Viral pathogenesis
process by which viral infection leads to disease
Primary replication of viral infection
virus replicates after initial host entry, determines if infection will be localized of systemic
Systemic spread of viral infection
virus spread via bloodstream + CNS
Secondary replication of viral infection
@ susceptible organs/tissue after systemic spread
cytolytic vs non-cytolytic productive infection (virus-cell interaction)
cytolytic - hot cell is permissive non-cytolytic - leads to persistent infection
abortive/non-productive infection
virus doesn't complete replication cycle, cells non-permissive
Direct cell damage and death from viral infection may result from
cell energy diversion, shutoff of cell synthesis, competition of viral mRNA for ribosomes or for viral promoters + transcriptional enhancers
Indirect cell damage from viral infection can result from
viral genome integration, intro of mutations in host, inflammation, host immune response
What happens if virus enters cell but not produced/virus within cell as DNA
either cell remains normal or malignant transformation
Viral latency
virus is present in the form of its genome only and there is little (mRNA, not at protein level) or no expression of viral genes, common in DNA viruses
Viral persistence
virus replicates continuously in the body at a very low level (ex HIV)
Latent infection
patient recovers from initial infection but virus persists + infection may recur
Chronic infection
virus detectable for long time
Slow virus infection
prolonged period bw initial infection + appearance of disease (ex prions)
Stages of viral infection
incubation prodromal specific-illness recovery
specific receptors, genetic constitution, age and physio states, and nutritional factors are all
Host factors related to virus infection
attenuated viruse
virus that lost virulence (ability to cause disease)
the signs and symptoms of a viral disease result from:
cell killing (from viral replication), loss of fnx cell damage (from immune response)
cellular immunity plays the major role in _____________ whereas humoral immunity protects against ________
clearing virus infection reinfection
horizontal transmittion
person to person, direct (secretions), indirect (contaminated food), blood
vertical transmission
perinatal, transplacental, @ delivery or during breastfeeding
Role of macrophages in systematic infections
they can either inactivate virus OR virus multiplies inside macrophage (HIV)
Tropism
range of host cells that can be infected by virus
Adherence/attachment
bacteria binds to surface of target cell
Dissemination/invasion
bacteria spreads from origin site to whole organism
Etiologic agent
the microorganism that causes the disease
Inapparent infection
infection in host w/o symptoms/signs, fxn not affected, mobilized immune system
Endogenous vs exogenous infection
endo - infectious agent already in body + was dormant exo - bacteria outside body, found host
Bacterial infection pathogenesis
incubation prodromal acute (replication) convalescence
Bacteria are pathogenic by
adherence to substrate, invasion, toxigenesis and ability to evade immune response
Infectious process of bacteria
Entry
Adherence
Bacterial multiplication
Dissemination
Elimination
Mechanisms of defense of respiratory tract
mucus and cilia (mechanically), IgA, macrophages and phagocytes in deep mucosal layer
Mechanisms of defense of GI tract
gastric acid + intestinal pH
proteolytic enzymes
biliary salts
mucus rich in IgA
Mechanisms of defense of genito-urinary tract
cervical mucus and vaginal pH
Mechanisms of defense of skin/mucosa
lipolysis of sebum (acidic)
Adherence step of infectious process of bacteria
adherence to epithelial cells, uses binding molecules, specific receptors and electric charge on cell surface
Bacteremia vs septicemia
bacteremia= bacteria present in the blood
septicimia= bacteria GROWING in the blood
the virulence factors that condition a bacterial strain virulence are
rate of multiplication and capacity of invasion
pili (somatic virulence factor)
adhesion fimbria
lectins (somatic virulence factor)
proteins that bind carbs
ligands (somatic virulence factor)
molecules that make specific binds w/ substrate
slime (somatic virulence factor)
substance around bacteria, mediates its non-specific attachment
capsule (somatic virulence factor)
role in antiphagocytosis and sometimes adherence
Vi surface antigen are for (somatic virulence factor)
gram - rods
coagulase (soluble virulence factor)
free or bound, in S.aureus
leucocidin (soluble virulence factor)
made by S.aureus after phagocytosed
catalse (soluble virulence factor)
inactivates free O2 radicals
Bacteria can produce 2 kinds of toxins:
proteic/exotoxins and lipopolysaccharidic/endotoxic
cytotoxic exotoxins act on
eukaryotic cell wall
AB toxins
type 3 - interfere w/ internal cell fxn a - active b - binding
what detach easily, have high molecular weight proteins, thermosensitive, antigens, decomposed by proteolytic enzymes?
exotoxins AB
_________ appear following disease or vaccine and can be transformed into _________
antitoxins, anatoxins
Endotoxins are produced by and reside in
gram - bacteria, ext cell wall
Endotoxins cannot be
transformed in anatoxins or decomposed by proteolytic enzymes
Which type of bacterial toxin is specific?
exotoxin
Endotoxins act by
stimulating cytokine release from macrophages