MICROBIOLOGY PPT LECTURE NOTES | Karya Tulis Ilmiah

Infection and Immunity

What does a pathogen have to
do?
• Infect (infest) a host
• Reproduce (replicate) itself
• Ensure that its progeny are transmitted to
another host

Mechanisms of
Transmission
• Aerosols - inhalation of droplets, e.g.
Rhinoviruses, the 'Common Cold Virus' or
Adenoviruses.
• Faecal-Oral - e.g. Astroviruses, Caliciviruses;
these viruses cause acute gastroenteritis.
• Vector-borne - e.g. in Arthropods such as
mosquitos, ticks, fleas: Arboviruses.
• Close personal contact - especially exchange of
bodily fluids: Sex; Blood, e.g. Herpesviruses


Entry into the Host
• Skin - dead cells, therefore cannot support virus
replication. Most viruses which infect via the skin
require a breach in the physical integrity of this
effective barrier, e.g. cuts or abrasions. Many
viruses employ vectors, e.g. ticks, mosquitos or
vampire bats to breach the barrier.
• Respiratory tract - In contrast to skin, the
respiratory tract and all other mucosal surfaces
possess sophisticated immune defence
mechanisms, as well as non-specific inhibitory
mechanisms (cilliated epithelium, mucus secretion,
lower temperature) which viruses must overcome.


Entry into the Host
• Gastrointestinal tract - a hostile
environment; gastric acid, bile salts, etc
• Genitourinary tract - relatively less
hostile than the above, but less

frequently exposed to extraneous
viruses (?)
• Conjunctiva - an exposed site and
relatively unprotected

Sites of virus entry

Transmission patterns
• Horizontal Transmission: Direct
person-to-person spread.
• Vertical Transmission: Relies on
PERSISTENCE of the agent to transfer
infection from parents to offspring.
Several forms of vertical transmission can
be distinguished:
• 1.Neonatal infection at birth, e.g.
gonorrhorea, AIDS.
• 2.Infection in utero e.g. syphilis, CMV,
Rubella (CRS), AIDS.
• 3. Germ line infection - via ovum or

sperm.

Primary Replication


Having gained entry to a potential host, the
virus must initiate an infection by entering a
susceptible cell. This frequently determines
whether the infection will remain localized at the
site of entry or spread to become a systemic
infection

Localized Infections
• Viruses
Replication
• Rhinoviruses
• Rotaviruses
epithelium
• Papillomaviruses


Primary

U.R.T.
Intestinal
Epidermis

Systemic Infections
Virus

Primary Replication Secondary Replication

Enteroviruses
Intestinal epithelium

Lymphoid
tissues, C.N.S.

Herpesviruses
Oropharynx or
G.U.tract


Lymphoid cells,
C.N.S.

Spread Throughout the Host
• Apart from direct cell-cell contact, there are
2 main mechanisms for spread throughout
the host:
• via the bloodstream
• via the nervous system

via the bloodstream
• Virus may get into the bloodstream by direct
inoculation - e.g. Arthropod vectors, blood
transfusion or I.V. drug abuse. The virus may travel
free in the plasma (Togaviruses, Enteroviruses), or
in association with red cells (Orbiviruses), platelets
(HSV), lymphocytes (EBV, CMV) or monocytes
(Lentiviruses). Primary viraemia usually proceeds
and is necessary for spread to the blood stream,

followed by more generalized, higher titre
secondary viraemia as the virus reaches other target
tissues or replicates directly in blood cells

via the nervous system
• spread to nervous system is preceded
by primary viraemia. In some cases,
spread occurs directly by contact with
neurons at the primary site of infection,
in other cases via the bloodstream.
Once in peripheral nerves, the virus can
spread to the CNS by axonal transport
along neurons (classic - HSV). Viruses
can cross synaptic junctions since these
frequently contain virus receptors,
allowing the virus to jump from one cell
to another

Cell/Tissue Tropism
• Tropism - the ability of a virus to

replicate in particular cells or tissues - is
controlled partly by the route of
infection but largely by the interaction
of a virus attachment protein (V.A.P.)
with a specific receptor molecule on the
surface of a cell, and has considerable
effect on pathogenesis. Many V.A.P.'s
and virus receptors are now known.

Secondary Replication
• Occurs in systemic infections when
a virus reaches other tissues in
which it is capable of replication,
e.g. Poliovirus (gut epithelium neurons in brain & spinal cord) or
Lentiviruses (macrophages - CNS +
many other tissues). If a virus can
be prevented from reaching tissues
where secondary replication can
occur, generally no disease results.


:
Localized Infections:
Primary Replication:
U.R.T.
Intestinal epithelium

Virus:
Rhinoviruses
Rotaviruses
Papillomavirus
Epidermis
es
Systemic Infections:
Virus:
Enteroviruses
Herpesviruses

Secondary
Primary Replication:
Replication:

Lymphoid tissues,
Intestinal epithelium
C.N.S.
Oropharynx or
Lymphoid cells, C.N.S.
G.U.tract

Incubation periods of viral infections
Influenza

1-2d

Chickenpox

13-17d

Common cold

1-3d


Mumps

16-20d

Bronchiolitis,croup

3-5d

Rubella

17-20d

Acute respiratory
disease

5-7d

Mononucleosis

30-50d


Dengue

5-8d

Hepatitis A

15-40d

Herpes simplex

5-8d

Hepatitis B

50-150d

Enteroviruses

6-12d

Rabies

30-100d

poliomyelitis

5-20d

Papilloma

50-150d

Measles

9-12d

HIV

1-10y

Types of Infection
• Inapparent
infection( Subclinical infection)
.
• Apparent infection:
• Acute infection
• Persistent Infection
Chronic infections
Latent Infection
Slow virus infections

Chronic Infection
• Virus can be continuously detected ;
mild or no clinical symptoms may be
evident.

Latent infection
The Virus persists in an occult, or cryptic,
from most of the time. There will be
intermittent flare-ups of clinical disease ,
Infectious virus can be recovered during
flare-ups . Latent virus infections typically
persist for the entire life of the host

Slow virus infection
• A prolonged incubation period, lasting
months or years, daring which virus continues
to multiply. Clinical symptoms are usually not
evident during the long incubation period .

Overall fate of the cell
• The cell dies in cytocidal infections
this may be acute (when infection is brief and selflimiting) or chronic (drawn out, only a few cells
infected while the rest proliferate)-Cytocidal
effect
• The cell lives in persistent infections
this may be productive or nonproductive (refers to
whether or not virions are produced) or it may
alternate between the two by way of latency and
reactivation - Steady state infection

Special cases
• Transformation-Integrated infection
(Viruses and Tumor)
• Apoptosis

Types of Viral infections at the cellular level
Type

Virus production

Fate of cell

Abortive

-

No effect

Cytolytic

+

Death

Persistent
Productive

+

Senescence

Latent

-

No effect

DNA viruses

-

Immortalization

RNA viruses

+

Immortalization

Transforming

Mechanisms of viral cytopathogenesis
Inhibition of cellular protein
synthesis

Polioviruses, HSV,
poxviruses, togaviruses

Inhibition and degradation of
cellular DNA

herpesviruses

Alteration of cell membrane
structure
Glycoprotein insertion
Syncytia formation
Disruption of cytoskeleton
permeability

All enveloped viruses
HSV, VZ virus, HIV
HSV, naked viruses
Togaviruses,
herpesviruses

Inclusion bodies

Rabies

Toxicity of Virion components

Adenovirus fibers

3. Viral
Immunopathology

Viral Immunopathogenesis
• Influenza-like symptoms( IFN, lymphokins):






DTH and inflammation(Tcell, PMNs):
Immune-complex disease(AB, complement):
Hemorrhagic disease( T cell,AB, Complement):
Postinfection cytolysis( T cells): enveloped viruses
Immunosuppression: HIV; CMV; measlesvirus and influenza

Persistence
Long term persistence of virus results from
two main mechanisms:
• a) Regulation of lytic potential
• b) Evasion of immune surveillance

Persistence vs. Clearance

Antiviral Immunity

Overview of the Immune System

Components
Components of
of the
the Immune
Immune
System
System
N o n s p e c if ic
H u m o ra l
complement,
interferon,
TNF etc.

C e llu la r
macrophages,
neutrophils
NK cell

S p e c if i c
H u m o ra l

C e llu la r

antibodies

T cells; other
effectors cells

Innate or Nonspecific
Immunity

Innate or Nonspecific
Immunity
• Anatomic and Physiologic Barriers:
Intact skin / Mucus membrane
Temperature /Acidity of gastric juices
Protein factors
• Phagocytic Barriers : 3 major types of
phagocytic cells
• Inflammatory Barriers and fever
• Mucociliary clearance

IFN
• Interferons are proteins produced by
cells infected with viruses, or exposed to
certain other agents, which protect other
cells against virus infection or decrease
drastically the virus yield from such cells.
Interferon itself is not directly the antiviral agent, but it is the inducer of one or
many anti-viral mechanisms
• Anti-tumor and regulation of immunity

Interferon inducing agents
• (1) Viruses.
• (2) dsRNA is a potent inducer, both viral
intermediates, and synthetic polyI-C.
• (4) Certain Bacterial infections, and the
production of endotoxin.
• (5) Metabolic activators/inhibitors.
Mitogens for gamma induction, also a
variety of tumor promoters induce IFNs. ,
in particular PTA-phorbol tetradecanoate
acetate, butyrate, dexamethasone

Properties of human interferons
Property

IFN-alpha

IFN-beta

IFN-gamma

Principal cell
source

Epithelium
leukocytes

Fibroblasts

Lymphocytes

genes

>20

1

1

Introns in genes

no

no

yes

induction

Viruses dsRNA

Viruses dsRNA

Immune
activation

Glycosylation

no

yes

yes

Stability at pH2

stability

stability

labile

Function

Antiviral
infection
activation of NK
cell

anti-tumor regulation of
enhancement of CMI

immunity

Activities of interferon
Antiviral actions
Interferons initiate an antiviral state in cells
Interferons block viral protein synthesis
Inferons inhibit cell growth
Immunomodulatory actions
Interferons-alpha and IFN-beta activate NK cells
Interferons-alpha activates macrophages
Interferons-gamma activate macrophages
Interferons increase MHC antigen expression
Interferons regulate the activities of T cells
Other actions
Interferons regulate inflammatory processes
Interferons regulate tumor growth

Mechanism of action
• Release from an initial infected cell occurs
• IFN binds to a specific cell surface receptor on
an other cell
• IFN induces the “antiviral state” : synthesis of
protein kinase, 2’5’ oligoadenylate synthetase,
and ribonuclease L
• Viral infection of the cell activates these
enzymes
• Inhibition of viral and cellular protein synthesis
occurs

Diseases currently treated with
IFN-alpha and IFN-beta
• hepatitis C
• hepatitis B
• papilloma warts and early trials with cervical
carcinoma
• Kaposi sarcoma of AIDS,
• colon tumors
• kidney tumors ( usually in combination with other
drugs).
• Basal cell carcinoma
• Breast cancer combined with tamoxifan.

Nature killer/ NK cell
•NK cells are Activated by IFN-alpha/beta
•NK cells are Activated by IFN-alpha and IL-2
and
Activate macrophage
•NK cells target and kill virus infected cells

NK cell

Macrophages

• Macrophages filter ciral particles from
blood
• Macrophages inactivate opsonized virus
particles
• Macrophages present viral antigen to
CD4 T cells

Complement
• Enhancing neutralization of Antibody
• Enhancing phagocytosis of virus
particles
• Lysis

Specific immunity
Active/passive

Overview of Specific immunity
• specific recognition and selective
elimination of foreign molecules.
• Involves specificity, diversity, memory, and
self/nonself recognition.

The Role of MHC
• The molecular basis of antigen recognition
by T cells is well understood. The TcR
recognizes short antigen-derived peptide
sequences presented in association with self
MHC class I or MHC class II molecules at
the surface of an antigen presenting cell
(APC).

The Role of MHC
• T cell recognition, therefore, involves direct
cell-cell contact between the antigenspecific TcR on the T lymphocyte and an
MHC compatible cell which presents the
processed antigen in association with
surface MHC molecules.

The Role of MHC
• The finding that self MHC molecules are involved
in the recognition of antigen by T lymphocytes led
to the concept of "MHC restriction" of T cell
responses, and pointed to the important role that
products of the major histocompatibility complex
play in the cell mediated immune response. The
major histocompatibility complex consists of a
cluster of genes, most of which encode products
with immunologically related functions.

The Role of MHC
• In humans, the MHC is located on the short arm of
chromosome 6 and spans approximately 4 megabases of
DNA. It can be divided into three regions termed class I,
class II and class III:
• The class III region contains genes which encode a number
of complement components and the tumour necrosis factor
cytokines, amongst other molecules.
• MHC class I molecules consist of a polymorphic, MHCencoded, membrane-spanning heavy chain, and a
monomorphic light chain, beta2-microglobulin.
• MHC class II molecules consist of a heterodimer of two
MHC-encoded, membrane-spanning proteins, the alpha and
beta polypeptide chains of the MHC class II molecule.

The Role of MHC

MHC class I molecules present
antigen to CD8+ T cells

MHC class II molecules present
antigen to CD4+ T cells

T cells
T cells are essential for controlling enveloped and noncytolytic viral
infections
T cells recognizes viral peptides presented by MHC molecules on cell
surfaces
Antigenic viral peptides can come from any viral protein
TH1 CD4 responses are more important than TH2 responses
CD8 cytotoxic T cells respond to viral peptide-class I MHC protein
complexes on the cell surface
TH2 CD4 responses are important for the maturation of antibody
response
TH2 CD4 responses may be detrimental if they prematurely limit the
TH1 inflammatory and cytolytic responses

Antibody
Antibody neutralizes extracellular virue:
it blocks viral attachment proteins
it destablilizes viral structure
Antibody opsonizes virus for phagocytosis
Antibody promotes killing of target cell by the complement cascade
and antibody-dependent cellular cytotoxicity
Antibody resolves lytic viral infections
Antibody blocks viremic spread to target tissue
IgM is an indicator of recent or current infection
IgG is more effective than LgM
Secretory IgA is important for protecting mucosal surfaces

Humoral Immunity

Antibody dependent cellular
cytotoxicity or ADCC

Antibody
IgG
Function

Memory
Blood and
tissue

IgM
Primary
response
Clear viruses in
blood

IgA
Mucus
immunit
y

C: classic
pathway

+++

-

-

C : C3 pathway

-

-

+

placenta

+++

-

-

ADCC

++

-

-

Antibody
• Neutralization antibody
• Other antibody

Passive Immunity
• A high titer of antibody against a
specific virus
• A pooled sample from plasma donors
that contains a heterogeneous mixture
of antibodies with lower titer