More Factor V Replacement Therapy example essay topic

... As more blood leaks into the joint it feels warmer than the opposite one and the swelling feels 'spongy'. Later the person holds the limb in a bent or 'flexed' position to ease pain. Flexion increases the space in the joint, making more room for further bleeding to occur. If untreated, the bleeding continues until the area feels hot and rock hard. Usually there is no bruising associated with a joint bleed, and since the bleeding occurs in an enclosed space (the joint capsule) and has nowhere to spread, the pressure caused by the bleeding eventually results in pain -- which can be quite severe.

Early treatment with clotting factor usually prevents the pain from becoming severe, and since only a small amount of blood will have leaked into the joint space, recovery will be quick, although the joint will sustain some permanent damage. In addition to pain considerations, inadequately treated bleeding irritates the joint surface which eventually leads to arthritis. A large volume of blood, which results from delayed treatment, takes longer to re-absorb into the body. The longer the period of irritation, the greater the chance of arthritic damage. Early treatment of each bleeding episode will limit the amount of irritation and reduce the risk of arthritis. Strong muscles protect joints from some bleeding episodes.

Therefore it is suggested that people with hemophilia exercise regularly. Bleeding in the mouth can be troublesome and messy, but is usually minor as long as there is no swelling of, or bruise, under the tongue. Blood mixed with saliva may make the bleeding look much worse than it actually is. Don't panic.

Older persons with hemophilia will know when they are bleeding, long before there is any externally noticeable symptom. While it does depend on the individual, one can expect a grown person with hemophilia to manage their own condition and treatment effectively in most cases. Prevention of injury is important for the patient with hemophilia. When bleeding occurs, replacement therapy may be necessary. Current products used to treat hemophilia are either manufactured from fresh frozen plasma, which are from single blood donors and require special freezing, or are 'freeze dried' factor V and factor IX concentrates. These concentrates are made in large lots, come in small bottles and may be kept at room temperature or in the regular refrigerator.

Some of the concentrates are made from large pools of donated plasma, and the newest and most expensive are made using recombinant gene technology. The recombinant factor is not made from human blood, however, it is manufactured using some human blood components, and other animal biological components. There is still risk involved in treatment with any of these products. However, not treating can be very painful, and lead to other serious problems.

All blood donors in the U.S. are tested for blood borne viruses and all blood products are tested for hepatitis and the virus that causes AIDS. In addition, concentrates are treated and purified in several ways to reduce the risk of hepatitis and virtually eliminate the risk of AIDS transmission. Monoclonal products are more pure than heated concentrates, and recombinant factor is considered the most pure. All factor replacement products are done intravenously. When clotting factor is administered the body begins to use it right away to form a clot. After 6-8 hours the body has 'used up' about half of what was administered.

Usually by this time most bleeding is well controlled. After about 24 hours the body has essentially used up all the clotting factor, at which time the clot is well established and the body begins to get rid of the blood which has leaked into the surrounding tissues, so that eventually the swelling subsides. There are two important points to keep in mind: A fresh bleeding episode can start if the clot becomes dislodged and natural reactions in the body cause a clot that is no longer needed to 'break down' or to be dissolved. The processes begin approximately five days after the initial clot was formed and occasionally a bleed may restart at the site. Although proficient, sometimes one infusion is not enough and one must be prescribe a follow up treatment.

The most significant advances in hemophilia treatment have been made in the last four decades. Baxter Healthcare Corporation introduced the first commercially available plasma-derived factor concentrate in the mid-1960's. This was a major advancement over earlier formulations, which contained much lower concentrations of anti hemophilic factor. In the early 1970's, home treatment of hemophilia became widely available, offering people with hemophilia greater independence and reduced hospital stays.

Today, recombinant DNA technology and the discovery of the genes that control production of factor V have led to the development of recombinant factor concentrates that do not rely on plasma at all. Patients should discuss with their physicians which factor V replacement therapy is best for them. Inhibitors are proteins called antibodies that are made by our immune system to defend us from harmful disease. When our immune system identifies a foreign substance, it makes antibodies that will specifically recognize that substance and destroy it. In some individuals with severe hemophilia, the factor V replacement therapy is identified as a foreign substance by their immune system. If this happens, their immune system will make antibodies against factor V. These antibodies will inhibit the ability of the factor to work in the clotting process.

The higher the antibody or inhibitor level, the more factor V replacement therapy it takes to overcome the inhibition and produce clotting. This can complicate the treatment of a bleed. The good news is that there are different types of therapies available to successfully treat most individuals who develop inhibitors. Work Cited Louis Levine, B.S., M.S. Ed., A.M., Ph. D. Professor, Department of Biology, City College of New York. 'Hemophilia,' Microsoft (R) Encarta (R) Online Encyclopedia 2000 web (c) 1997-2000 Microsoft Corporation. All rights reserved.