<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 55-year-old female presents with pain in both hands and wrists for the past several years. It is associated with morning stiffness that lasts for almost an hour. Physical examination reveals tenderness and swelling in both hands and wrists, most severe over the proximal interphalangeal joints. Laboratory investigation reveals the presence of anti-cyclic citrullinated peptide anti-CCP. Which of the following immune-mediated injuries is responsible for this patients condition?? A: Self-tolerance, B: Both type II and III hypersensitivities, C: IgE-mediated immune responses only, D: Type IV hypersensitivity, E: Type III hypersensitivity,  <response>: This is a clinical vignette describing a patient with joint pain, morning stiffness, and laboratory evidence of anti-CCP antibodies. The key findings are pain and swelling of the hands and wrists, especially the PIP joints, morning stiffness, and positive anti-CCP. This presentation is classic for rheumatoid arthritis, which is an autoimmune condition caused by immune-mediated inflammation and injury to the joints. Anti-CCP is highly specific for rheumatoid arthritis. The inflammation and joint damage in rheumatoid arthritis is mediated by type III hypersensitivity reactions. E: Type III hypersensitivity 