hopkins Arthritis Center. Retrieved March 23, 2023, from https://www.hopkinsarthritis.org/arthritis-info/rheumatoid-arthritis/ra-treatment/#metho#metho

Whalen, K. (2018). Lippincott’s illustrated reviews: Pharmacology (7th ed.). Lippincott Williams & Wilkens. ISBN-13: 9781496384133