Invasive Aspergillosis: How Immunosuppression May Lead to Contraction

1. Explain why you think the patient presented the symptoms described.

The patient developed fever, cough, chest pain, and hemoptysis because invasive aspergillosis typically begins in the lungs before spreading to other organs via the bloodstream. Once Aspergillus has infiltrated the lungs (airborne pathogenic mold), the epithelial cells within the respiratory system are triggered, and inflammatory mediators such as cytokines are released. Cytokines then recruit polymorphonuclear leukocytes, and its infiltration causes fever (Cadena, Thompson, & Patterson, 2016). Therefore fever (chief complaint) demonstrates the actions of the inflammatory response, which is the second line of defense after innate immunity (McCance & Huether, 2019).

2. Identify the genes that may be associated with the development of the disease.

The following six genes are associated with the development of invasive aspergillosis: 1) NF?B1, 2) NF?B2, 3) RelA, 4) RelB, 5) REL, and 6) IRF4 (Lupianez et al., 2016). Nuclear factor kappa-light-chain enhance of activated B cells (NF?B) is a protein complex that regulates the immune response to infections. It is held in the cytoplasm but moves to the nucleus once pathogens infiltrate a cell, tissue, or an organ. NF?B is made up of NF?B1 and NF?B2, which bound to either RelA, RelB, or REL. The IRF4 gene belongs to the interferon regulatory factor (IRF) family. It activates interferons in response to infections caused by viruses (Lupianez et al., 2016).

3. Explain the process of immunosuppression and the effect it has on body systems.

Immunosuppression refers to the decreased capacity or efficacy of the immune system (McCance & Huether, 2019). It is caused by auto-immune diseases such as rheumatoid arthritis, Crohn’s disease, or systematic lupus erythematosus. Additionally, it can be induced by medications, radiation therapy, or surgery (splenectomy). Overall, immunosuppression increases the severity of infections and neoplastic diseases because the immune system is not functioning optimally.

References

Cadena, J., Thompson, G. R., & Patterson, T. F. (2016). Invasive Aspergillosis. Infectious Disease Clinics of North America, 30(1), 125-142. DOI:10.1016/j.idc.2015.10.015

Lupiañez, C. B., Villaescusa, M. T., Carvalho, A., Springer, J., Lackner, M., Sánchez-Maldonado, J. M., … Sainz, J. (2016). Common Genetic Polymorphisms within NF?B-Related Genes and the Risk of Developing Invasive Aspergillosis. Frontiers in Microbiology, 7. DOI:10.3389/fmicb.2016.01243

McCance, K. L., & Huether, S. E. (2019). Pathophysiology: The Biologic Basis for Disease in Adults and Children (8th ed.). St. Louis, MO: Elsevier Health Sciences.