Medical Microbiology powerpoint

A Few Concepts Normal flora: mostly non-pathogenic / dont cause disease. But if immune system is compromised, or if diffuses to tissue/other areas they are not supposed to be, can become pathogenic o Ex: Candida causes thrush (due to immune system being compromised) / or can be found in the gut (abnormal area) and must be treated with probiotics Contamination: used for diagnostic purposes. Can mislead diagnostic tests o Ex: epithelial skin cells present in a urinalysis can mislead diagnosis and mimic infection (but are really just due to not obtaining a clean catch urine specimen) Colonization: bacteria has reached a certain number that it can start colonizing and developing Infection: tissue/organ is infected with a pathogen. Starts the innate immunity response

Viruses Examples of viruses: Influenza, Chickenpox (varicella), Rhinovirus, HIV/AIDS, Herpes Simplex virus 1 (typically oral) & 2 (usually genital) HSV 2 has a dormant phase the 2 strands can intertwine between oral & genital Viruses cannot be seen by a microscope o Ex: RBC diameter = 3000 nm / a virus = 50 300nm Viruses are so small because they have to be able to diffuse into our tissues to reach target receptors & use host cell to propagate o Ex: Rabies brain : has high affinity for neurons. Small enough to pass the bloodbrain barrier Virulence = what makes something pathogenic Herd immunity = If most people in a population are vaccinated, the chance of becoming infected is close to zero Side note: The brain and eye are special privilege organs = something has to have special characteristics to be able to reach it

Bacteria Remember to always wear gloves, masks, protective wear & wash hands to prevent spread of bacteria

Fungi Do not need a host cell to propagate

Normal Flora In sterile environments, if anything other than normal flora is present, it is considered pathogenic Skin is covered by normal flora o Part of the innate immunity mucosal & skin membrane are one of the 1st parts of immunity Know the normal flora in each tract!

Importance of the Normal Flora The oral bacterial flora exert microbial antagonism against nonindigenous species by production of inhibitory fatty acids, peroxides, bacteriocins, etc. o These productions are secreted from the normal flora if transient bacteria that is not part of the normal flora is present, it can be destroyed by these secretions In the mouth, some of the normal flora can cause infection in teeth & gum if hygiene is not well kept aka normal flora can become pathogenic

Normal Flora of the Skin The most important sites are the: axilla, groin, & areas between the toes o Contains the highest concentration of normal flora of the skin o Due to the high concentration, if disease/infection is starting these are areas that will be first affected

Normal Flora of the Conjunctiva The eye is another of the privileged sites There is a strong relationship between the retina, optic nerve & brain o Disease of back of eye = disease of brain & nervous system o Ex: macular degeneration One normal flora of one area can be pathogenic if diffuses to another organ o Ex: Haemophilus influenza normal if present in eye, but pathogenic (causes otitis media middle ear infection) if present in ears of infants

Normal Flora of the GI Tract Both bottle feeding & breast feeding help to establish some of the normal flora in the GIT for infants (b/c at birth the entire tract is sterile, until bacteria enter with first feeding) Different parts of the GIT have different pH values makes normal flora different than the rest of the body Antibiotics destroy normal flora susceptible to Crohns disease Candida albicans (yeast) is the most common infection of GIT/mouth in an immunocompromised person

In humans the GIT flora are influenced by: o 1. Age o 2. Diet o 3. Cultural conditions o 4. The use of antibiotics o 5. (added- not in powerpoint) Probiotic consumption o 6. (added- not in powerpoint) Environment where you live Opportunistic means not part of the normal flora pathogenic if not in native organ Mutualistic means they get nutrition from the host, but still provide advantages. Both parties win.

The Immune System powerpoint

Vaccines = sample of bacteria that will elicit responses / expand T & B cells. Then effector cells will come back and fight the pathogen B cells make antibodies & carry antibodies as receptors The human immune system recognizes self from non-self. Antibodies get alarmed when encounter non-self & become activated. Then receptors travel to closest lymph node & enlarge it. RBCs and platelets do not have a nucleus You see an increase in eosinophils with allergic reactions & parasite infections Web of the immune system: (specific parts explained in detail) o 1. Pluripotent stem cell comes from the bone marrow; can go to thymus to make T cells, NK cells & B cells o 2. Plasma cell when B cells are encountered with dendritic cells, they become plasma cells that can secrete antibodies o 3. Myeloid stem cells make RBCs and megakaryotes (which make platelets), monocytes which become macrophages (engulf antigen or present the antigen), and granulocytes aka neutrophils and eosinophils Monocyte = in the blood / Macrophage = in the tissue

Immunity and the Immune Response System Cell Mediated Response Antigen o Mostly viruses that require cell mediated response AND antibody mediated response Antibody Mediated Response Antigen o Sensitized B cells - are sensitized, meaning they encounter the antigen presenting cell to alarm them of the invader o Memory B cells in case you see non-self pathogen again, your body will remember it Make sure future process goes faster Similar concept as receiving a vaccine

Booster shot = durable antibody response with lots of memory cells

Classes of Antibodies (Immunoglobulins) IgA1 & IgA2 = secretory antibodies found in saliva, genital secretions; helps to prevent STDs; contributes to mucosal immunity; most produced immunoglobulin IgD = only on surface of Bcells IgE = allergy & parasite (remember E for eosinophil, which increase in allergic reactions/parasites) o Releases histamine from mast cells o Undetectable in many people o So low that it has its own unit of measurement IgG & IgM = main antibodies IgG = major Ig in serum, can cross the placenta IgM = first line response to infection; if positive, can tell a person recently had an infection

Immunology powerpoint
Primary defenses physical and chemical barriers; part of the innate defense system o Skin primary protection o Mucous secretion o Tears secrete enzymes to wash away particles o Acid pH o Surface cleansing mechanisms (swallowing, blinking) Immune Defenses o Three critical processes in the immune defense Recognition Amplification Control o When danger comes, the immune system reaction increases o The immune response to viral infection consists of: Innate (nonspecific) defense first line of defense, consists of macrophages, neutrophils, natural killer cells, dictates the adaptive response Adaptive (specific) defense antibody response and the lymphocyte, consists of memory cells (B and T cells), AKA the humoral cell-mediated response Antigen innate immune response antigen recognized adaptive immune response evaluate antigen structure and fine-tune recognition clonal expansion of lymphocytes (not all clones will expand, only the clones that recognize the antigen will expand) and creation of memory cells

Antigen innate immune response antigen not recognized no adaptive immune response o The Innate immune response: Can be activated rapidly and functions within hours of a viral infection Continued activity is damaging to the host Considerable interplay occurs between the adaptive and innate immune defenses Components include: Cytokines Complement Collectins Natural killer (NK) cells they dont recognize any specific antigen o The adaptive immune response: Differentiates self from non-self Has memory Consists of: Antibody response humoral response o Consists of lymphocytes of the B-cell lineage o Interaction of a specific receptor on precursor B lymphocytes with antigens promotes differentiation into antibody secreting cells (plasma cells) Lymphocyte mediated response cell-mediated response (CMR) o Consists of lymphocytes of the T-cell lineage o Cytotoxic T cells (CD8, Tc cells, kill infected cell) and Thelper (CD4, Th cells, release cytokines) are the key effectors of this response o Recognize antigens on the surface of self-cells o Antigens on self-cells can be recognized only by a receptor on the surface of T cells when they are bound to the MHC family of membrane proteins o Th cells recognize antigens bound to MHC class II molecules and produce powerful cytokinds that affect B and T cells by promoting or inhibiting cell division and gene expression o Once activated by the Th cells, Tc cells differentiate into CTLs that can kill virus infected cells o T cells will reject something that is non-self T Cells can see inside the cell and can tell if the cell is infected Antibodies cannot see inside the cell, they can only work extracellularly o The inflammatory response: Essential in initiating immune defenses Cell and tissue damage caused by infection induces the inflammatory response

Provides communication with the components of the immune system Characterized by redness, heat, swelling and pain It is initiated by Toll-like receptors, which are present on the surface of dendritic cells. Bacteria will have toll like molecules that will bind to tolllike receptors and then release cytokines that are responsible for redness and swelling

Cytokines how cells talk to each other o Regulatory proteins that mediate intercellular communication during antiviral defense o Recruit other cells to come to the affected area o Their presence is one of the first indicators that the host has been infected o Act locally, near the cells that make them o Control inflammation, induce and antiviral state in cells and regulate the adaptive immune response o Exert their activities by binding to specific receptors and activating gene expression o 3 types of interferons are the most important cytokines in the innate response Antigen receptors on the surface of B and T cells o B cells have about 100,000+ identical antibodies which has a specificity for one antigen epitope o T cells CD4 will always bind to MHC class II and function as T helper cells o T cells CD8 will always bind to MHC class I and function as T cytotoxic cells o All cells have MHC class I, but only antigen presenting cells have MHC class II Endogenous antigen processing: MHC class I peptide presentation o CD8 T cells o Cell-mediated o Two types of antigen presentation intracellular and extracellular antigens Intracellular viruses, some bacteria Extracellular bacteria Virus starts in the protein, moves to the proteasome, goes through MHC class I and is presented to the T cell. The T cell can see inside the cell and will destroy the virus. If the cell is not infected with the virus, MHC class I do not have anything bad on them, so the T cells will not attack them Exogenous antigen processing: MHC class II peptide presentation o CD4 T cells o Complex is transported through the Golgi, where the invariant chain is removed, activating MHC class II complex

Immunoglobulin consists of 4 polypeptide chains o 2 light chains Has a variable portion Has a constant portion o 2 heavy chains Identical o We have antibodies against any antigen, even if the virus doesnt exist. Our immune system will recognize it as non-self o Constant region binds to complement Hypersensitivity Reactions allergies o Type I bee sting, medications, environmental, immediate reactions (within minutes), IgE-antigen triggers mast cell mediators. Every year allergies get worse because it is like a booster and you are re-exposed to the antigen. Secretion of histamine. Skin prick test: particle is placed on the skin and then skin is scraped with a lancet. If the area swells or becomes red, they are allergic. You cannot do a skin test on babies, people with skin conditions, or HIV. Blood test: draw a sample of blood and test for allergies o Type II IgG or IgM binds to cell surface, ADCC or complement, occurs within a few hours. VERY RARE. Antibody mediated. o Type III IgG, immune complexes, inflammation, occurs within a few hours. Results in nephrology issues. o Type IV cytokines (T cells, macrophages, CTL) are triggered, occurs within 1-3 days. o Anaphylactic shock extreme allergic reaction, need an Epi pen to release enzyme such as epinephrine Page 363 figure in textbook Type I allergy Eosinophil number increases Name one of the diseases related to the hypersensitivity (ON EXAM!!) o Type I Uriticaria, systemic anaphylaxis o Type II Hemolytic anemia o Type III Serum sickness, glomerulonephritis o Type IV Contact Dermatitis

Basic Immunology powerpoint

Definitions o Immune System cells, tissues, and molecules that mediate resistance to infections o Immunology study of structure and function of the immune system o Immunity resistance of a host to pathogens and their toxic effects Role of the immune system

Defense against microbes Defense against the growth of tumor cells Homeostasis Immune system organs o Tonsils and adneoids o Thymus in an adult, it is almost gone (gets smaller as you age) o Lymph nodes o Spleen o Payers patches o Appendix o Lymphatic vessels o Bone marrow Immune system molecules: o Antibodies o Complement o Cytokines o Interleukines o Interferons Two types of immunity o Innate Immnunity No memory Universal First line of defense Does not have any expansion Mechanical barriers include skin, acidic pH in stomach, cilia Humoral mechanisms include lysozymes o Adaptive Immunity Second line of response Responds more slowly (after a few days) Expands into memory and effector cells Most events occur in either lymph nodes, spleen or peyers patches Two types Active o Natural clinical, sub-clinical infection o Artificial vaccination Passive o Natural via breast milk, placenta (these antibodies are passed to baby and usually are good for up to 1 year until baby develops their own antibodies) o Artificial immune serum, immune cells

T lymphocytes 2 types o Helper T lymphocytes (CD4) Activate phagocytes o Cytotoxic T lymphocytes (CD8) Destroy bacteria Cell mediated immune response o Primary response Develops in several days Does not limit the infection Production of specific clones of effector T cells and memory clones o Secondary response More pronounced, faster More effective at limiting the infection Humoral Immune response o B lymphocytes recognize specific antigens o Antibodies bind to specific antigens IgG o o o o 70-75% of total immunoglobulin CAN CROSS THE PLACENTA! Secreted in high quantities in secondary exposures Major functions include: Neutralize microbes and toxins Activate the complement Protect the newborn Opsonize the antigens for phagocytosis

IgM o o o o

Secreted initially during primary infection CANNOT cross the placenta Pentamer Major functions include: Secreted first during primary exposure Activates the complement Used as a marker of recent infection

IgA o Dimer with secretory component in the lumen of the GI tract and resp. tract o Monomeric in serum

IgE o Mediates type I hypersensitivity

o Monomeric o Major functions: Associated with anaphylactic shock Plays a role in immunity to helminthic parasites Immunodeficiency o Can be acquired or inherited Congenital primary, genetic abnormality Defect in lymphocyte maturation Acquired secondary, results from infections, nutritional deficiencies or treatments AIDS, leukemia o Can affect B cells, T cells, complement o Immuno-compromised host has an impaired function of immune system and is at a high risk of infection