Bergers Disease: IgA Nephropathy

Bergers Disease: IgA Nephropathy Sarah A. Poorman IgA nephropathy, or Bergers disease, is one of the most prevalent, primary, and chronic glomerular disease and an imperative cause of renal failure (Mayo Clinic, 2017). IgAN is one of the most common renal diseases present in todays world. It can occur at any age, perceiving first evidence of renal disease when people are in their teens to late 30s (Wyatt and Julian, 2013). It is twice more likely to appear in men than women, being the most common amongst Asian and Caucasian populations (Wyatt and Julian, 2013). Early stages of Bergers Disease may not have symptoms. It can be silent for years, sometimes even decades before a single symptom shows. The most common symptom witnessed is hematuria, or bloody urine (NIDDK, 2015). This is a definite sign of a damaged glomeruli. Usually, the tint of urine will become a hue of pink or resemble the color of tea or cola (National Kidney Foundation, 2016). Another common symptom to arise is albuminuria. This is when urine contains an overabundance or albumin. Albumin is a protein, typically found in the blood, which maintains fluid balance throughout the human body (Nephcure, 2016). Blood loses its capacity to absorb fluid from the body once albumin leaks into the urine. Due to the lost blood supply, low blood albumin levels will occur. Too much fluid will let to edema, or swelling, of various body parts. The most common body parts to experience edema are the legs, feet, and ankles, leaving the face and hands to be the least commonly affected (NIDDK, 2015). Foamy urine is a signal of albuminuria. The least common symptoms associated with IgAN are high blood pressure and high cholesterol levels (NIDDK, 2015). Glomerulus is a system of capillaries situated at the beginning of a nephron in the kidney (Wyatt and Julian, 2013). Its focal objective is to assist as the first phase of the filtration process of the blood, which is carried out by the nephron in the creation of urine (Mayo Clinic, 2017). IgA nephropathy, or IgAN, is considered an autoimmune disease that affects the glomeruli of the kidneys. Glomeruli are tiny filtering units where the blood is cleared. As the IgA deposits build up in the glomeruli, it causes the kidneys to leak blood and protein into the urine. Human IgA antibodies have two subclasses, IgA1 and IgA2, while IgA1 constitutes 85% of the total IgA in the circulation, starting in the bone marrow (Wyatt and Julian, 2013). Predominantly, these deposits consist of IgA, but they can also exhibit IgG and IgM antibodies by themselves or combined. As the IgA deposits build up in the glomeruli, it causes the kidneys to leak blood and protein into the urine. IgA in the glomerular deposits are exclusively of the IgA1 subclass and are in the polymeric form (Wyatt and Julian, 2013). IgA1 exhibits galactose deficiency in the O-linked glycans in the hinge region of the heavy chain (Suzuki et al, 2011). Going all the way back to basic chemistry, galactose, or Gal, is a monosaccharide sugar that is composed of the same element as glucose, but has a different arrangement of atoms (Maillard et al, 2015). The Fc receptor will blind the GD-IgA1 to create immune complexes that leads to the complement activation. The transcription of IgG and IgM trigger the pathways of complement activation, containing immune complexes (Maillard et al, 2015). Eventually, over time, the massive discharge of ctyokines, components of the ext racellular matrix, and oxidants that disrupt the function of the glomerular basement membrane will induce apoptosis (the product of TGF-B and IL-6) and glomerular scarring (Maillard et al, 2015). This creates the destruction of the kidneys which leads to the major development of end-stage renal disease. To put it simply, T cell-dependent activation of B Cells is initiated by APCs, which processes the antigen, and creates peptides to present, in MHC 11, to CD4+ T cells. This results in the production of T Helper cells. With the interaction of B and T cells, the expression of CD40L, a protein apart of the TNF (tumor necrosis factor) family, begins. Isotype switching of naà ¯ve B cells towards IgA1 and IgA2 producing plasma cells takes place. The B cells carry the antigens to the surface of the cell by Ig expression. They present this to MHC II, which aids in the recruitment of T cells. With the expression of CD40L and cytokines and signals from APCs will begin the regulation of production for IgA the IgA immunoglobulin will typically bind oneself to an antigen or infection found in the body. This will result in the activation of an immune response, which will find a way to rid the body of the infection. People with IgAN have an augmented blood result of IgA that signifies less galactose than what is considered normal. This galactose-deficient IgA, or GD-IgA1, in the blood, is recognized as foreign by the other antibodies circulating the blood. But, when an individual has IgAN, a flawed arrangement of IgA antibodies attach their selves to another IgA antibody, as an alternative of an infection or antigen, resulting in the creation of immune complexes. These immune complexes turn out to be jammed in the kidneys glomeruli, causing damage to the filters. Inflammation takes place, which causes blood and proteins to leak out of the kidneys and into the urine. Eventually, this will lead to end-stage renal disease (ESRD) and total kidney failure, resulting in death or the dire need of a kidney transplantation. Currently, there is no known cure for IgA nephropathy, with no ultimate way of knowing what path the ailment will take. Once the kidneys are scarred, they cannot be repaired. Therefore, the vital goal of IgA nephropathy treatment is to inhibit or delay the inevitable, end-stage renal disease. Some people experience complete remission and others live normal lives with low-grade blood or protein in their urine. Treatment with numerous of medications can slow the progress of the disease and help manage symptoms such as high blood pressure, protein in the urine, and swelling. Some of the medications that are currently being used to treat IgAN are as follows: 1) Angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) which lowers blood pressure and reduces the amount of albumin in the urine. 2) Omega 3 Fatty acids, which aid in the reduction of inflammation throughout the body, in this case the glomeruli, leaving no harmful side effects. 3) Immunosuppressants such as corticosteroids medication (prednisone) will suppress the immune system response, allowing to protect kidney function. However, these can cause serious side effects such as high blood pressure and high blood sugar. 4) Statin therapy are cholesterol lowering medications that are known to help slow the damage to the kidneys. 5) Mycophenolate mofetil, or CellCept, has been successfully used in some pati ents who have had persistent protein in the urine, however, most studies so far have failed to show the benefit for using this medication. There are no sources in the current document.   Ã‚  

Carbon Sinks and Global Climate Change :: Environment Earth Papers

Carbon sinks have been a hot topic surrounding global climate change. To understand this debate it is first essential to understand what carbon sinks are and what they do. Plants have the natural ability to soak up carbon dioxide from atmosphere, storing it as carbon. In relation to global climate change, plants, especially trees, can help to absorb some of the carbon dioxide that humans have emitted into the atmosphere. This becomes one possible solution in mitigating climate change. As with many possible solutions to climate change, there are positive and negative sides of carbon sinks as a mitigation option. There is also quite a divergence of viewpoints between countries. The issue of carbon sinks continues to be debated today. Is this an area in which consensus and cooperation can occur? Unfortunately, this has just been another area in which there has been controversy in global environmental politics. After an in depth look at the negative and positive aspects of carbon sinks i n relation to global climate change, it seems at this time the negative aspects outweigh the positive. Due to scientific uncertainty, an inadequate monitoring and measuring system, as well as a lack of rules and guidelines, the use of carbon sinks will prove to be more of a problem than a solution to the global climate change problem. First of all, what are carbon sinks? The earth contains various natural stocks or reservoirs of carbon. These stocks can be found in the ocean, forests, soils, and the atmosphere. When one of these stocks releases carbon, such as when a forest is reduced by fire, decomposition, or deforestation, it is known as a source of carbon. When these stocks absorb carbon they are called sinks (Sedjo, 4). The ocean can hold the most carbon; it contains about fifty times as much carbon as the atmosphere. Forests and soils contain about 3.5 times as much carbon as the atmosphere (Kolshus, 2). This paper mostly focuses on carbon sinks in forests because it is currently the subject under debate in the climate change regime. Sinks can be used to mitigate global climate change in two ways: either by producing new forests to absorb the carbon, or by preventing the release of carbon into the atmosphere through actions such as deforestation (Pagiola, 25). However, currently there is a lack of consensus as to how much carbon can actually be absorbed by these sinks.

Dream of the Rood Essay

In the poem The Dream of the Rood, many parallels between a seemingly inanimate object directly correlates with the crucifixion and resurrection of Christ. Although, Christ is mentioned in the poem he is never the speaker, rather the Rood is personified and is the central speaker and theme of the poem. The poem begins with the dreamer’s account of what he experienced as he saw the rood â€Å"gloriously graced† then bleeding as the tree spoke directly to the dreamer. Like Christ has done in biblical stories, the â€Å"tree† speaks him in a dream, depicting the first parallel of the Rood and Christ. The rood tells of how soldiers were forced to carry â€Å"him† on their shoulders and set him up on a mountain, just as Christ was forced to do before his crucifixion. The rood continues to display his bravery as he stands steadfast even though the earth was trembling, for he â€Å"dare not act against the Lord’s word. † This depiction of bravery in the rood is to parallel the bravery Jesus showed and his experience as there was an earthquake during his crucifixion. He expresses how he was â€Å"pierced† just as Christ was pierced, and how he was mocked just as Christ was mocked by onlookers. The cross seems to physically suffer as it â€Å"raised up a mighty king, the heaven’s lord; I dared not bow in homage. † This scene represents all the suffering that Christ endured, yet his bravery prevailed. The rood continues his account as he illustrates his and Christ’s death; â€Å"Finally men brought axes to fell us to earth. That was a frightful destiny! They buried us in a deep pit. Although in the biblical account of Christ’s crucifixion the cross was not buried, the author choose to show a connection between Christ and cross by showing they both perished that day. In the same likeness as Christ, the rood is resurrected and adorned by â€Å"friends â€Å"who learned about him, just as Christ was adorned after his resurrection. The rood announces to the dreamer that he must tell others of his triumph â€Å"so that far and wide men worship me everywhere on earth, and all creation pray to this sign. This metaphor shows the correlation between the rood and Christ, and the reason for which Christ endured all the suffering, so that all those who worship him shall have everlasting life. The rood states: â€Å"On me the son of God suffered a time; therefore I now tower in glory under heaven, and I may heal any of those in awe of me. † The rood explains that he is adorned above all other trees, just as Christ was after his resurrection. He continues to tell the dreamer that he must let all know about Christ and use the rood as a tool to explain his second coming and mankind’s salvation. Although no biblical stories tell of Christ coming to one in a dream, this was to represent God’s plan in sending his Son to tell of God’s plan and their salvation through his crucifixion and resurrection. This idea is clearly displayed when the rood professes â€Å"And on this earth each soul that longs to exist with its savior forevermore must seek His kingdom through that cross. As the dialogue of the poem switches back to the dreamer, he states that he was renewed with hope and joy as he â€Å"prayed to that tree. † Again another depiction of a parallel between Christ and the rood, instead of being described as a rood or crucifix, it’s described as a tree, something unlikely for one to worship. Perhaps the tree is to symbolize Christ, as the tree of life who should be worshiped and adorned with â€Å"gold and gemstones† just as the tree gleamed at the opening of the poem.

Taking a Look at Interpersonal Communication - 1139 Words

I do not need to copy many definitions from books, use plagiarism, or check thousands of websites to w honestly write about the concepts taught in this course. Concepts that have modified many of my ways of thinking that were previously erroneous. The contents of this class have helped me learn more about the verbal, and non-verbal communication among different cultures, ethnic groups and societies. We all practice communication some how, but I feel privileged of learning more details about the concepts of interpersonal communications after finishing the course. Each chapter of the book offers a very interesting, and educational instruction about social problems in relation to communication. I enjoyed reading about the roots of the different types of human behaviors. I consider the study of interpersonal communication as a very intellectual discipline that is essential in our daily lives. I each unit, different concepts were described, but the five of them that captured most of my attention are the following: Internal Tensions The book describes internal tensions as â€Å"relationship stresses that grow out of peoples needs, and peoples interactions.†(Wood 332) For me, it was very important to learn about the influence of the internal tensions that affect the health of friendships, psycological health, and physical health. All human beings have experienced internal tensions that somehow affected relationships with other people. In our lives, we have experiencedShow MoreRelatedTaking a Look at Interpersonal Communication716 Words   |  3 Pagesunderstood,† said Ralph Nichols and this thought is agreeable as the interpersonal skills are the skills people use throughout their life to interact with individuals or group of people in the society. 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