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Microbes and Human Disease The seven (7) components of pathogenicity: What it takes to cause disease 1) Maintain a reservoir • All pathogens must have at least 1 reservoir • Most common for humans: – Other humans – Animals – Environment Human reservoirs • Carry MO’s too fragile to live in the environment – Pertussis, measles, gonorrhea • Healthy people – Incubatory carrier • Staph • Chlamydia • HIV – Chronic carrier • Typhoid fever • Strep • Peptic ulcers? • Sick people Animal reservoirs • Typically within warm-blooded animals • Disease transmitted from animal to man = zoonosis (>150 known) – – – – – – – Lyme disease Rabies Leptospirosis RMSP Anthrax Typhus West Nile encephalitis Environmental reservoir • Mo’s tough/robust enough to survive environmental variation – From water: • • • • Vibrio Salmonella Shigella Escherichia – From soils: • Clostridium 2) Enter a suitable host • Transmission is via a “portal of entry” – – – – – Nose/upper respiratory Skin Conjunctiva Mouth – g.i. Urethra • Mucus membrane (400 m2 – area of basketball court) – Placenta Mode of transmission a) b) c) Respiratory droplets Fomites Direct contact i. ii. d) Fecal-oral route i. ii. e) direct contact indirect contact Arthropod vector i. ii. f) g) touching/kissing congenital biological vector mechanical vector Airborne transmission Parenteral transmission 3) Adhere to the surface of a host • If no adhesion, there is no problem… • Bacterial adhesins – glycoprotein glycolipid -Streptococcus pneumoniae -Bordetella pertussis -Haemophilus influenza • Bacterial pili – Escherichia and Neisseria • Receptors on our cells are typically sugars Adhesins or ligands Figure 15.1 - Overview • Specificity exists between pathogen and host • Some adhesins stimulate host cell phagocytosis and are called invasins Biofilms • Affects blood vessels, teeth, catheters, and water pipes • Strep mutans degrades glucose dextrans which it uses for capsule • Bacterial biofilm in b.v.’s stimulate inflammation at site lipid deposition 4) Ability to invade host cells • Invasion allows bacteria to enter safe and nutrient rich environment • Most penetrate via phagocytosis • Many kill/destroy host cell • Other effects: – Surface damage/direct damage – Toxin production transported by blood/lymph to other locations – Induce hypersensitivity/allergic reaction Exotoxins: Type 1 • Called “superantigens” • Stimulate levels of cytokines to be released from T cells into bloodstream – – – – Ex: staph food poison, staph TSST-1 Nausea Diarrhea Loss of blood volume Shock death Exotoxins: Type II • Extracellular enzymes 1) Act to lyse cells – Referred to as: • Hemolysins • Leukocidins • Assayed via blood agars – α-hemolysis – β-hemolysis – γ-hemolysis 2) Also: coagulases kinases hyaluronidase Exotoxins: Type III • Typical exotoxin-highly potent! • a domain = active • b domain = binding • a unit disrupts ATP formation or disrupts protein synthesis Figure 15.5 - Overview Type III Exotoxins (cont’d) • Named several ways: – By microbe: • Botulinum toxin • Vibrio enterotoxin – By disease: • Diptheria toxin • Tetanus toxin – Target tissue • Cytotoxin – Cardiotoxin – Hepatotoxin • Neurotoxin • Enterotoxin Antitoxins • As with any protein, animals can produce antibodies against an exotoxin = antitoxin • “toxoids” can be produced to trigger antitoxin production Endotoxins • Requires bacterial cell death and release of LPS • Lipid A of LPS • All produce similar symptoms: – – – – Figure 15.6 - Overview Fever Weakness Generalized aches Shock death Table 15.3 (1 of 2) Table 15.3 (2 of 2) 5) Evasion of Host defenses • Upon entering the body foreign cells are assaulted by cells and proteins of IR • Bacteria have evolved several ways to block host IR through: 1) preventing phagocytosis 2) buying time Prevention of phagocytosis • Primary means of particle removal from the body • Capsules – insulate surface antigens M proteins project as pili for strong attachment and to prevent complement from attaching • M proteins “buying time” • • • • • Antigenic variation IgA protease Serum resistance Waxes in cell wall Sequestering Fe 6) Multiplying in the host • Produces the disease state – Involves components 4 and 5 • Ability to cause disease relates to: – Toxin production – Effects of prolonged IR to the body in chronic infections 7) Leaving the Host • Respiratory droplets • gi pathogens – fecaloral route • gu tract – across mucus memb of urethra • Parenteral route – via blood