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					Ch 15 Microbial Mechanisms of Pathogenicity Student Learning Outcomes Identify the principal portals of entry and exit. Using examples, explain how microbes adhere to host cells. Explain how capsules and cell wall components contribute to pathogenicity. Compare the effects of coagulases, hyaluronidase, and collagenase. Describe the function of siderophores. Provide an example of direct damage, and compare this to toxin production. Contrast the nature and effects of exotoxins and endotoxins. Outline the mechanisms of action of A-B toxins and superantigens Vocabulary Pathogenicity: Ability of a pathogen to cause disease by overcoming the host defenses Virulence: ________ of pathogenicity. Attachment via ______________ is step 1: Bacteria use ___________ ___________ Viruses use ___________ (Preferred) Portals of Entry Mucous membranes  Conjunctiva  Respiratory tract: Droplet inhalation of moisture and dust particles. Most common portal of entry.  GI tract: food, water, contaminated fingers  Genitourinary tract Skin  Impenetrable for most microorganisms; possible to enter through hair follicles and sweat ducts. Parenteral Route Trauma (S. aureus, C. tetani) Arthropods (Y. pestis) Injections Numbers of Invading Microbes ID50: ____________________________________ LD50: ____________________________________ Bacillus anthracis Portal of Entry ID50 Skin 10–50 endospores Inhalation 10,000–20,000 endospores Ingestion 250,000–1,000,000 endospores at http://www.cdc.gov/ncidod/EID/vol5no4/cieslak.htm Clinical and Epidemiologic Principles of Anthrax What is the LD50 for the bacterial toxin tested in the example below? Adherence Adhesins: surface projections on pathogen, mostly made of glycoproteins or lipoproteins. Adhere to complementary receptors on the host cells. Adhesins can be part of:  Glycocalyx: e.g.Streptococcus mutans Fig 15.1  Fimbriae (also pili and flagella): e.g.E. coli Host cell receptors are most commonly sugars (e.g. mannose for E. coli Biofilms provide attachment and resistance to antimicrobial agents. Penetration of Host Defenses  Capsules: inhibition or prevention of _____________  Cell Wall Proteins: e.g. M protein of S. pyogenes  Antigenic Variation: Avoidance of IS, e.g. Trypanosoma Neisseria  Penetration into the Host Cell Cytoskeleton: Salmonella and E. coli produce invasins, proteins that cause the actin of the host cell’s cytoskeleton to form a basket that carries the bacteria into the cell. See Fig 15.2 MASTERING ANIMATION Virulence Factors: Hiding from Host Defenses Penetration into the Host Cell Cytoskeleton  Invasins  Salmonella alters host actin to enter a host cell  Use actin to move from one cell to the next  Listeria Fig 15.2 Enzymes Coagulase: Blood clot formation. Protection from phagocytosis (virulent S. aureus) Kinase: blood clot dissolve (e.g.: streptokinase) Hyaluronidase: (Spreading factor) Digestion of “intercellular cement”  tissue penetration Collagenase: Collagen hydrolysis IgA protease: IgA destruction Enzymes Used for Penetration How Pathogens Damage Host Cells 1. Direct damage 2. Use host’s nutrients; e.g.: Iron 3. Produce toxins 4. Induce hypersensitivity reaction Mastering: Virulence Factors – Penetrating Host Tissues & Enteric Pathogens Toxins Exotoxins: proteins (Gramand + bacteria can produce) Endotoxins: Gram- bacteria Foundation Fig 15.4 only. LPS, Lipid A part  released upon cell death. Symptoms due to vigorous inflammation. Massive release  endotoxic shock Mastering: Virulence Factors – Exotoxins Vocabulary related to Toxin Production  Toxin: Substances that contribute to pathogenicity.  Toxigenicity: Ability to produce a toxin.  Toxemia:  Toxoid:  Antitoxin: Exotoxins Summary Source: Relation to microbe: Chemistry: Fever? Neutralized by antitoxin? LD50: Gram + and Gram - By-products of growing cell _________ No _________ Small Circulate to site of activity. Affect body before immune response possible. Exotoxins with special action sites: Neuro-, and enterotoxins Toxin Examples Portal of Entry Botulinum (in mice) Staphylococcal enterotoxin Shiga toxin LD50 0.03 ng/kg 1.35 g/kg 250 ng/kg Which is the least potent toxin? A. Botulinum B. Shiga C. Staph Type of Exotoxins: A-B Exotoxins Fig 15.5 Fig 15.5 Superantigens as Toxins Special type of Exotoxin Nonspecifically stimulate T-cells.  Intense immune response due to release of cytokines.  Fever, nausea, vomiting, diarrhea, shock, and death. Representative Examples of Exotoxins Bacterial Species Exotoxin C. diphtheriae A-B toxin S. pyogenes Membrane-disrupting erythrogenic toxin C. botulinum A-B toxin; neurotoxin C. tetani A-B toxin; neurotoxin V. cholerae A-B toxin; enterotoxin S. aureus Superantigen Endotoxins  Bacterial cell death, antibiotics, and antibodies may cause the release of endotoxins.  Endotoxins cause fever (by inducing the release of interleukin-1) and shock (because of a TNF-induced decrease in blood pressure).  TNF release also allows bacteria to cross BBB.  The LAL assay (Limulus amoebocyte lysate) is used to detect endotoxins in drugs and on medical devices. Fig 15.6 Endotoxin Summary Source: Relation to microbe: Chemistry: Gram – Present in LPS of outer membrane _____________________ Fever? Neutralized by antitoxin? Yes LD50: Relatively large _______ Pathogenic Properties of Viruses Evasion of IS by  Growing inside cells  Rabies virus spikes mimic ACh  HIV hides attachment site  CD4 long and slender Visible effects of viral infection = Cytopathic Effects 1. cytocidal (cell death) 2. noncytocidal effects (damage but not death). Pathogenic Properties of Fungi  Fungal waste products may cause symptoms Fungal Toxins  Chronic infections provoke allergic responses  Ergot toxin  Proteases  Aflatoxin  Candida, Trichophyton  Capsule prevents phagocytosis  Cryptococcus  Claviceps purpurea  Aspergillus flavus Pathogenic Properties of Protozoa & Helminths  Presence of protozoa  Protozoan waste products may cause symptoms  Avoid host defenses by  Growing in phagocytes  Antigenic variation  Presence of helminths interferes with host function  Helminths metabolic waste can cause symptoms Wuchereria bancrofti Portals of Exit  Respiratory tract: Coughing and sneezing  Gastrointestinal tract: Feces and saliva  Genitourinary tract: Urine and vaginal secretions  Skin  Blood: Biting arthropods and needles or syringes Microbial Mechanisms of Pathogenicity Overview Foundation Fig 15.9