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Stanley Falkow, May 2007 HostHost-Pathogen Interaction and Human Disease Stanley Falkow Host-Pathogen Interaction and Human Disease, Part 1 HostHost-Pathogen Interaction and Human Disease Part 1. What is a Pathogen? Stanford University Trying to Understand Human Biology by the Study of Pathogenic Bacteria Humans are Heir to a Veritable Sea of Smaller Creatures Humans are Heir to a Veritable Sea of Smaller Creatures Professor of Microbiology Bacteria –the smallest freefree-living organisms Humans are Heir to a Veritable Sea of Smaller Creatures Parasites like the Protozoa, Worms and Flukes The American Society for Cell Biology Viruses –Obligate Intracellular Parasites Humans are Heir to a Veritable Sea of Smaller Creatures And even insects that live in your eyebrows, hair and elsewhere 1 Stanley Falkow, May 2007 90% of the Cells Humans Carry are Microbes 1013 Human Cells 1014 microbial cells Normal (Commensal) Flora in Humans 1. The makeup of our flora depends upon various factors, including genetics, age, sex, stress, nutrition, and diet of the individual Host-Pathogen Interaction and Human Disease, Part 1 90% of the Cells Humans Carry are Microbes 1013 Human Cells 1014 microbial cells Normal (Commensal) Flora in Humans 3. The flora often reflects specific anatomic sites 2. Our flora synthesize and excrete vitamins that can be absorbed as nutrients by the host Normal (Commensal) Flora in Humans Normal (Commensal) Flora in Humans 4. The Normal Microbial Flora contributes to the first line of innate immune defense against incursion by ‘foreign’ microorganisms The American Society for Cell Biology 2 Stanley Falkow, May 2007 What is the Difference Between a Pathogen and a Commensal? Pathogens can establish themselves in a niche usually devoid of commensal microbial populations What is the Difference Between a Pathogen and a Commensal? Host-Pathogen Interaction and Human Disease, Part 1 What is the Difference Between a Pathogen and a Commensal? Pathogens possess the inherent ability to cross anatomic barriers or breach other host defenses that limit commensals. The Pathogen –CommensalCommensal-Host Ecological Landscape It’s in the Genes! Three Phases of Host Defense The American Society for Cell Biology Phase 1 Non-induced Innate Immunity 3 Stanley Falkow, May 2007 Host-Pathogen Interaction and Human Disease, Part 1 Bacteria and Other Microbes Have Unique Structures Bacteria and Other Microbes Have Unique Structures Bacteria and Other Microbes Have Unique Structures Phase 2 induced Innate Immunity That form the basis for how host’s detect microbes who ‘go to far’ Phase 2 induced Innate Immunity The American Society for Cell Biology Phase 2 induced Innate Immunity 4 Stanley Falkow, May 2007 Phase 3 Induced Adaptive Immunity And, of Course the Type of Host Matters Young Host-Pathogen Interaction and Human Disease, Part 1 Thus, A Significant Part of Human Evolution has gone into Developing Ways to Thwart Microbial Intrusion Bacterial Pathogenicity – A “Lifestyle” Old Entry into Host Entry into Host Humans have nine “Portals” Portals” serve as a point of entry for one or more pathogenic microbes. The American Society for Cell Biology 5 Stanley Falkow, May 2007 Colonize Host-Pathogen Interaction and Human Disease, Part 1 They may get there by swimming Many bacterial pathogens are motile Attachment to a unique host cellular target usually determines the niche. They may get there by swimming Many bacterial pathogens are motile Colonize To avoid physical and immunological removal, bacteria must adhere near or to host cells Colonize Attachment to a unique host cellular target usually determines the niche. The American Society for Cell Biology 6 Stanley Falkow, May 2007 PersistDespite Host Defenses AvoidAvoid- hide, mimic PersistDespite Host Defenses Host-Pathogen Interaction and Human Disease, Part 1 PersistDespite Host Defenses AvoidAvoid- hide, mimic PersistDespite Host Defenses Circumvent the host Enzymes and toxins allow local tissue spread and perturb immune function The Streptococcus Strategy to Circumvent the host PersistDespite Host Defenses HideMicrobial Invasion The Streptococcus Strategy to Circumvent the host The American Society for Cell Biology 7 Stanley Falkow, May 2007 HideMicrobial Invasion Host-Pathogen Interaction and Human Disease, Part 1 HideMicrobial Invasion •Why? –escape immune surveillance –nutrients –parasitize host cell machinery –transportation HideMicrobial Invasion What do you do once you’ve gotten in? •How? –tight adherence –pick right receptor (internalization) –provoke a “disturbance” disturbance” at cell surface What do you do once you’ve gotten in? Subvert the Host’s Defense Bacterial Toxins Break-out of the vacuole and even swim around The American Society for Cell Biology 8 Stanley Falkow, May 2007 Some Bacterial Components trigger inflammation Host-Pathogen Interaction and Human Disease, Part 1 Some Bacterial Components trigger inflammation Bacterial Endotoxin Gramnegative cell cytopl. mem. peptidoglycan outer mem. Lipopolysaccharide (LPS) Lipid A Core polysaccharide O sidechain The toxic part Helps solubilise Lipid A Some Bacterial Components trigger inflammation Some Bacterial Components trigger inflammation Somatic antigen Some Bacterial Components trigger inflammation Subvert the Host’s Defense Bacterial Exotoxins The ‘’Floppy’ Baby Syndrome – Infant Botulism The American Society for Cell Biology 9 Stanley Falkow, May 2007 Host-Pathogen Interaction and Human Disease, Part 1 Subvert the Host’s Defense Bacterial Exotoxins Are Among the Most Potent Poisons Known Yet, From a Biological Viewpoint They Are Extraordinary in Their Variety and Mode of Action All in All, Pathogens are Impressive Cell Biologists All in All Pathogens are Impressive Cell Biologists Pathogenic bacteria Interfere or Manipulate for Their Own Benefit Normal Function(s) of the Host Cell Replicate “Every bacterium’s dream is to be bacteria” The American Society for Cell Biology 10 Stanley Falkow, May 2007 Exit the Host Host-Pathogen Interaction and Human Disease, Part 1 Exit the Host Sooner or later you have to find a new host The Corollaries of Pathogenicity Bacterial Pathogens Use Elaborate Regulatory Mechanisms to Key on Biochemical “Cues” Cues” From Their Host pH, temperature, O2 CO2, osmolarity etc. The Corollaries of Pathogenicity Pathogens Respond to a Host’ Host’s Biological and Social Behavior The American Society for Cell Biology The Corollaries of Pathogenicity Some Diseases of Human Progress Legionnaire's Disease Toxic Shock Syndrome HIV/AIDS Lyme Disease E. coli Hemorrhagic Fever 11 Stanley Falkow, May 2007 The Corollaries of Pathogenicity Legionnaire's Disease Host-Pathogen Interaction and Human Disease, Part 1 The Corollaries of Pathogenicity Legionnaire's Disease Legionella Really Likes to Grow in Fresh Water Protozoa The Corollaries of Pathogenicity Legionnaire's Disease The Corollaries of Pathogenicity We Changed Some of Our Habits Over Time Legionella Really Likes to Grow in Fresh Water Protozoa The Corollaries of Pathogenicity And so Did Legionella The Corollaries of Pathogenicity Legionnaire's Disease So a Human Alveolar Macrophage Looks Pretty Good Too! The American Society for Cell Biology 12 Stanley Falkow, May 2007 The Corollaries of Pathogenicity Some Diseases of Human Progress Host-Pathogen Interaction and Human Disease, Part 1 The Corollaries of Pathogenicity Toxic Shock Syndrome Legionnaire's Disease Toxic Shock Syndrome HIV/AIDS Lyme Disease E. coli Hemorrhagic Fever The Corollaries of Pathogenicity Women Changed Their Habits The Corollaries of Pathogenicity The Corollaries of Pathogenicity Toxic Shock Syndrome Human – Microbe Interactions is Still a “Work in Progress”‘ And it provided Staphylococci with a ‘new opportunity’ And Human Misery The American Society for Cell Biology 13 Stanley Falkow, May 2007 Host-Pathogen Interaction and Human Disease, Part 1 Evolve and Share The Experience Evolve and Share The Experience Evolve and Share The Experience Horizontal GeneTtransfer Bacterial Pathogenicity can evolve in genetic quantum leaps A Single Genetic Event can Change a Commensal into a Pathogen A Single Genetic Event can Change a Commensal into a Pathogen E. coli that cause urinary tract infection differ from those that are commensal inhabitants of the bowel because they inherited several blocs of genes The American Society for Cell Biology 14 Stanley Falkow, May 2007 Host-Pathogen Interaction and Human Disease, Part 1 Pathogenicity factors of the uropathogenic strain E. coli 536 Iron Uptake Fe3+ 3+ Fe Enterobactin Yersiniabactin Hemin uptake Iro-system α-Hemolysins 3+ S-fimbrial adhesin I (Sfa I) Fe Fe3+ Serumresistance P-related fimbriae (Prf) PAI I PAI V PAI II PAI IV PAI III Flagella (H31) O-antigen (O6) K-antigen ( K15) Curli (Fim) Type I-fimbriae key colonization factor for the urinary tract The iceberg concept of infectious disease poliomyelitis in a child 0.1-1% of infections are clinically apparent Asymptomatic Infection Rates classical clinical disease less severe disease rubella 50% of infections are clinically apparent asymptomatic infection Spectrum of virulence Overt Clinical Disease Need Not be the Outcome of a Host-Pathogen Interaction M. tuberculosis - 90% Salmonella typhi – 80% Helicobacter pylori - 80% Disease is the more the Exception than the Rule rabies 100% of infections are clinically apparent Pathogenicity is the reflection of ongoing evolution between a parasite and a particular Host The American Society for Cell Biology When we study pathogens we learn as much about ourselves as we do about them 15