Once a Pathological Process Has Started One Damn Thing Leads to Another (Spector, W.G

‘Once a pathological process has started ‘one damn thing leads to another’ ” (Spector, W.G. 1989). Discuss this statement with reference to named examples

Pathological processes are the organic processes that occur in consequence to disease. Although disease itself normally has one principle agent, there is ever increasing evidence that is becoming apparent that there are several factors evolved with the initiation of the disease process, and the causes of it. This therefore creates the believed concept that ‘one damn thing leads to another’ when one falls ill. There are many diseases that are associated with other disease or illnesses or in fact the causes and symptoms themselves that can also be related to something else. This could lead to the understanding of one thing leading to another as there is evidence both for and against this statement in relation to many pathological processes within the body. (Dubinina,, E.E. and Pustygina, A.V., 2007)

Ageing is one of the body’s own pathological processes. It is commonly known for its troubles and is often referred to as a ‘downward spiral’ due to the negative influences it has on the body. There are many diseases that are much more prevalent in the elderly and are commonly linked to other things. However the molecular mechanisms linking age to related diseases are not understood in general. The genes shown to influence ageing within lower organisms may afford an avenue to arrive at a molecular understanding how ageing poses a risk to these diseases.

(Donmez, G. and Guarente, L., 2010). However Immunoscenescence is the deterioration of the immune function seen in the elderly. It’s when the body naturally gets rid of the thymus organ leading to the reduction in number of T cells, increases the susceptibility to infection, autoimmune disease and cancer as they are less able to fight off new pathogens, causing the likelihood of these infections and diseases. (McLeod, J.D.,2001) However there are many more causes and links to why one becomes more prone to a certain disease or illness then others.

Age related diseases include; arthritis, osteoporosis, inflammation, cancer, cardiovascular disease and Alzheimer’s and many more, that can be associated with increased age themselves. Chronic inflammation is associated with a broad spectrum of neurodegenerative diseases of aging, (McGeer, P.L. and McGeer, E.G.,

2004) such as Alzheimer’s disease. This is the best known cause for dementia accounting for two-thirds of cases within the elderly. Symptoms include disorientation, confusion, reduced judgment and mood changes. Alzheimer’s is linked to aging however the symptoms are caused by the death of cells within the brain, causing breakages in the connections between them causing the common symptoms associated with Alzheimer’s. Although Alzheimer’s itself is caused by many factors related to ageing it however is not known to cause other detrimental diseases alone. The result in Alzheimer’s would eventually lead to death due to the devastating effects it has on the body, resulting in an increased chance of fatality.

However although Alzheimer’s is a disease caused by cell death in the brain and is not known to lead to other diseases, strokes that also cause cell death in the brain; are in contrast known to cause higher risk of other diseases and problems within the body; Some of which are Dysphagia and impaired vision. Although strokes do have ongoing effects that can lead to different problems in the body most of these can be treated or maintained in order to minimize the effect it can have on the body however

Alzheimer’s is not known to cause other effects but cannot be treated and increasingly progresses within the body leading to death.( Hughes, J.C., 2011)

Cancer is also a disease that is normally linked to ageing and therefore other burdens that occur from this. It is linked to ageing due to the body’s increased exposure to the environment over time; resulting in increased formations of free radicals.( Dubinina,, E.E. and Pustygina, A.V., 2007) It is only due to this there is a relationship between the two as there may be an increased chance of cell mutation.

However although cancer is normally associated with age there is a cancer that is predominantly found in the young, which is leukemia. (Tanday, 2013) Advanced

Cancer however can also metastasize itself, causing a greater spread of cancer within the body. Things such as bone metastasizes are common in people suffering from malignant cancers and can be detrimental on the body. This can back up the theory that one thing leads to another as cancer as a disease is known to metastasize effecting more than one part of the body, which can eventually end in death. Although there are also cases from which the cancer can be benign and has been treated and nothing more has come about it, with no consequence effects on the body. (Drudge-Coates, L. and Turner,, B., 2013) This shows there is a relationship between cancers and ageing however there are still exceptions. There is also proof that cancer as a disease can lead to other cancers, which can relate to the theory stated above. There is however still evidence that there are still cases that don’t, although the treatment alone for these specific cancers can be a cause for other damaging effects and diseases within the body.

Osteoporosis is also a known age related disease; it is commonly linked to the elderly as they are more at risk due to the thinning of bones naturally as we age.

Osteoporosis is the thinning of the bones, resulting in them becoming brittle, weak as well as being more susceptible to fractures. (Bartl, R. and Frisch, B., 2009) Age is the main risk factor associated with osteoporosis however there is evidence that other bone diseases could be linked to osteoporosis in the future. People that have rheumatoid arthritis (RA) are often known to have increased risk of osteoporosis, due to the many reasons. One of which is to do with the medication taken for RA also known as Glucocorticoid is known to trigger significant bone loss. Also the pain and discomfort felt with someone suffering from RA can also result in a decrease in activity of the joint, further increasing the risk of osteoporosis (Suzuki, Y. and

Mizushima, Y., 1997). There are also studies relating to Multiple Sclerosis (MS) with increased risk of Osteoporosis within females. Nieves, J., et al, (1994) studies suggest that females suffering from MS have increased risk of Osteoporosis due to their gender, corticosteroid use and immobility. There is also a general believe that anyone suffering from MS have an increased risk of Osteoporosis due to the many reasons associated with low bone mineral density.(Dobson, R. et al, 2012)As well as autoimmune disorders other diseases such as the celiac disease can also be a cause of osteoporosis, or can increase the risk of getting the disease. This is due to the diet and the links between people suffering from celiac disease not being able to absorb the nutrients from there food, including vitamin D and calcium ( Bianchi,, M.L. and Bardella, M.T.,2008). As mentioned before some cancers such as leukaemia and lymphomas can also be at higher risk due to medicine and chemotherapy used to treat these cancers resulting in bone loss and therefore Osteoporosis. (Hogler, W. and Shaw, N., 2009) Therefore although Osteoporosis is linked to age, there are other factors that could influence the cause of Osteoporosis and the risk associated with it.

Cardiovascular disease is a class of disease associated with the heart, blood vessels or both. It is commonly linked to a number of physiological changes that occur when we age that alter cardiovascular function. (Souza, C.D. and Luis, J., 2013) Although cardiovascular disease is common in the elderly it is noticeable caused during earlier life consequences, for example arthrosclerosis is one of the main cardiovascular disease however the antecedents of this disease start from childhood, due to many effects, making primary prevention necessary from childhood. (Celermajer, D.S. and

Ayer, J.G., 2005) There are many diseases that can be associated with cardiovascular disease, anything to do with the heart or blood vessels fall into this category, however considering the detrimental effects these can have on the body, there are also many consequences that can be caused from the effect of cardiovascular disease. Direct effects include things such as myocardial infarction, unstable angina and angina pectoris all of which can be life threating. Indirect effects include things such as heart failure and cardiac arrest which most commonly result in death. (Aggarwal, S. et al, 2009) So although there are many causes that can lead to cardiovascular disease there is also many other diseases or problems that can be linked to the disease as part of its large effect it has on the body alone, all corresponding to the ageing process.

Chronic inflammation is the distortion of a normal body response that is associated with the diseases of aging. (Cavanagh, M.M. et al, 2012) Many researchers have linked the effects of chronic inflammation accumulation over time to the number of disorders associated with age, such as arthritis, Alzheimer’s, cancer and heart disease. Chronic inflammation is when there is a failure in acute inflammation to stop frequently, resulting in chronic inflammation; harming the whole body by injuring cells. (Weiss, U., 2008) In comparison acute inflammation is the body’s attempt at self-protecting itself after being wounded; starting rapidly, but only lasts for a few days. Chronic inflammation is long-term lasting anything from months to years and can result from many things. It can be caused by the body’s failure to eliminate the original source for the cause of acute inflammation, the response in the body’s autoimmune response to a self-antigen, or a chronic irritant of low intensity that persists. (Mulvihill, N.T. and Foley, J.B. , 2002) Diseases that cause chronic inflammations include things such as tuberculosis, rheumatoid arthritis, asthma and active hepatitis. However chronic inflammation itself can also eventually cause several diseases including rheumatoid arthritis, some cancers, Alzheimer’s and many others due to the destruction of tissues, death of cells and tissues. There is therefore evidence that chronic inflammation is caused by other factors and causes other diseases itself and therefore is one of the many vicious circles involved within the body’s pathological processes. (Grivennikov, S.I et al, 2010)

Most of the evidence researched proved that age can itself be the cause of most age related diseases, some of which is down to the aging of cells itself in diseases such as dementia, when most is down to the impact the body has encountered over a period of time, and the environmental factors that coincide with this. There is also a substantial number of links between many of these age related diseases and conditions caused within the body by ageing. Concluding the statement ‘one damn thing leads to another’ to be relatively correct relating to most pathological processes and ageing. However there is also evidence that shows there is a substantial link between most of these diseases as a whole, increasing the risk for one if you have another, which in itself is not linked directly with the process of ageing. This concludes there are much more links between pathological processes and other diseases within the body, making it a very complex system. This could be due to the fact that each disease has its own cause and affects but conclusively is down to the body from which they attack to determine how detrimental and effective the disease can become, as the nature of the response is modified by the nature of the agent as well as the host itself. Therefore even though one thing generally leads to another the susceptibility of the individual is an ever present variable (Mottet, K.N. and

Quaife, C.,2006).

References:

 Aggarwal, S., Kumar, S., Rafikov, R., Fonseca, F., Smith, A., Fineman, J.R. and Black, S.M. (2009) Cardiovascular diseases. Free Radical Biology and Medicine [online]. 47 (1), pp. 53- 71. [Accessed 20 November 2013].

 Bartl, R. and Frisch, B. (2009) Osteoporosis. 2nd ed. Germany: Springer Verlag.

 Bianchi,, M.L. and Bardella, M.T. (2008) Bone in celiac disease. Osteoporosis International [online]. 19 (12), pp. 1705-1716. [Accessed 19 November 2013].

 Cavanagh, M.M., Weyand, C.M. and Goronzy, J.J. (2012) Chronic inflammation and aging: dna damage tips the balance. Current Opinion in Immunology [online]. 24 (4), pp. 488-493. [Accessed 20 Novemeber 2013].

 Celermajer, D.S. and Ayer, J.G. (2005) Childhood risk factors for adult cardiovascular disease and primary prevention in childhood. Education in Heart [online]. 92 (11), pp. 1701-1706. [Accessed 19 November 2013].

 Dobson, R., Ramagopalan, S. and Giovannoni, G. (2012) Bone health and multiple sclerosis. Multiple Sclerosis. 18 (11), pp. 1522-1528.

 Donmez, G. and Guarente, L. (2010) Aging and disease: connections to sirtuins. Aging Cell [online]. 9 (2), pp. 285-290. [Accessed 20 November 2013].

 Drudge-Coates, L. and Turner,, B. (2013) Cancer-induced bone disease. Nursing Standard. 27 (19), pp. 48-56.

 Dubinina,, E.E. and Pustygina, A.V. (2007) Free radical processes in aging, neurodegenerative diseases and other pathological states. Biochemistry (Moscow) Supplement Series B: Biomedical Chemistry. 1 (4), pp. 284-298.

 Grivennikov, S.I., Greten, F.R. and Karin, M. (2010) Immunity, Inflammation, and Cancer. Cell. 140 (6), pp. 883-899.

 Hogler, W. and Shaw, N. (2009) Bone mineral density in young adult survivors of acute lymphoblastic leukemia. Cancer. 115 (20), p. 4885.McGeer, P.L. and McGeer, E.G. (2004) Inflammation and the degenerative diseases of aging. Protective Strategies For Neurodegenerative Diseases. 1035, pp. 104-116.

 Hughes, J.C. (2011) Alzheimer's and Other Dementias. Oxford: Oxford University Press.

 McLeod, J.D. (2001) Mechanisms of ageing and development. Apoptotic Capability in Ageing T Cells [online]. 121 (1-3), pp. 151-159. [Accessed 21 November 2013].

 Mottet, K.N. and Quaife, C. (2006) McGraw-hill Concise Encyclopedia of Science and Technology [online]. New York, NY, USA: McGraw-hill. [Accessed 20 November 2013].  Mulvihill, N.T. and Foley, J.B. (2002) Inflammation in acute coronary syndromes. Heart [online]. 27 (3), pp. 201-204. [Accessed 22 November 2013].

 Nieves, J., Cosman, F., Herbert, J., Shen, V. and Lindsey, R. (1994) High prevalence of vitamin d deficiency and reduced bone mass in multiple sclerosis. Neurology [online]. 44 (9) [Accessed 20 November 2013].

 Souza, C.D. and Luis, J. (2013) Bk channels in cardiovascular diseases and aging. Aging and Disease [online]. 4 (1), pp. 38-49. [Accessed 19 November 2013].

 Suzuki, Y. and Mizushima, Y. (1997) Osteoporosis in rheumatoid arthritis. Osteoporosis International [online]. 7 (3), pp. 217-222. [Accessed 19 November 2013].

 Tanday, (2013) Genetic cause of common childhood leukaemia revealed. The Lancet Oncology [online]. 14 (11), p. 444. [Accessed 21 November 2013].

 Weiss, U. (2008) Inflammation. Nature [online]. 454 (7203), p. 427. [Accessed 19 November 2013].