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Huntington's Disease

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Cellular Pathophysiology
Huntington’s disease causes many changes in the immune system and the inflammatory response. According to Ellrich, Reick, Saft and Linker (2013), “increased inflammation in HD might be the response to neuronal death induced by mhtt toxicity” (para. 10). The immune system initiates the inflammatory response that is seen in Huntington’s disease. The exact impact of the innate and adaptive immune system is unknown in Huntington’s disease (Ellrichmann, Reick, Saft and Linker, 2013). It has been proven that the immune system, inflammatory response and stress provide more harm to the body than good. Eventually those diagnosed with Huntington’s disease end up succumbing to an illness that is contracted from a failing immune system (Mayo Clinic, 2014). Huntington’s disease is an autosomal dominant inherited disease that causes cell loss (Revilla, 2014). According to Raymond et al. (2011), cell loss occurs in the striatum, cortex, globus pallidus, thalamus, hypothalamus, subthalamic nucleus, substantia nigra, and the cerebellum. The exact mechanism of cellular death is still unknown in Huntington’s disease. According to Revilla (2014), “Several mechanisms of neuronal cell death have been proposed for HD, including excitotoxicity, oxidative stress, impaired energy metabolism, and apoptosis”.

Systemic Dysfunction Huntington’s disease not only affects the brain but the entire human body. According to Zielonka et al. (2014), “patients experience a wide array of peripheral organ dysfunction including severe metabolic phenotype, weight loss, HD-related cardiomyopathy and skeletal muscle wasting”. The loss of brain cells leads to problems in the musculoskeletal system, digestive system and the respiratory system. Problems in the musculoskeletal system lead to problems with movements that include involuntary movements, falls and eventually immobility (St. John, 2010). The disease ends up leaving the patient non-ambulatory and can lead to problems with skin integrity. The loss of brain cells causes issues with chewing and swallowing in patients which leads to the inability to swallow, weight loss and poor nutritional status (St. John, 2010). The respiratory system also becomes compromised with cell death. Due to difficulty swallowing and chewing, choking becomes more frequent which causes pneumonia (St. John, 2010). According to St. John (2010), “the Huntington's Outreach Project for Education at Stanford University reports that pneumonia is the leading cause of death among people with Huntington's disease”. Huntington’s disease is an inherited disease that is more prevalent in those with European ancestry. It is characterized by involuntary movements, decline in cognition, inability to control muscle movement and decline in physical and mental condition. Huntington’s disease causes loss of cells in the brain which leads to problems with many other systems in the body. These problems lead to the decline in physical condition and eventual death for those diagnosed. There currently is no treatment for Huntington’s disease but focus is on providing a better quality of life for those diagnosed. References
Ellrichmann, G., Reick, C., Saft, C., & Linker, R. A. (2013). The Role of the Immune System in Huntington’s Disease. Clinical and Developmental Immunology, 2013. http://dx.doi.org/10.1155/2013/541259.
Ellrichmann, G., Reick, C., Saft, C., & Linker, R. A. (2013). The Role of the Immune System in Huntington’s Disease. Clinical and Developmental Immunology, 2013. http://dx.doi.org/10.1155/2013/541259
Huether, S. E., & McCance, K. L. (2012). Understanding pathophysiology (5th Ed.). St. Louis, MO: Mosby.
Mayo Foundation for Medical Education and and Research. (2014). Huntington's disease. Retrieved from http://www.mayoclinic.org/diseases-conditions/huntingtons-disease/basics/definition/con-20030685
Pringsheim, T., Wiltshire, K., Day, L., Dykeman, J., Steeves, T., & Jette, N. (2012). The incidence and prevalence of Huntington's disease: a systematic review and meta-analysis. Movement Disorders: Official Journal Of The Movement Disorder Society, 27(9), 1083-1091. doi:10.1002/mds.25075
Raymond, L. A., André, V. M., Cepeda, C., Gladding, C. M., Milnerwood, A. J., & Levine, M. S. (2011). Pathophysiology of Huntington’s Disease: Time-Dependent Alterations in Synaptic and Receptor Function. Neuroscience, 198, 252–273. doi:10.1016/j.neuroscience.2011.08.052
Revilla, F. (2014). Huntington Disease. Retrieved from http://emedicine.medscape.com/article/1150165-overview#showall
Schoenstadt, A. (2013). Huntington's Disease Statistics. Retrieved from http://nervous-system.emedtv.com/huntington's-disease/huntington's-disease-statistics.html
St. John, T. M. (2010). What are the organ systems affected by Huntington's disease? Retrieved from http://www.livestrong.com/article/188900-what-are-the-organ-systems-affected-by-huntingtons-disease/
Zielonka, D., Piotrowska, I., Marcinkowski, J. T., Mielcarek, M., Robia, S. L., & Voss, A. A. (2014). Skeletal muscle pathology in Huntington's disease. Frontiers In Psychology, 51-5. doi:10.3389/fphys.2014.00380

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